Men’s Health Awareness Month serves as a reminder that about one in nine men will be diagnosed with prostate cancer in his lifetime, and the earlier it is found, the better the outcome, says an expert from Mubadala Healthcare provider National Reference Laboratory (NRL).
NRL’s Chief Medical Officer, pathologist Dr. Basel Altrabulsi, explains that when the disease is diagnosed in its initial stages, the survival rate is as high as 99%. However, if left undetected and allowed to spread to other areas in the body, the five-year survival rate drops significantly to 30%.
He says that all men between the ages of 50 and 70, as well as men over 40 who have a family history of cancer, should speak to their doctor about screening tests appropriate to them, which might include a physical exam, blood test, and genetic tests. Explaining the steps in the screening process, Dr. Altrabulsi says: “Commonly, physicians perform two initial tests to look for prostate cancer, and sometimes these are used to complement each other.
“The first is a digital rectum exam, where the doctor feels the prostate to look for lumps and abnormalities. The second is a blood test that is sent to a lab to determine if there are elevated levels of a protein called prostate-specific antigens (PSA).
Raised PSA levels may indicate the possible presence of prostate cancer, but these must be evaluated in light of factors such as age, the size of the prostate gland, how quickly the PSA levels are changing, and whether the person has another medical condition or is taking medications that could be causing the higher levels.
“To confirm the suspicions arising from either of these two tests, a biopsy will be performed and sent to a lab to be analyzed.” Dr. Altrabulsi explains that genetic testing can also be used to help determine a man’s risk of developing prostate cancer.
He says that among the genes tested for mutations are breast cancer-related genes (BRCA1 and BRCA2) and the Ataxia-Telangiectasia mutated (ATM) gene. Men who inherit a BRCA1 mutation are 3.8 times more likely to develop prostate cancer than men without the mutation, and those who inherit a BRCA2 mutation are 8.6 times more likely to develop the disease.
Dr. Altrabulsi says that since most mutations are hereditary, screening via genetic testing is recommended for men with a strong family history of cancer – not only prostate cancer but also breast, pancreatic or colon cancer – in order to better understand their risk. “Based on the results of the patient’s genetic tests, his physician can determine how often he will need to be screened, and also advise the patient of preventative measures he can take, and potentially plan an early intervention,” Dr. Altrabulsi says.
Commenting on the demonstrated effectiveness of PSA testing, Dr. Altrabulsi says that research results vary. However, the long-term European Randomized Study of Screening Prostate Cancer involving more than 162,000 men aged 50-74 from eight countries, revealed that over 13 years of follow-up, routine PSA testing reduced the number of prostate cancer deaths by 21%.
“As prostate cancer is the third most common cancer in the UAE, men who are in the high-risk age brackets, or whose family history increases their risk, should speak to their physician about screening as soon as possible. “Early detection is key when it comes to managing prostate cancer. The sooner it is diagnosed, the less aggressive the treatment, but the better the outcome,” concludes Dr. Altrabulsi.