By Dan Murphy
September is National Prostate Health Month (NPHM), and a time to highlight the importance of prostate health and early detection of prostate cancer. Prostate cancer is the most diagnosed cancer in men in the United States. About 1 in 7 men will be diagnosed with prostate cancer, and 30,000 men in the US will die every year from prostate cancer.
We spoke with Dr. Vannita Simma-Chiang, of Mount Sinai Doctors-Westchester, and Assistant Professor of Urology, Icahn School of Medicine at Mount Sinai, to discuss options for middle aged and high-risk men of getting tested for Prostate Cancer and treatment options.
“Prostate cancer, as with all cancers, is an abnormal growth of cells in the body, which originate in the prostate. While there are different types of prostate cancer, the one that we know about most is adenocarcinoma, which is the most common and prevalent type of prostate cancer,” said Dr. Simma-Chiang.
“Most Urologist based studies have found that the risk of prostate cancer is more likely in men over the age of 55. African American men have a higher rate of prostate cancer, with studies finding 1 in 6 African American males will be diagnosed at some point in their lives. Non-Hispanic, white men also have the 2nd highest rate of Prostate cancer. And while Asian-American and Latino men have a lower rate of prostate cancer, it doesn’t mean its zero.
“We have also noticed in studies a link to being overweight in your 50’s with a greater risk of prostate cancer. These are all findings that we should be aware of.”
What are the signs and symptoms that men can look out for to prevent prostate cancer? “Most Prostate Cancer is asymptomatic. Most men don’t experience any symptoms at all. That’s why it is so important to have a screening before reaching the later stages of prostate cancer, where lots of symptoms can be exhibited. They include patients noticing slower stream and difficulty urinating, or a greater urgency in frequency. Blood in some patient’s urine, painful ejaculation, pain in your pelvis, bone pain, weight loss, back pain, and an inability to urinate are all symptoms that men can experience,” said Dr. Simma-Chiang.
How can men prevent prostate cancer? “I tell all of my patients that the healthier you are the better chance you have at preventing Prostate Cancer. That means, exercising regularly, and eating healthy, with fruits and vegetables in your diet.”
“Men that are overweight have a greater risk of prostate cancer. Physical activity and weight loss improves energy and self- esteem and increases your muscle strength and bone health. By eating lower fat content, limiting your sugars and processed fats, and increasing your consumption of vegetables. That’s the best way to do what you can to prevent Prostate Cancer,” said Dr. Simma-Chiang.
All men over the age of 55 should be tested for prostate cancer. And the way to get tested is through a PSA test and a Digital Rectal Exam, DRE. “A PSA test is a blood test to look at the PSA level proteins produced by glandular tissue. It is a test that can be done with your annual physical, depending on your health. The standard of care to detect for prostate cancer is through a PSA and a digital rectal exam.”
Dr. Simma-Chiang also recommends that men with a family history of cancer should also get tested before the age of 55. “We recommend screening earlier, with men that have a family history of cancer and in high-risk populations. If you are age 40 or older and have a history of prostate cancer in your family, you should consider a PSA screening and exam. Studies show that patients with a family history have twice the risk.”
Some patients are apprehensive about taking a prostate cancer screening and exam. But Dr. Simma-Chiang explains “it is worth it and for your own health, to go through a diagnosis and a physical exam. It’s what we do and it’s for your own health. “
“After a man’s first PSA test, we can check your PSA annually. We want to spare our patients from the anxiety and discomfort, but we also want to diagnose you earlier, instead of waiting until we are unable to offer a curative treatment,” said Dr. Simma-Chiang, who wants males over the age of 55 to get tested to avoid a missed diagnosis, or not catching prostate cancer early enough. Most prostate cancers are slow growing and do not spread to other parts of the body, as long as we can diagnose it early enough.”
The types of treatment for prostate cancer depend on the stage of cancer, and whether the cancer is local, within the prostate, or advanced, outside the prostate. If the prostate cancer is local, surgery and radiation are the two most common treatment options. Hormone therapy is an additional option for an advanced prostate cancer diagnosis.
The good news is that Prostate Cancer is a curable disease. “Most definitely, if caught early, surgery and radiation can be curative. And while we are getting better at detection, COVID has impacted all of us in the medical community from treating our patients. Now that we are vaccinated, it’s important to come in and get tested. It’s time to come in and have peace of mind. Most patients want to know because knowledge is power. I’m here to help patients navigate what are the best options for them.”
While technology and medical research continues to look for alternative methods to test for Prostate Cancer, including an option where patients can provide a urination sample to detect for Prostate Cancer, Dr. Simma-Chiang says “we are not there yet. And until we get there, the only reliable testing options are a PSA and a DRE.”
“We like to have a conversation with our male patients ages 55-69 and engage in shared decision making. It’s important to have this conversation with each patient and decide whether to do screening. We are here to help educate patients and explain that it is beneficial to start screening. Most patients say yes and agree, after their conversation with their doctor.
The message from Dr. Simma-Chiang during Prostate Cancer Awareness Month is “If you are a man, age 55-69, talk to your primary care doctor about getting a PSA and a DRE. If you have a man in your life age 55-69, encourage them to get tested.”
Vannita Simma-Chiang, M.D., is a Board-Certified Urologist, Assistant Professor, and Associate Residency Program Director in the Department of Urology at the Icahn School of Medicine at Mount Sinai. She graduated with Honors Distinction from Brown University with a Bachelor of Arts in Human Biology. She then received her medical doctorate (M.D.) from the Keck School of Medicine and continued on to complete her Urology Residency with the USC Institute of Urology in Los Angeles, CA. She completed a Voiding Dysfunction/Female Urology Fellowship at NYP-Weill Cornell. She then joined the faculty at Mount Sinai West/Morningside in 2017.
She is also a member of the AUA (American Urological Association), the Society of Women in Urology (SWIU), Society of Urodynamics, Female Urology, and Urogenital Reconstruction (SUFU), and the Society of Asian Academic Surgeons (SAAS). She is also a member of the Brown University President’s Advisory Council on Biology and Medicine..
To make an appointment, visit https://www.mountsinai.org/locations/westchester.
