2. Prostate Cancer……. Facts Every Man Should Know!

3. What is the Prostate Gland? The prostate gland is part of the male reproductive system that makes the fluid that carries sperm. The prostate gland is part of the male reproductive system that makes the fluid that carries sperm. It is a walnut size gland that only men have. It is a walnut size gland that only men have. The gland is located in front of the rectum and below the bladder. The urethra (the tube that carries urine from the bladder to exit the body) runs through the center of the prostate. As men age, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow. The gland is located in front of the rectum and below the bladder. The urethra (the tube that carries urine from the bladder to exit the body) runs through the center of the prostate. As men age, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow.

4. The Prostate Gland

5. How Significant is Prostate Cancer Source: CDC Cancer Control Initiatives Website Over 232,000 men are diagnosed with prostate cancer annually, and approximately 30,000 men will die from the disease each year. Source: ACS 2005 Facts & Figures

6. Prostate cancer is the most diagnosed cancer in American men and the second leading cause of cancer death. Prostate cancer is the most diagnosed cancer in American men and the second leading cause of cancer death. Prostate cancer strikes as many men as breast cancer does women, but lacks the national awareness and research funding breast cancer currently receive. Prostate cancer strikes as many men as breast cancer does women, but lacks the national awareness and research funding breast cancer currently receive. The 5-year survival rate for patients whose cancer is caught while still confined to the prostate is 99% while the 5-year survival rate for those diagnosed with advanced disease is 30.9%. The 5-year survival rate for patients whose cancer is caught while still confined to the prostate is 99% while the 5-year survival rate for those diagnosed with advanced disease is 30.9%. Source: National Cancer Institute’s SEER (Surveillance, Epidemiology, and End-Results) Program Source: National Cancer Institute’s SEER (Surveillance, Epidemiology, and End-Results) Program

7. Who is at Risk for Prostate Cancer FAMILY HISTORY - Men with a father, brother, or son who has had prostate cancer are at greater risk for developing it themselves FAMILY HISTORY - Men with a father, brother, or son who has had prostate cancer are at greater risk for developing it themselves RACE - Prostate cancer is more common in African-American men than in white men. It is less common in Hispanics, Asians, Pacific Islanders, and Native Americans than in Whites. RACE - Prostate cancer is more common in African-American men than in white men. It is less common in Hispanics, Asians, Pacific Islanders, and Native Americans than in Whites. While all men are at risk for prostate cancer, some factors increase the risk.

8. The preponderance of prostate cancer among Black males is almost at epidemic levels.The preponderance of prostate cancer among Black males is almost at epidemic levels. Black men in America are at least 50% more likely to develop prostate cancer than men of any other racial or ethnic group in this country.Black men in America are at least 50% more likely to develop prostate cancer than men of any other racial or ethnic group in this country. Roughly 66% of Black men diagnosed with prostate cancer survive at least five years compared to 81% of white men with the disease.Roughly 66% of Black men diagnosed with prostate cancer survive at least five years compared to 81% of white men with the disease. Mortality rates among Black prostate cancer victims are twice as high as that for white men, and this rate is increasing almost 2% per year.Mortality rates among Black prostate cancer victims are twice as high as that for white men, and this rate is increasing almost 2% per year. Source: National Cancer Institute’s SEER (Surveillance, Epidemiology, and End-Results) Program

9. Incidence And Death Rates by Race Incidence per 100,000 Death African American 272.173.0 Caucasian164.330.2 Hispanic137.224.1 Asian100.013.9 Native American 53.621.9 Source: National Cancer Institute’s SEER (Surveillance, Epidemiology, and End-Results) Program

10. What is Prostate Cancer Cancer is a cellular disease. Cancer is a cellular disease. It is a disordered and abnormal cell growth. It is a disordered and abnormal cell growth. In prostate cancer, as in other types of cancer, cells grow out of control and form tumors. In prostate cancer, as in other types of cancer, cells grow out of control and form tumors.

11. If the tumor is within the gland, the cancer is said to be localized and curable. If the tumor is within the gland, the cancer is said to be localized and curable. If the cancer escapes the gland it is considered incurable. If the cancer escapes the gland it is considered incurable. Early detection before the cancer escapes the gland becomes very important. Early detection before the cancer escapes the gland becomes very important.

12. EARLY detection and EFFECTIVE treatment when the cancer is localized can save your life!

13. What Are The Symptoms Of Prostate Cancer Unfortunately, prostate cancer can progress without symptoms or show symptoms that occur with other conditions – as a result, many men with prostate cancer never know it until it is too late! Unfortunately, prostate cancer can progress without symptoms or show symptoms that occur with other conditions – as a result, many men with prostate cancer never know it until it is too late! Major symptoms are: urinary frequency, slow urinary flow, painful urination, blood in urine or semen, back or thigh pain and impotence. Major symptoms are: urinary frequency, slow urinary flow, painful urination, blood in urine or semen, back or thigh pain and impotence. Because these symptoms can be caused by other conditions, testing for prostate cancer with PSA and DRE becomes fundamentally important to avoid an advanced stage diagnosis. Because these symptoms can be caused by other conditions, testing for prostate cancer with PSA and DRE becomes fundamentally important to avoid an advanced stage diagnosis.

14. What You Should Know About The PSA And DRE Tests Medical opinion is divided on use of the PSA. (Us Too recommends PSA and DRE annually) Medical opinion is divided on use of the PSA. (Us Too recommends PSA and DRE annually) PSA is not prostate cancer-specific. PSA is not prostate cancer-specific. One test out of range may have various causes. One test out of range may have various causes. The real value of the PSA test is in serialization: Testing year to year and observing the rate of change. The real value of the PSA test is in serialization: Testing year to year and observing the rate of change. An exponential variation in PSA has been documented to represent tumor growth 7 to 9 years prior to a diagnosis of prostate cancer. An exponential variation in PSA has been documented to represent tumor growth 7 to 9 years prior to a diagnosis of prostate cancer.

15. What is PSA (Prostate Specific Antigen) PSA is a protein secreted by both normal and malignant prostate cells. PSA is a protein secreted by both normal and malignant prostate cells. PSA is measured by a simple blood test sent to a lab – results are usually returned within 24 to 48 hours. PSA is measured by a simple blood test sent to a lab – results are usually returned within 24 to 48 hours. When tested for prostate cancer, ask your doctor for a copy of your results. Normal PSA range is based on age. When tested for prostate cancer, ask your doctor for a copy of your results. Normal PSA range is based on age. Serial PSA can detect sudden changes in year-to- year measurement value that need to be investigated. Serial PSA can detect sudden changes in year-to- year measurement value that need to be investigated. Sudden PSA changes can be caused by infection, irritation, Benign Prostate Hyperplasia (BPH) or prostate cancer. Infection needs to be ruled out. Sudden PSA changes can be caused by infection, irritation, Benign Prostate Hyperplasia (BPH) or prostate cancer. Infection needs to be ruled out.

16. Age-adjusted Normal PSA Range Age (yr) Normal Range (ng/ml) 40-49 0-2.5 (0-2.0 for African Americans) 50-590-3.5 60-690-4.5 70-790-6.5 Source: Mayo Clinic

17. What is DRE (Digital Rectal Examination) Your doctor will examine your prostate gland for irregularities by feeling the gland through the rectum. DRE takes only a few seconds to perform. Your doctor will examine your prostate gland for irregularities by feeling the gland through the rectum. DRE takes only a few seconds to perform. DRE is an important evaluation that enhances the value of PSA testing in early disease detection. DRE is an important evaluation that enhances the value of PSA testing in early disease detection. DRE and PSA are complementary and together are able to detect prostate cancer when individually they might not. DRE and PSA are complementary and together are able to detect prostate cancer when individually they might not.

18. Us TOO International and all of its affiliates recommend: Men at higher risk (African American men 40 years and older) should begin testing annually with both a PSA and DRE.Men at higher risk (African American men 40 years and older) should begin testing annually with both a PSA and DRE. Caucasian, Hispanic and Native American men should be tested annually beginning by age 50. If your doctor does not suggest it, you should request it.Caucasian, Hispanic and Native American men should be tested annually beginning by age 50. If your doctor does not suggest it, you should request it.

19. When Should I have my PSA Test and Digital Rectal Exams African American men, as well as men with family history of prostate cancer, should have PSA testes and digital rectal exams annually beginning at age 40. African American men, as well as men with family history of prostate cancer, should have PSA testes and digital rectal exams annually beginning at age 40. PSA tests and DRE should be performed every year for men beginning at age 50 according to Us Too International guidelines. PSA tests and DRE should be performed every year for men beginning at age 50 according to Us Too International guidelines. Some physicians may not offer annual PSA and DRE to men at risk. Men should demand the test! Remember it is YOUR HEALTH you are dealing with.

20. What if My PSA Test Results Came Back Above Normal Learn more about your treatment options by contacting your doctor. Learn more about your treatment options by contacting your doctor. Your doctor may order a biopsy; a small sample of prostate tissue is removed with a needle and examined under a microscope. Your doctor may order a biopsy; a small sample of prostate tissue is removed with a needle and examined under a microscope. Get a second opinion on the biopsy sample by a pathologist specializing in prostrate cancer, and from an unbiased specialist in prostate cancer treatment. Get a second opinion on the biopsy sample by a pathologist specializing in prostrate cancer, and from an unbiased specialist in prostate cancer treatment.

21. Other reasons your test results may be high are: 1) Benign Prostrate Hyperplasia (BPH) a non-cancerous condition that shares some symptoms of prostate cancer, and 2) BPH causes the prostate to get bigger and can place pressure on the urethra, the tube that carries urine, resulting in urinary problems. Other reasons your test results may be high are: 1) Benign Prostrate Hyperplasia (BPH) a non-cancerous condition that shares some symptoms of prostate cancer, and 2) BPH causes the prostate to get bigger and can place pressure on the urethra, the tube that carries urine, resulting in urinary problems.

22. Four ways to Avoid Advanced Stage Diagnosis 1. Men assuming responsibility for their health. 2. Early Detection. 3. Early Detection 4. Early Detection And

23. How is Prostate Cancer Diagnosed If either the PSA and DRE are abnormal a biopsy may be done. (Transrectal ultrasound guided biopsy) The procedure is relatively simple, just like the DRE. If either the PSA and DRE are abnormal a biopsy may be done. (Transrectal ultrasound guided biopsy) The procedure is relatively simple, just like the DRE. The ultrasound uses sound waves to detect signs of cancer on the prostate gland. Then a tiny needle is used to take a biopsy; very small samples of tissue from at least six different areas of the prostate. The ultrasound uses sound waves to detect signs of cancer on the prostate gland. Then a tiny needle is used to take a biopsy; very small samples of tissue from at least six different areas of the prostate. The samples are sent to a medical laboratory for evaluation by a pathologist and the results are normally back within a few days. The samples are sent to a medical laboratory for evaluation by a pathologist and the results are normally back within a few days.

24. IN CASE OF A POSITIVE BIOPSY DO NOT PANIC DO NOT PANIC LEARN MORE ABOUT YOUR TREATMENT OPTIONS BY CONTACTING YOUR DOCTOR LEARN MORE ABOUT YOUR TREATMENT OPTIONS BY CONTACTING YOUR DOCTOR

25. Types of Treatment Procedures Watchful Waiting – Monitoring the patient’s prostate cancer by performing PSA test and Digital Rectal Exam regularly, and treating it only if and when the prostate cancer causes symptoms or show signs of growing. Watchful Waiting – Monitoring the patient’s prostate cancer by performing PSA test and Digital Rectal Exam regularly, and treating it only if and when the prostate cancer causes symptoms or show signs of growing. Radical Prostatectomy – Removal of the entire prostate gland and nerves. Radical Prostatectomy – Removal of the entire prostate gland and nerves. External Radiation Therapy – High-energy rays to kill or shrink cancer cells. External Radiation Therapy – High-energy rays to kill or shrink cancer cells. When prostate cancer has been found in its early stages and has not spread beyond the prostate, a doctor and his/her patient may decide upon various treatment options; each has its own risks and benefits.

26. Cryosurgery – Freezes abnormal cells of the prostate with a metal probe. Cryosurgery – Freezes abnormal cells of the prostate with a metal probe. Hormone Therapy – Decreases the androgen (testosterone) levels in the body by giving certain hormones to keep prostate cancer from growing. Hormone Therapy – Decreases the androgen (testosterone) levels in the body by giving certain hormones to keep prostate cancer from growing. Chemotherapy – Anticancer drugs injected into the vein or taken by mouth. Chemotherapy – Anticancer drugs injected into the vein or taken by mouth. Transurethral Resection of the prostate (Brach Therapy) – Confined dosage of radioactive seeds inserted directly into the prostate while minimizing healthy tissue damage. Transurethral Resection of the prostate (Brach Therapy) – Confined dosage of radioactive seeds inserted directly into the prostate while minimizing healthy tissue damage.

27. Side Effects of Treatment Side effects may depend on: Side effects may depend on: The type of treatmentThe type of treatment Patient age, andPatient age, and Overall healthOverall health Person could experience pain, discomfort, and other mild to severe side effects such as: Person could experience pain, discomfort, and other mild to severe side effects such as: Impotence, the inability to attain and maintain an erection hard enough to complete sexual intercourse more than half the time sex is desired.Impotence, the inability to attain and maintain an erection hard enough to complete sexual intercourse more than half the time sex is desired. Incontinence, loss of bladder control or dribbling.Incontinence, loss of bladder control or dribbling. Bowel problem, burning and rectal pain and/or diarrhea.Bowel problem, burning and rectal pain and/or diarrhea. Ask a doctor about side effects. He/she may be able to prescribe something to relieve them. Ask a doctor about side effects. He/she may be able to prescribe something to relieve them.

28. Making the Choice to Know Your Score! Meet with your physician and discuss your questions and concerns. Make a joint decision with your physician and family. Remember: The earlier prostate cancer is discovered, the better the chances are that it can be treated effectively. Make the choice to KNOW YOUR SCORE!