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FAQ: What you need to know about prostate cancer

Maryland state Senate President Thomas V. Mike Miller, Jr., announced a recent diagnosis in the Senate Chamber, referencing that he has been diagnosed with prostate cancer, Thursday January 10, 2019.

Maryland Senate President Thomas V. Mike Miller is among hundreds of thousands of men who are diagnosed with prostate cancer each year.

The American Cancer Society projects 174,650 men will be diagnosed in 2019 alone.

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The prognosis varies by patient, but here’s a primer on prostate cancer.

How common is prostate cancer?

Prostate cancer is the most common cancer in men aside from skin cancer, according to the American Cancer Society. About one in nine men will be diagnosed with prostate cancer.

Who is at risk of developing prostate cancer?

Prostate cancer is most common among older and African-American men. The average age of diagnosis is 66, according to the American Cancer Society.

Are there different types of prostate cancer?

Yes. The vast majority of prostate cancers are adenocarinomas, which form from gland tissue in the prostate. Rarer forms include sarcomas, small cell carcinomas, neuroendocrine tumors and transitional cell carcinomas.

What are the symptoms?

While early prostate cancer does not often cause symptoms, more advanced cancers can cause symptoms including problems urinating, blood in urine or semen, erectile dysfunction, pain in the other areas of the body if the cancer has spread, weakness or numbness in the legs or feet, or loss of bladder or bowel control.

How is it diagnosed?

The prostate-specific antigen (PSA) blood test and digital rectal exams are used to screen for prostate cancer. Doctors must confirm the presence of cancer with a prostate biopsy.

Dr. Sanford J. Siegel, chairman of Chesapeake Urology, said early diagnosis is key.

“If you can diagnose this disease early you can save lives,” said Siegel, who treats patients with prostate cancer and was also diagnosed with an aggressive form of prostate cancer about a year ago.

Siegel said African-American men should begin screenings after age 40, while Caucasian men should begin at age 50, particularly if they have a family history of prostate cancer.

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What are the stages of prostate cancer?

There are four main stages of prostate cancer (I through IV), which are further broken down by letter grades. Doctors determine the stage of cancer based on factors including the extent of the main tumor, whether the cancer has spread to lymph nodes and other parts of the body, the PSA level at the time of diagnosis and the “Gleason score” or grade group, which is based on how abnormal the tissue appears under a microscope.

What is the survival rate?

About one in 41 men diagnosed with prostate cancer die from it, according to the American Cancer Society, which says it is the second-leading cause of cancer death in men behind lung cancer. The organization estimates 31,620 men will die from prostate cancer in 2019. African-American men are more than twice as likely to die of prostate cancer as their white counterparts, according to the cancer society.

Survival rates vary by the stage of cancer. For prostate cancers that are local — which have not spread to other areas of the body — the five-year survival rate is nearly 100 percent, meaning nearly all men diagnosed will live for at least five years, according to the American Cancer Society. Prostate cancers in the regional stage — in which the cancer has spread to nearby areas — also carry a five-year survival rate of nearly 100 percent. Distant stage prostate cancers, which have spread to lymph nodes, bones or other organs, have a five-year survival rate of about 29 percent, the cancer society reports.

Overall, the five-year survival rate for prostate cancer is 99 percent, the 10-year survival rate is 98 percent and the 15-year survival rate is 96 percent, according to the American Cancer Society.

What are the treatment options?

Treatments can vary depending on the aggressiveness of the tumor, age of the patient and other factors. Options include chemotherapy, hormone therapy, immunotherapy, radical surgery to remove the prostate, high-intensity focused ultrasound and radiation. For less aggressive forms of prostate cancer, many doctors recommend active surveillance — monitoring slow-growing tumors instead of treating them.

What’s new in prostate cancer research?

Researchers are looking to learn more about which patients should have prostate biopsies based on PSA screenings; genetic mutations linked to prostate cancer; foods that can lower risk of developing prostate cancer; and new diagnostic techniques including color Doppler ultrasounds.

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