The Medical Minute: Q&A about two cancers

October 31, 2012

“You have cancer.”

Three words everyone hopes they never have to hear. Any cancer diagnosis is scary, but for men diagnosed with prostate cancer and women diagnosed with ovarian cancer, uncertainty regarding diagnosis, side effects of treatment and support groups that are available can make their battle with cancer even scarier.

Penn State Milton S. Hershey Medical Center has a team of experienced oncologists who are prepared to help patients fight prostate and ovarian cancer. Joshua Kesterson, a gynecologic oncology specialist, and Joseph Drabick, specialist in hematology and oncology, shared some key information about these two cancers for the Medical Minute.

Why is it so important to talk about prostate and ovarian cancer?

Kesterson: Ovarian cancer affects a significant number of women. In the United States, there are about 20,000 cases of ovarian cancer per year and about 15,000 deaths per year. Ovarian cancer affects one out of every 70 women and is the most lethal gynecologic malignancy.

Drabick: Prostate cancer is the No. 1 cancer in men. If a man lives long enough, he is almost guaranteed to develop prostate cancer. My youngest patient was 40, and if you do develop prostate cancer at a younger age, it’s usually more aggressive than what is found in older men.

Who is at highest risk for developing these cancers?

Kesterson: While most cases of ovarian cancer are sporadic, women with a family history or carriers of the BRCA mutation -- a mutation that affects cells in the ovary -- are at increased risk for ovarian cancer.

Drabick: African-American men have an inordinately higher risk of developing prostate cancer than anyone else. Family history is also a risk factor, even if the prostate cancer wasn’t the cause of death.

Are there any tests to screen for prostate and ovarian cancer?

Kesterson: Unfortunately, there aren’t any effective screenings for ovarian cancer. There are efforts looking into imaging with ultrasound or serologic markers, but those are not sensitive or specific enough to be applicable to the general population.

Drabick: Men over age 50 should have a digital rectal exam to determine if the prostate is hardened and to feel for nodules. Men with a family history should start screening 10 years before the age your family member was diagnosed. The problem with this exam is that a lot of men won’t have any symptoms. If there are, it means that the disease is advanced.

A PSA blood test can be done, but the screening doesn’t necessarily lead to longer life or better chances of survival. Sometimes men will have prostate cancer for a while without causing any more problems. It can move very slowly -- over decades even -- and you could still be healthy. This has led to tremendous controversy regarding the role of PSA blood test screening.

What are your patients’ biggest concerns following their diagnosis?

Kesterson: Anytime someone is diagnosed with cancer, they want to know directly or indirectly how long they can expect to live. For women with ovarian cancer, the first line treatment is surgery to remove the entire tumor, followed by chemotherapy, which works well to achieve remission. I tell my patients that there are two things we can control: the type of surgery and the chemotherapy regimen. We want to get the best treatment options for our patients.

Drabick: The first thing we give patients with prostate cancer is a shot to decrease testosterone. When men lose testosterone, they lose muscle mass and libido, get hot flashes and put on weight. Those are all reasons for men to be concerned about the treatment. I recommend my patients go to the gym to lift weights and run to keep up their strength. Soy can help with hot flashes, too.

Are there any efforts to advocate for prostate or ovarian cancer awareness and research for a cure?

Kesterson: Ovarian cancer is starting to gain more public attention in the media and advocacy groups. We are seeing more runs and walks to support the cause. Groups supporting research include the Gynecologic Cancer Foundation, the Society of Gynecologic Oncologists and the Gynecologic Oncology Group.

Drabick: For men, support for cancer isn’t as intense, since they aren’t usually talkers and many deal with things stoically. The de-masculating effects of the treatment can make men embarrassed as well. There are support groups for men with prostate cancer, like Us Too and ZERO, but they aren’t as active in the media as breast cancer support.

Even though cancer is scary, it is important to arm yourself with information about the disease after diagnosis. Although prostate and ovarian cancers may not get the media attention that other cancers do, your doctor can guide you and your family through your diagnosis and treatment and connect you with support groups.

The Medical Minute is a weekly health news feature brought to you by Penn State Milton S. Hershey Medical Center. Articles feature the expertise of Penn State Hershey faculty physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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Last Updated November 08, 2012