2. Wake-up man…

3. Can you guess who can get prostate cancer? Not you? Well, guess again… any male can get prostate cancer Hey, Smart Guy!

4. THIS PRESENTATION IS SPONSORED BY: US TOO! INTERNATIONAL, INC

5. Prostate Cancer Facts That Every Man Over 40 Should Know

6. WHAT IS THE PROSTATE GLAND?

7. The prostate is part of the male reproductive system Its major function is to secrete a fluid to nourish semen during intercourse The prostate is about the size of a walnut but it can grow with age It is located below the urinary bladder, in front of the rectum surrounding the urethra (the canal for the discharge of urine that extends from the urinary bladder to the outside)

9. What Is Prostate Cancer? Not Much! What do you know about prostate cancer?

10. What is Cancer anyway?

11. Cancer is a cellular disease 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 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 Early detection before the cancer escapes the gland becomes very important EARLY DETECTION AND EFFECTIVE TREATMENT WHEN THE CANCER IS LOCALIZED CAN POSSIBLY SAVE YOUR LIFE

12. Possible Levels of Prostate Cancer At Diagnosis Tumor CAPSULE GLAND PROSTATE Local-Regional Disease Spread Bone Systemic Spread Lymph Node Other Organs

13. What are the symptoms of prostate cancer? You might not have any at all! Often there are none, or they are not recognized Major symptoms: Urinary frequency Slow urinary flow Painful urination Blood in urine or semen Impotence Lower back or thigh pain

14. How Significant Is Prostate Cancer? In the USA, 230,110 men will be diagnosed with prostate cancer. That is one man diagnosed every 3 minutes Prostate cancer deaths are estimated at 29,900 That is one death every 18 minutes In Texas, an estimated 11,600 new cases were reported in 2002. Source: Cancer Facts and Figures –2004- American Cancer Society and Texas Department of Health

15. How much of a threat?  Prostate cancer is the most diagnosed non- skin cancer in American men and the second leading cause of cancer death.

16. Who Is at Most Risk? Prostate cancer is almost twice as common in African- American men than in Caucasian men African Americans are more than twice as likely to die when diagnosed than Caucasian men

17. Prostate cancer risk factors: Age: The risk increases with age, but 25% of diagnoses are made under age 65. Race: African-Americans have a rate of incidence double that of Caucasian men Family history of prostate cancer: Men with a family history have two- to three-fold increase in the risk of prostate cancer Diet: A diet high in saturated animal fat can double the risk of developing prostate cancer.

18. Risk Factors AGE RISK 45 – 49 : 23 per 100,000 50 – 54 : 103 per 100,000 55 – 59 : 273 per 100,000 60 - 64 : 568 per 100,000 65 + : 1,000 per 100,000 Source: SEER Incidence rates 1992 - 1996

19. Risk Factors RACE Incidence Death Afr.-Am.230.3 55.0 Cauc. 153.5 24.1 Hisp. 106.7 16.8 Asian 91.3 11.1 Source: Rates per 100,000 and age-adjusted. SEER incidence and U.S. cancer death rates, 1990-95, in Cancer 82: 1197-207, 1998 (SEER = NCI Surveillance, Epidemiology, and End-Results Program

20. Risk Factors FAMILY HISTORY 2.4 times increased risk for men with a first- degree relative (Spitz, et al, “Familial patterns of prostate cancer: A case-control analysis”, J Urol, 1991, 146:1305-1307)

21. Risk Factors DIET Eating red meat increases the risk of developing prostate cancer 2.64 times Red meat and dairy products are high in saturated fat rich in arachidonic acid (a fatty acid) Vegetable oil is rich in alpha linolenic acid (a fatty acid) By-products of these fats promote the growth and seriousness of prostate cancer Eating a diet high in fats also lowers the body’s defenses

22. So what CAN I eat? A balanced diet rich in fruits and vegetables! (5 servings/day) Lower your intake of red meat, processed and fried foods. Eat more plant-based food like soy protein. Watch portion sizes (3 oz meat/serving) Eat foods with lycopene (tomatoes, watermelon and red grapefruit) which may be associated with a decreased risk of prostate cancer

23. PREVENTION Selenium supplements in the organic form grown in yeast. (200 mcg) In randomized studies this dose reduced the incidence of prostate cancer 63% Natural vitamin E (50 IU) Shown in clinical trials to reduce the risk of prostate cancer by 40%

24. How does early detection help? Survival rate at 5 years is 99% for those whose cancer is still just in the prostate gland (localized). Survival rate at 5 years for those whose cancer has spread beyond the gland (late diagnosis) is only 31%

25. How to Avoid an Advanced Stage Diagnosis: Early Detection is the Answer Men Assuming Responsibility for Their Health PSA DRE

26. No Warning! Since symptoms can be caused by other conditions annual testing is KEY! Prostate Specific Antigen (PSA), a blood test Digital Rectal Examination (DRE), a physical exam Basic tools to find Prostate Cancer EARLY!

27. What You Should Know About the PSA Test PSA is checked by a blood test The real value of the PSA test is in testing year to year and observing the rate of change Medical opinion is divided about the usefulness of a single PSA One test out of range could be caused by other problems PSA is not prostate cancer specific

28. Why do I have to have a DRE? In the DRE the doctor examines you by feeling the prostate gland through the rectum with his finger (digit) DRE improves the value of PSA testing in early disease detection DRE and PSA together are often able to detect prostate cancer better and sooner than either test alone

29. When do I need to start getting tested? DRE: 40 years and older every year (American Cancer Society guidelines) PSA: 50 years and older every year (American Cancer Society guidelines) If family history of prostate cancer and/or African-American: 45 years and older every year (American Cancer Society guidelines)

30. What if the doctor doesn’t offer PSA and DRE? Some doctors do not offer these tests to men at risk These men have the right to request to be tested annually if so desired You may have to insist on being tested

31. Be a man! Take responsibility for your health! Ask your doctor for a copy of your results. The normal range for PSA is 0.0 to 4.0 ng/ml. (This is just a guideline range) Knowing your “PSA number” lets you help track your own health. Do not accept “your PSA is fine” from your doctor without getting a copy of the real number.

32. What if my PSA is high? Infection needs to be ruled out Antibiotics are prescribed to rule out infection Free-PSA ratio test - Ordered if PSA remains high after antibiotics. It helps detect the presence of prostate cancer. A free-PSA ratio of 15% or less indicates a high probability of prostate cancer Ultrasound and biopsy examination may be ordered if the Free-PSA ratio indicates possible cancer

33. In Case of a Diagnosis With a Positive Biopsy… Do not panic, learn your treatment options by contacting your local US TOO prostate cancer support group chapter. To locate a local chapter call: 1-800-80-US TOO or access their website at: http://www.ustoo.com Get a second opinion on the biopsy sample by a pathologist specializing in prostate cancer. Your treatment decision depends on a good assessment of the biopsy material Get a second opinion about your diagnosis and treatment options from an unbiased specialist in prostate cancer treatment