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Southern Ocean County Hospital would like to thank everyone who e-mailed questions for this edition of Ask-The-Expert and would like to especially thank Dr. Fernicola for taking part in the program.

March : Prostate Cancer

Question 1
I am a 67-year old man and for a number of years I have suffered from frequent urination. I get up about five or six times at night to go to the bathroom. Is this a sign of prostate cancer or could it be something else.

Urinary frequency and nocturia are common symptoms of many urologic problems. In your age group a benign enlarged prostate is more likely to cause these symptoms. A examination of your prostate and a PSA would help evaluate your risk of prostate cancer. Then your doctor can discuss various medications or treatments available to help with this problem.

Question 2
Could you explain how the PSA blood test works. I have heard it can detect prostate cancer, but sometimes comes back as a false positive. What does that mean? Is the PSA test accurate?

The PSA is a blood test that measures a protein molecule in the blood that is produced by prostate cells. Both benign and malignant cells can produce PSA. The level of PSA tends to be higher in patients with prostate cancer. The PSA level gives an indication of that patients risk of having prostate cancer . This is similar to the way an elevated cholesterol will tell a patient he is at increased risk of heart disease. Another blood test called the percent free PSA can also provide further information about prostate cancer risk.The PSA is a helpful test but it should be done in conjunction with an annual rectal exam as well.

Question 3
My father is 72 and was just diagnosed with prostate cancer and his doctor has proposed a wait and see approach. I prefer that he have surgery or some kind of chemotherapy. Why would a doctor suggestion a wait and see approach?

Once prostate cancer has been diagnosed further testing such as bone scans and CT scans are done to determine the stage of the cancer. Then depending on the grade and stage of the cancer and the patients medical condition a treatment plan can be made. If the patient has a localized cancer and has a good life expectancy,then a curative treatment such as surgery, radioactive seeds, or external radiation may be offered. If the cancer is advanced or the patient has serious medical problems then he may be advised to take a more conservative approach. Prostate cancer can be a very slow growing cancer and waiting until the patient develops symptoms and then starting hormonal treatment can provide many years of cancer control. Chemotherapy is usually used when the cancer has spread and the patient has failed other therapies.

Dr. Ferinacola's answers are informational only and should not be used as a diagnosis or for treatment. Please talk to your physician about official diagnosis of your condition and treatment.