What is a PSA test?
It is a blood test where a small blood sample is drawn from the arm and sent to a lab. The results indicate the level of prostate specific antigen (a substance secreted by the prostate gland) present in the blood. While some level of PSA is normal, an elevated or rapidly rising number indicates an abnormality that should be investigated by a doctor. Causes of a rising PSA could include infection, inflammation, an enlarged gland, or prostate cancer.
Who should have a PSA test?
For men at high risk for prostate cancer, such as African-Americans or men with a family history of prostate cancer, testing could begin as early as age 35 or 40. It is good to establish a baseline reading at some point for comparison purposes later in life. This is currently a subject of considerable debate among medical professionals and the best course of action is to discuss this with your doctor.
What does the prostate do?
The prostate gland is located between the bladder and the penis. It produces the fluid that carries sperm when ejaculation occurs. It tends to enlarge as a man ages and this can cause problems with urination. It can also become cancerous.
What is the best treatment for prostate cancer?
There are several treatment options available including surgery, several types of radiation therapy, hormone therapy as well as an approach which can be appropriate for many men called active surveillance or watchful waiting. The best treatment varies with the individual and depends on the severity of the disease detected, the age of the individual, and the differing side effects among appropriate treatments. If time allows, and it almost always does, it is usually a good idea to get a second opinion to confirm the original assessment.
What are the side effects of treatment?
Side effects vary by age, diagnosis stage and treatment. They may include urinary incontinence, diminished sexual function or impotence. There are medications and devices that can help men achieve an erection if they are no longer able to do so naturally.
What are some good sources of information on prostate health?
The best initial source is almost always your doctor; he or she knows both you and your medical history. For more information, the best source is the Internet, but the Internet contains at least as much bad information as it does good. Your doctor may recommend other sources. Two that we have found to be both accurate and written in language that lay people can understand are:
- Us TOO International (International prostate cancer organization)
- Prostate Cancer Research Institute
How common is testicular cancer?
Testicular cancer is very rare, but it is the most common cancer found in men between the ages of 15 and 34. White men are four times more likely than black men to get testicular cancer. Click here for more information.
One in 260 men will be diagnosed with testicular cancer in his lifetime. Approximately 48% of the men diagnosed with testicular cancer are between the ages of 20—34 years. The five-year overall survival rate is 95.3%. Click here for more information.
Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk. Risk factors for testicular cancer include the following:
- Having cryptorchidism (an undescended testicle).
- Having a testicle that is not normal, such as a small testicle that does not work the way it should.
- Being white.
- Having a personal or family history of testicular cancer.
What are the symptoms of testicular cancer?
Common symptoms of testicular cancer include a swelling and/or lump in one or both of the testes; pain in the testes or scrotum may or may not be present. Men may also experience a feeling of heaviness in the scrotum or a dull feeling of pain in the region of the lower abdominal area, groin, or lower back. Sometimes these symptoms can be caused by problems other than cancer such as a hydrocele (build-up of fluid) or epididymitis (infection.) Not all lumps found in the testes are cancerous. Only a doctor can determine the cause of a lump and when detected early, testicular cancer is highly treatable.
Are there any screening tools to check for testicular cancer?
There is no standard or routine screening test used for early detection of testicular cancer. Most often, testicular cancer is first found by men themselves, either by chance or during self-exam. Sometimes the cancer is found by a doctor during a routine physical exam.
Do I need to worry about my ability to have children in the future?
Cancer and cancer treatment may put men at risk for infertility. Testicular cancer, newly-diagnosed Hodgkin’s disease, lymphoma and leukemia are cancers more likely to cause male infertility than other cancers. Cancer treatment, not cancer itself, is often the factor that damages a man's fertility. Radiation therapy can slow down or stop sperm cell production if the testicle is in or near the target area for the radiation. A lead shield can help protect the testicles during radiation aimed at a nearby organ such as the prostate, but radiation “scatters” within the body so it is not possible to shield the testicles completely. Total body irradiation used before some bone marrow transplants often causes permanent infertility. If the testicles get a mild dose of radiation, a man's fertility may drop but can then recover over the next one to four years. Some boys treated for acute leukemia need to have radiation directly to the testicles. Not only sperm production, but their hormone production may be permanently damaged. The alkylating chemotherapy group does the most damage to fertility. Ask your doctor if this treatment pertains to you. Radical surgery to treat prostate or bladder cancer removes the prostate and seminal vesicles. These glands make the liquid part of a man's semen. Surgery also cuts the pathway for sperm cells to be included in the semen. Men with testicular cancer or colon cancer sometimes have surgery that can damage nerves involved in orgasm. The result may be a “dry orgasm” or the sensation of pleasure, but without ejaculating any semen. Click here for more information.
Will cancer affect my sex life?
Cancer treatment can cause a variety of sexual changes. Even though the causes may be different – surgery, chemotherapy, hormone treatment or radiation – the resulting changes are often similar. Some patients experience changes in some or all phases of sexual response (desire, arousal, orgasm, resolution), while others experience no sexual changes. Cancer treatment side effects, such as fatigue, nausea, vomiting, diarrhea, constipation, hair loss, weight changes, scars and sensitivity to tastes and smells may leave you feeling exhausted and uncomfortable. These side effects consume so much energy that sex may be a low priority at times. Coping with sexual changes when they do occur generally means understanding that they may not improve right away. Finding the most helpful remedy may take time and patience because sexual changes can be caused by both psychological and physical factors. It is usually safe to have sex during cancer treatment unless your doctor tells you not to. Talk with your doctor before participating in sexual activities. Click here for more information.
What is human papillomavirus (HPV)?
Genital human papillomavirus (HPV) is a common virus transmitted by sexual activity in both men and women. It can infect the genital areas of men, including the skin on and around the penis or anus. It can also infect the mouth and throat.
Is HPV common and what problems can it cause?
About 1% of sexually active men in the U.S. have genital warts at any one time. Cancers of the penis, anus and oropharynx are uncommon, and only a subset of these cancers is actually related to HPV. Each year in the U.S. there are about:
- 400 men who get HPV-related cancer of the penis
- 1,500 men who get HPV-related cancer of the anus
- 5,600 men who get cancers of the oropharynx (back of throat), but many of these cancers are related to tobacco and alcohol use, not HPV.
Most men who get HPV (of any type) never develop any symptoms or health problems. But some types of HPV can cause genital warts. Other types can cause cancers of the penis, anus, or oropharynx (back of the throat, including base of the tongue and tonsils.) The types of HPV that can cause genital warts are not the same as the types that can cause cancer. (Note: Anal cancer is not the same as colorectal cancer. Colorectal cancer is more common than anal cancer, and is not caused by HPV.) Click here for more information.