Early Screening for Prostate Cancer Is Key

March 2, 2005 — -- Sen. John Kerry and former Secretary of State Colin Powell may belong to different political parties, but they have one thing in common -- they are both survivors of prostate cancer, the No. 2 cause of cancer-related deaths in American men.

They talked about the important cancer-screening tests that saved their lives with ABC News' medical editor, Dr. Timothy Johnson, on "Good Morning America."

Health-care professionals say that prostate cancer is treatable if the cancer is caught before the disease spreads outside the prostate, a walnut-sized gland located below the bladder and in front of the rectum. But once the cancer has already spread to distant parts of the body, the survival rate drops to 34 percent.

Johnson offered these facts and tips on prostate cancer:

Age: All men are at risk, but the most common risk factor is age. More than 70 percent of men diagnosed with prostate cancer each year are over 65.

Race: African-American men have a higher risk of prostate cancer than white men.

Diet: There is some evidence that a diet higher in fat, especially animal fat, may account for higher incidences of prostate cancer.

Heredity: Genetic factors also appear to play a role, particularly for families in whom the diagnosis is made in men under 60. The risk of prostate cancer rises with the number of close relatives who have the disease.

Prostate cancer often does not cause symptoms for many years. By the time symptoms occur, the disease may have spread beyond the prostate. When symptoms do occur, they may include:

Two tests can be used to detect prostate cancer in the absence of any symptoms. One is the digital rectal exam, in which a doctor feels the prostate through the rectum to find hard or lumpy areas.

The other is a blood test used to detect a substance made by the prostate called prostate-specific antigen. Together, these tests can detect many "silent" prostate cancers, those that have not caused symptoms.

The American Cancer Society recommends that all men age 50 and older have both tests annually. Those who are at a higher risk should start testing at age 45, the society suggests.

But the tests have their flaws. Some men with a PSA reading in the "normal" range can still have cancer; likewise, there are males with elevated PSA readings who do not have prostate cancer.

That's why doing just these tests is insufficient when screening for cancer. It's important to look at three components -- a physician visit, the PSA test result and an exam by a doctor.

Doctors say it's important to consider the stage and grade of the cancer, as well as the physiological and chronological age of the patient when considering treatment.

A younger patient, with a life expectancy of about 10 years or more, would generally lean toward surgery or radiation treatment. Those with a shorter life expectancy may opt for "watchful waiting," where active treatment is started if the cancer begins to grow more quickly or symptoms appear.