Prostate cancer top killer of Utah men

More Utah men die of prostate cancer than any other cancer, although nationally, lung cancer is No. 1. Nationally, a new case is diagnosed every 2.5 minutes, and someone dies every 17 minutes from the disease.

"A nonsmoking man is more likely to get prostate cancer than lung, colon, rectal, bladder, lymphoma, melanoma, oral and kidney cancers combined," said Dr. George Middleton, a urologist at Cottonwood Hospital.

The good news is that it's typically slow-moving and, with early detection, the cure rate is impressive. But that requires vigilance on the part of men, who should begin annual screenings at age 50 with both a blood test that measures prostate-specific antigen and a digital rectal exam.

Prostate cancer is the topic of tomorrow's Deseret Morning News/Intermountain Health Care Hotline. Middleton and Dr. Richard Labasky, an Alta View Hospital urologist, will take questions about screening and treatment options from 10 a.m. to noon. All calls are confidential.

Labasky describes the prostate as a thick doughnut, about the size of a walnut, that wraps around the urinary channel. It can become greatly enlarged, but the size alone does not define whether a man will have problems. Men with very large prostates may have none and men with small prostates may be miserable.

The need for the two-punch screening is simple. Each of the two tests has about a 20 percent false negative rate, said Middleton. But between them they detect prostate cancer well.

The survival rate overall is 98 percent, even with no treatment. At 10 years the relative survival rate is 84 percent. At 15 years, treated or not, the rate is 56 percent. That's a compelling argument for not treating someone who is over 80, since that individual is likely to die with, not of, prostate cancer.

If it is painful for the elderly, the pain is treated. And there's a lot that can be done without radical intervention, Middleton said.

Someone who waits until there are clear symptoms is unlikely to survive, he said.

Early on, there may be no symptoms or symptoms that are not specific, the kind of thing that occurs with enlargement of the prostate, which most men experience, Labasky said.

The cardinal symptom is frequent urination and a sense of urgency. Advanced cases may be painful because the cancer tends to spread to the big bones — the ribs, the scapula, the spine. Twice in his career, Middleton has seen paraplegia caused when the cancer encroached on the spinal cord. Anemia could be a symptom, as well.