OU Health Highlights Screening Guidelines for Prostate Cancer

OKLAHOMA CITY – Prostate cancer is the most common cancer in men, but screening for early detection gives patients a better chance for successful treatment.

Urology specialists at Stephenson Cancer Center at OU Health cite guidelines developed by the American Urological Association (AUA) and urge men to discuss screening with their doctors.

Urologic oncologist Michael Cookson, M.D., explained that early detection means discovering prostate cancer before symptoms appear – when a man would otherwise have no reason to seek medical care, and early discovery has been shown to save lives.

Diagnostic tools for screening include prostate specific antigen, or PSA, a simple process that requires a blood draw. Elevated levels of PSA in the blood may indicate a prostate disorder, such as prostate cancer or enlarged prostate.

“When tumors of the prostate are detected early, men often have many options, ranging from surveillance to localized treatments,” Cookson said. “Tumors detected only after symptoms develop tend to be more advanced in stage, with fewer curative options.”

AUA recommends routine screening primarily for men from 55 to 69 years of age, assuming the absence of other risk factors.

“The association does not recommend routine screening for men younger than 40, as prostate cancer is rare in this age group,” Cookson said. “Similarly, there is no compelling reason to routinely screen men of normal risk between the ages of 40 and 54.”

Men at greater risk include African Americans and those with a family history of prostate cancer, male and female breast cancer, ovarian and pancreatic cancers. In all cases, however, Cookson said decisions should be individualized.

“While the intent of these guidelines is to reduce unnecessary biopsies, men should discuss the benefits of screening with their doctors and make decisions weighing all relevant information.”

Cookson said MRI-guided fusion biopsy is an advanced imaging tool that may result in earlier diagnosis.

“Small, potentially aggressive tumors were often undetectable using traditional diagnostic methods, which were little improved in 20 to 30 years. MRI with targeting now allows us to find these tumors before they spread beyond the prostate. Men with high PSA levels may not have prostate cancer, and men with low levels aren’t necessarily cancer-free. A biopsy of prostate tissue is needed to confirm a diagnosis.”

MRI-guided fusion biopsy combines the technology of detailed MRI scans with live, real-time ultrasound images of the prostate gland. The patient first undergoes the MRI. A radiologist reviews those images, marking any areas of concern. An outpatient procedure follows, which “fuses” the real-time ultrasound images with detailed 3-D ultrasound of the prostate.

“This technology makes it possible to be more selective about taking prostate tissue for biopsy. It’s far more precise – not a random sampling of tissues that may or may not be suspicious,” Cookson said.

Urologists and primary care providers are on the front lines of men’s health concerns and understand the limitations of annual screening. While no method is perfect, Cookson said it is still important to use available tools to the best advantage.

“In the same way that research resulted in detecting genetic mutations that enhance breast cancer risk, we are now appreciating the added predictive and prognostic role of genomics and genetics in diagnoses and treatment of prostate cancer,” Cookson said. “Early versions of this form of testing are already making a difference in how we determine appropriate modes of treatment.”

According to the American Cancer Society, prostate cancer will claim more than 30,000 lives this year. More than 170,000 new cases of prostate cancer will be diagnosed.

Like other cancers, prostate cancer has many forms, ranging from less aggressive to more aggressive. One emphasis of ongoing research is the ability to identify gene mutations that take on such variability in each person, including differences in immune function, environment and lifestyle.

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STEPHENSON CANCER CENTER
Stephenson Cancer Center at OU Health ranks in the Top 50 in the nation for cancer care in the 2019-2020 U.S. News & World Report rankings. As Oklahoma’s only National Cancer Institute-Designated Cancer Center, Stephenson Cancer Center is one of the nation’s elite centers, representing the top 2% of cancer centers in the country. It is the largest and most comprehensive oncology practice in the state, delivering patient-centered, multidisciplinary care for every type of cancer. As one of the nation’s leading research organizations, the Stephenson Cancer Center uses the latest innovations to fight and eliminate cancer, and is currently ranked No. 1 among all cancer centers in the nation for the number of patients participating in clinical trials sponsored by the NCI’s National Clinical Trials Network. For more information, visit stephensoncancercenter.org.

OU MEDICINE

OU Health — along with its academic partner, the University of Oklahoma Health Sciences Center — is the state’s only comprehensive academic health system of hospitals, clinics and centers of excellence. With 11,000 employees and more than 1,300 physicians and advanced practice providers, OU Health is home to Oklahoma’s largest physician network with a complete range of specialty care. OU Health serves Oklahoma and the region with the state’s only freestanding children’s hospital, the only National Cancer Institute-Designated Stephenson Cancer Center and Oklahoma’s flagship hospital, which serves as the state’s only Level 1 trauma center. OU Health is the No. 1 ranked hospital system in Oklahoma, and its oncology program at Stephenson Cancer Center and OU Medical Center ranked in the Top 50 in the nation, in the 2019-2020 rankings released by U.S. News & World Report. OU Health’s mission is to lead healthcare in patient care, education and research. To learn more, visit oumedicine.com.