The ABC’s Of Prostate Cancer

“What Patients Need to Know About Early Stage Detection and Treatment”

Peter Carroll, MD, MPH

Professor & Chair – Dept. of Urology

UCSF Medical Center

A Recap of The Lecture Conducted on 10/28/09

· In 2009 there were 192,000 new diagnosis of prostate cancer

· In 2009 there were 27,000 deaths from prostate cancer

· These numbers are greatly reduced from the high point in 1995

· There is much less advanced disease detected than previously

· Only 1-2% of men today are diagnosed with metastasis

· Systemic treatments (ADT) are on the increase

· The rationale for screening:

PC is a burdensome disease when detected late

There is no cure for late stage disease

PSA screening detects disease when it is still treatable

· Get a baseline PSA number at 40 years old, also a free and total PSA test

· PSA is more specific for younger men

· There should be no recommended threshold for PSA

· Once a baseline PSA is established watch for PSA velocity

· More core samples are now recommended during biopsy

· There is no one treatment option that is more effective than another

· All treatment options have their side effects and they are more widespread and under estimated than once thought

· When choosing a treatment path make sure you use a high volume practitioner experienced in the procedure. The average urologist has done 12 radical prostatectomy’s

· Don’t rush into a treatment path decision. You have time, do your homework

· ADT: There are many side effects, all can be dealt with

· Brachytherapy: Only should be done on smaller prostate glands

· Active Surveillance (AS) 1/3 of men on this therapy opt for conventional intervention within 5 years

· Dr Carroll predicts major and remarkable advances in prostate cancer treatment within 7-10 years

· There is no substitute for a biopsy

· A healthy prostate diet has proven to create favorable terrain for a healthy prostate

· Diet is more important than the supplements you take

· Myths about prostate cancer you should know:

Younger men have more aggressive pc – False. This is true of older men

Prostate cancer is always slow growing

Everyone should have immediate treatment

There is nothing you can do pro-actively to improve outcome

My doctor knows best

You don’t need a second opinion