by Susan Weiner, Energy Times

Roughly 40,170 times a year, or nearly once every 13 minutes, an American woman dies of breast cancer. It is the most common malignancy among women except those affecting the skin. But while most skin cancers are non-lethal, breast cancer is the second leading cause of female cancer deaths.

The chance of developing invasive breast cancer at some time in a woman’s life is a little less than one in eight, according to the American Cancer Society (ACS). Last year, 62,280 new cases of carcinoma in situ (CIS, the non-invasive, earliest form) and 192,370 new cases of invasive breast cancer were diagnosed in American women. What many people don’t realize is that men aren’t spared. The ACS says that 1,910 new cases of invasive male breast cancer were diagnosed in 2009, with 440 deaths.

Ductal cancer, which affects cells lining the ducts that carry milk to the nipple, is the mostwidespread form. The other primary type, lobular cancer, develops in the milk-producing areas of the breast. These mutated cells can break away and move around the body to form secondary breast cancer.

The likelihood of disease development increases with age, since exposure to risk factors accumulates over time.

The good news is that breast cancer rates decreased by 2% a year between 1999 and 2006 (the last year for which comparative data is available). The ACS attributes this decrease to a drop in the use of synthetic hormone replacement during menopause.

Cancer Triggers

Genetic, environmental and lifestyle factors are all believed to play a role in cancer development. “Alcohol is definitely a key risk for breast cancer, particularly because it increases the levels of estrogen,” says Natalie Ledesma, MS, RD, CSO, oncology dietician with the Cancer Resource Center at the UCSF Helen Diller Family Comprehensive Cancer Center in San Francisco (www.cancer.ucsf.edu). “What you eat and drink modulates the way your genes are expressed and that can influence the tendency to develop cancer.” The link between alcohol and breast cancer has been extensively documented. The Million Women Study, a seven-year British investigation, concluded that as many as 11% of breast cancers can be attributed to alcohol consumption (Journal of the National Cancer Institute 3/4/09).

Common chemicals in the home, garden and workplace act like estrogen in the body, a hormone linked directly to breast cancer. Your body probably contains a chemical called bisphenol A, or BPA, a synthetic estrogen used in everything from plastics to epoxies to the interior coating in many cans. More than 200 studies show links between low doses of BPA and cancer, according to the Breast Cancer Fund (www.breastcancerfund.org), a nonprofit environmental watchdog group.

Overweight women are more susceptible to breast cancer. Risk increases depending on how late in life weight gain occurs, with triple the probability of breast cancer if body mass index is at its maximum after age 50, according to a study in the Journal of Cancer Epidemiology (9/09). The research also found that smoking a pack of cigarettes a day for nine years increased breast cancer odds by 59%.

While having a mother or sister with breast cancer raises risk, only an estimated 5% to 10% of all breast cancers are hereditary. Particular genetic mutations are more common among certain geographic or ethnic groups, including people of Ashkenazi Jewish heritage and individuals of Dutch, Norwegian or Icelandic ancestry. “Most breast cancers are not due to strong hereditary factors,” explains medical geneticist Patricia Kelly, PhD, who has a cancer risk assessment practice in Berkeley, California. Breast cancer development is complex even if genetics isn’t involved; Kelly says that it takes about 15 different changes inside one cell to bring about a non-hereditary malignancy.

“If a woman has a relative diagnosed with breast cancer before age 50, or several relatives on one side of the family with breast, ovarian or other cancers, she may benefit from a visit to a genetic counselor who specializes in cancer risk assessment,” says Kelly, author of Assess Your True Risk of Breast Cancer (Holt). “Testing is available to detect some of the strongly inherited breast cancers.” The genes most commonly linked with cancer are BRCA-1 and BRCA-2; other genes that may play a role in disease development include ATM, P53 and P65.

Some researchers believe that up to one-third of all breast cancer case could be avoided through dietary and other lifestyle changes (Seventh European Breast Cancer Conference, Barcelona, 3/10). But it’s important to remember that while a healthy lifestyle can help reduce one’s risk of cancer, this disorder can affect anyone. Bob Riter first noticed the lump under his left nipple while reading in bed, absent-mindedly scratching his chest. The growth, about the size of a pencil eraser, didn’t alarm him; he simply filed a mental note to discuss the matter with his healthcare provider and fell asleep. Three weeks later, while driving home from work, Riter felt wetness on his chest, looked down and saw blood on his white shirt. His nipple was bleeding.

A biopsy confirmed that Riter had breast cancer. He was 40 years old, in good health, an avid exerciser and had no history of breast cancer in his family. “I knew in theory that men got breast cancer,” says Riter, associate director of the Cancer Resource Center of the Finger Lakes in Ithaca, New York (www.crcfl.net), a nonprofit that helps people deal with the ramifications of cancer diagnosis and treatment. “It was like knowing in theory that you could get hit by an asteroid.”

Detection Toolbox

For a woman, a breast cancer diagnosis can be emotionally devastating. “There are a lot of psychosocial issues around breasts. The disease, in so many ways, is so related to being a woman,” says Eliot Edwards, ND, at Cancer Treatment Centers of America (CTCA) Midwestern Regional Medical Center in Zion, Illinois (www.cancercenter.com/midwestern-hospital.cfm). “It’s potentially a deadly disease and the treatments are invasive.” Finding cancer early can help improve a woman’s chance of saving the affected breast.

Small breast cancers, the most treatable kind, typically produce no symptoms. That makes detection difficult without the proper diagnostic tools. ACS guidelines for early detection include mammography and the clinical breast exam (CBE), in which the practitioner carefully palpitates (feels) the breast. Magnetic resonance imaging (MRI), in which a magnetic field is used to create images of body structures, is also suggested for women at increased breast cancer risk.

During a mammogram, X-rays are used to provide a picture of the breast’s internal structure; its proponents say that mammography can show abnormal tissue changes before they can be found by any other method. In November 2009, the US Preventive Services Task Force released new recommendations suggesting that women begin routine mammogram screenings at age 50, as opposed to age 40, a long-recommended guideline. Additionally, the group advised mammograms every two years, as opposed to annually, and discouraged women from conducting self-breast exams.

While the new recommendations were intended to limit radiation exposure, they instead created debate and uproar in the medical community. To date the American Cancer Society and the National Cancer Institute, along with the American College of Obstetricians and Gynecologists, still recommend yearly mammograms beginning at age 40, in addition to self-breast exams.

“Any exposure to radiation has a potential risk, but mammograms have been an effective tool in identifying cancers,” says Edwards. “Patient risk factors, such as family history, smoking or if they’ve been diagnosed with other cancers, increases the necessity of mammograms. I’m still in the camp that, until we have better methods of detection, that is the method that we have right now.” Research continues into mammography’s usefulness. For example, one Danish study suggests that it may not improve overall cancer survival rates (British Medical Journal 3/24/10 online).

Some practitioners recommend thermography (also known as digital infrared imaging, or DII) as an alternative. This method measures differences in temperature within the breast; it is based on the idea that cancer cells are more metabolically active and require increased blood flow, which makes malignant areas warmer than the surrounding tissue.

Lifestyle Support

To ward off the chances of developing breast cancer, Edwards stresses lifestyle changes that incorporate nutritional support and exercise. “Clearly, anything we do that causes oxidative damage to the body—drinking, smoking, eating trans fats, not exercising—are factors,” he says. “Exercise is the best way to detoxify your body. It will lower body fat and lower estrogen production.”

Women who consume more fiber and less fat have lower levels of estrogen in their bodies. Ledesma advocates a vegetarian-based diet of beans, legumes, whole grains and plant-based foods. “Use animal protein as a condiment as opposed to up to 50% or more of a meal,” she says. “Load up with cancer-fighting phytonutrients to help inactivate carcinogens and nourish and detoxify the body. There’s no real room for processed and fast foods in a healthy, cancer-fighting diet.”

“From a naturopathic perspective, it’s about how well our bodies are metabolizing those estrogens,” explains Edwards. “One of the main things to prevent cancers in general is to support the body in its ability to detoxify.” Cruciferous vegetables such as broccoli and cabbage contain diindolmethane, or DIM, a plant compound (available in supplement form) that helps the body effectively eliminate hormones. Freshly ground flax seed, high in cancer-fighting omega-3 fatty acids, can also aid in estrogen metabolism.

“The two big anti-cancer herbs that we use are green tea extract and curcumin, the principal curcuminoid of the Indian spice turmeric,” says Edwards. Studies show that curcumin can block estrogen-mimicking chemicals from getting into cells, while regular consumption of green tea may reduce a woman’s risk of breast cancer by about 12% (Journal of Nutrition 2/09).

With death rates from breast cancer on the decline, it seems that increased awareness, earlier detection, effective screenings and lifestyle changes are paying off. So eat a healthy, balanced diet rich in vegetables, take long walks, use natural cleaners and get screened. Your breasts will thank you.

By Susan Weiner, Energy Times

Darlene Kipling felt like she’d been sideswiped by a city bus when her doctor announced that she had colon cancer. What made the diagnosis even more alarming is that Kipling, a registered nurse, tends to cancer patients for a living. “I really didn’t expect it to be colon cancer,” she says. “My symptoms were so minor. Probably if I had not been an oncology nurse, I would not have realized I had a problem until much later.”

The minor symptom that prompted Kipling, then 52, to see her physician would easily have been overlooked by most of us: a tiny speck of burgundy in her stool. She spotted it once, then again three weeks later. At the urging of her physician, Kipling underwent a colonoscopy (the most comprehensive test for colon cancer), where he discovered and removed three polyps, growths that project from the lining of the intestine or rectum.

Polyps, which grow on a stalk and may appear like a mushroom or a cherry on a stem, can turn into cancer with time. A biopsy of Kipling’s polyps determined that two of the mushroom-like growths were, indeed, cancerous.

Kipling was fortunate: The disease was early-stage. Colon cancer caught early can often be cured simply by removing the offending growths, but her doctor opted for a bowel resection, surgery that entails removing portions of the diseased bowel and reattaching the remainder to create a functioning colon. The surgery is significant and not without risks, including infection, abscess, fistula, obstruction and lifetime use of a colostomy bag. Fortunately, she came through it without a hitch.

Had Kipling not been a self-described “stool watcher,” she never would have detected what turned out to be a life-saving symptom. If she’d missed the sign, or waited, the symptoms would have progressed and could have included severe abdominal pain, constipation, bleeding and black stools. Early-stage colorectal cancer—which includes cancers of the colon, rectum, appendix and anus—is highly treatable, with a five-year survival rate of 90%, yet only 39% of all cases are diagnosed at this highly curable stage, mostly due to low rates of screening.

“The bottom line for me is that I had the earliest possible form of colon cancer,” says an indebted Kipling, who presently works for Cancer Treatment Centers of America at Southwestern Regional Medical Center in Tulsa, Oklahoma. “The lesson is that people need to check their stool.”

A Warning for Women

Once considered a man’s disease, colon cancer now afflicts more women than men. Colon cancer is the third leading cancer and the second leading cause of cancer death among both sexes in the US, but significantly more women than men are now diagnosed with the malady. The American Cancer Society estimates that 57,460 women will learn that they have colon cancer in 2006, compared to 49,220 new cases among men. Yet the disease continues to be perceived as more prevalent among men.

“It might be a bias in the medical community that we don’t think of women as having colon cancer as much as men,” says Eliot Edwards, ND, who treats patients at Complementary Medicine and Healing Arts in Vestal, New York and Oneonta, New York. “In general, over the years there’s been an inclination in medical research towards looking at men more than women in all areas.”

Colorectal cancers develop slowly over years and most begin as polyps, common in nearly half of all adults. Not all polyps are cancerous, but those known as adenomas, which constitute nearly three-fourths of all polyps, have the potential to turn malignant. Although the causes of polyps are not completely understood, these protruding lumps, which may look the same as normal colon tissue or ulcerate and bleed, are widespread in women and men who live in industrialized countries, suggesting that dietary and environmental factors—such as cigarette smoking, obesity and a low-fiber diet high in red meat and fat—are vital to their development. Over time, polyps are more likely to develop into cancer, with more than 90% of cases diagnosed in individuals older than 50.

Just like the plumbing in your house, avoiding a backup in your internal plumbing is crucial to maintaining a healthy colon and preventing the growth of polyps, explains Edwards. “If a person is constipated, metabolic waste is sitting in the colon for an extended period of time. By correcting constipation, it helps to decrease the tendency to develop polyps.”

In Edward’s experience, constipation is far more frequent among women, which may offer insight into rising rates of colon cancer among the fairer sex. The doctor urges his patients to adopt a constipation-fighting diet low in meat and dairy and high in fiber: “Fiber helps to increase buteric acid, a byproduct of good intestinal flora, which is shown to decrease the incidence of cancer.”

Although the landmark Nurses’ Health Study did not show a strong direct correlation between fiber intake and incidence of colon cancer, the Harvard School of Public Health, which sponsored the study, still recommends a minimum amount of 20 to 35 grams of dietary fiber per day in the form of fruits, whole grains, salads, vegetables and legumes.

Exercise is another approach to keeping bowels healthy and flowing freely. Numerous studies—including the American Cancer Society’s Cancer Prevention Study II and the Nurses’ Health Study—found benefits of up to a 30% to 40% reduction of colon cancer risk through carefully measured physical activity. “Exercise has definitely been shown to help in the prevention of colon cancer, as well as decrease constipation,” says Edwards.

Eat Well, Live Well

Simply by carrying excess body weight, your chances of developing colon cancer are greatly increased. “Obesity is an independent risk factor for colon cancer,” says Pankaj Vashi, MD, gastroenterologist and chief of surgery at Cancer Treatment Centers of America at Midwestern Regional Medical Center in Zion, Illinois. “If everything else is equal, your chance of getting colon cancer is significantly higher if you are obese.” The logical way to reduce the risk of developing colon cancer, suggests Vashi, is to initiate a program that incorporates weight loss, dietary changes and exercise.

“In my opinion, the most important thing is diet,” says Vashi, who notes that in India, his native country, colorectal cancers are very rare. “That’s because 90% of the Indian population, even today, is vegetarian.” In some families, genetic factors can predispose members to colon cancer, a syndrome known as familial adenomatous polyposis (FAP), but the majority of colorectal cancers are clearly attributed to lifestyle.

Vashi suggests initiating lifestyle changes before polyps ever have a chance to develop. “The same instructions hold true for heart disease and colon cancer,” he says. “A low-fat, high-fiber diet, weight reduction, and obviously avoiding chemical toxins in your body like smoking and alcohol.”

It also makes good sense to add a variety of vitamin and mineral supplements to your daily routine. “These are definitely plus points that have been shown to reduce the incidence of colon cancer,” says Vashi. Helpful ones include selenium and zinc; calcium may decrease the risk of large colon polyps, reports the Journal of the National Cancer Institute. Studies have also shown the benefits of antioxidants like vitamins C and E, and beta carotene. “We are more on the go, producing more free radicals [which damage cells and can cause cancer], and we need something to reduce this.” By stabilizing free radicals, antioxidants may prevent damage that they might otherwise cause.

Screening Time

Since colorectal cancer usually causes no symptoms in its early stages, by the time an individual experiences pain or bleeding the disease is often advanced. Given that 75% of colorectal cancers have no risk factors other than age, both the National Cancer Institute and the American Cancer Society recommend that screening for colon cancer should be part of routine care for all adults starting at age 50.

While there are several methods to screen for polyps, including a stool blood test, barium enema x-ray and sigmoidoscopy, they can be limited in their ability to diagnose colorectal cancers. At the same time, checking your stool or looking for other signs is inadequate, as symptoms come and go, or there may be none at all.

Colonoscopy is the most effective examination because it offers direct visualization of the entire colon and allows the doctor to remove polyps for laboratory analysis. Characteristics, number and size of polyps are easily analyzed under a microscope throughout the procedure. The colonoscopy itself is relatively simple; after being given a sedative and pain reliever, the patient lies on his or her side. A flexible colonoscope is gently inserted and advanced. The most difficult part of the exam, say many, is the preparation, which involves fasting and cleansing the bowel. “Ninety-nine percent of my patients would come back and ask me, ‘Are you sure you gave me this procedure?’” says Vashi.

While no one is expected to look forward to a colonoscopy, fear and embarrassment prevent many from pursuing the potentially life-saving exam. Many individuals who should get screened don’t, despite the fact that as many as 60% of deaths from the disease could be prevented if everyone over age 50 were checked once every decade. The Centers for Disease Control and Prevention (CDC) reports that only 42.5% of US adults aged 50 or older underwent a colonoscopy or sigmoidoscopy within the previous 10 years. Among African-Americans and Hispanics, screening rates run as low as 28%.

Darlene Kipling, for one, is grateful that she had a colonoscopy. Now cancer-free for 12 years, Kipling has made important dietary changes, including forgoing some favorite foods and cutting back on salt and sugar. “I stopped eating red meat. I had been a very big meat eater and there is a link between red meat eating and colon cancer,” says Kipling. “I was a chronic soda pop drinker, and I immediately stopped and began drinking bottled water.”

Colorectal cancer may not be polite dinnertime conversation, but maybe it should be. More and more patients have been asking doctors for colonoscopy exams, perhaps accounting for an average decline in deaths from colorectal cancers by 1.8% per year since 1990. Still, nearly 60% of all Americans have never had an exam. “Get yourself screened,” urges Vashi. “If that message is spread, then we have done our job.”

It’s a disease that will kill more than 30,000 this year alone, yet most men over 40 seem oblivious to the potential threat. Here, ET educates you on a health risk you can’t afford to ignore.

By Susan Weiner, Energy Times

If you were to compile a top ten list of things men would rather just avoid, prostate exams might even rate above taking out the garbage, doing dishes and going shopping. But there’s no good excuse to ignore this walnut-sized gland located between the bladder and the penis and in front of the rectum. Confused by the debate surrounding nearly every aspect of prostate cancer and embarrassed to request a physical exam, many men ignore prostate health, only to discover that the benefits of screening far outweigh its risks. As women openly talk about breast and ovarian cancers, prostate health remains a difficult and controversial topic for men to discuss, forcing many to forgo the manual exam that could lead to early detection and straightforward treatment.

Though most males eventually develop some cancerous cells in their prostates, many prostate cancers develop so slowly that men often die of other causes. Indeed, it’s often said that most men die with prostate cancer, not from it. But the fact remains that prostate cancer kills more men who don’t smoke than any other cancer: The American Cancer Society reports that more than 232,000 men will be diagnosed with prostate cancer in 2005 and 30,350 will die from it. These statistics seem fairly overwhelming when you consider that one in six men will be diagnosed with prostate cancer in his lifetime, while one in eight American women will develop breast cancer in her lifetime.

Despite the ongoing debate about whether the results of a prostate screening may cause unnecessary treatment, growing evidence suggests that testing for prostate cancer saves lives. The number of men who died of the disease fell by 26% from 1991 to 2001, with a five-year survival rate for men diagnosed with early-stage prostate cancer of nearly 100%; the 10-year survival rate for all prostate cancer patients stands at 92%, while the 15-year survival rate fell to 61%.

Energy Times evaluated some of the key issues surrounding prostate cancer, including screening misconceptions, risk factors and lifestyle choices that can influence the likelihood of developing this potentially deadly disease. We hope they help you, or your significant other, make well-informed health decisions.

1. A prostate-specific antigen (PSA) blood test can help detect prostate cancer, as well as other prostate conditions.

A routine blood test, the prostate-specific antigen (PSA) test measures the level of a protein produced by the cells of the prostate gland. When the prostate gland enlarges, PSA levels can rise due to cancer or other medical conditions. However, a high PSA reading is not a cancer diagnosis.

An elevated PSA level can point to common benign conditions such as prostatitis, inflammation of the prostate, or benign prostatic hyperplasia (BPH), enlargement of the prostate.

While the PSA blood test is currently the best tool for monitoring the status of prostate cancer, the test alone does not determine if a cancer is present. Many men with high PSA levels do not have cancer, while nearly 25% of men with a low PSA do have the disease. Studies indicate that it is even possible for patients with healthy PSA levels to have cancer that has spread to the bones. An abnormal PSA level should always be verified by repeating the test, and every PSA test should be accompanied by a digital rectal exam. If a nodule or abnormality is detected on the prostate, a biopsy can determine if cancer is present.

2. The benefits of a manual exam for prostate cancer far outweigh any embarrassment.

While women routinely visit the GYN for yearly or even bi-yearly exams, many men find the idea of being examined so intimately to be disconcerting. “It’s not their favorite exam, but it’s not that painful,” admits Dr. E. Roy Berger, MD, FACP, Director of North Shore Prostate Cancer Consultation and Treatment Service at North Shore Hematology/Oncology Associates in East Setauket, New York. “There is no speculum involved. It’s just a finger.” Education and understanding are the key to men overcoming their anxiety. It’s also an opportunity for women to reassure their significant others that this type of exam is vital to good health and a gratifying love life. “Patients should actually ask their primary care doctor for a digital rectal exam,” suggests Berger. “It’s a matter of mindset.”

3. More men under 65 are being diagnosed with prostate cancer.

More than 75% of prostate cancers are diagnosed in men over 65, but the disease is now found more frequently in men in their 50s. While doctor recommendations for prostate cancer screenings vary, many encourage yearly screening for men over 50. For those with high risk factors, such as race (see the next item), having a father or brother with the disease or eating a diet high in animal fat, screening should start at age 45. Ongoing studies are evaluating whether yearly screening to detect prostate cancer will decrease a man’s chance of dying from the disease.

4. Prostate cancer is more common among certain ethnic groups.

African-American men are more likely to be diagnosed with prostate cancer than men of any other racial or ethnic background, and they are twice as likely to die of the disease. “Genetics and poverty are two things that may contribute to the numbers of African-Americans who have prostate cancer,” says Berger. “They also tend to have a more advanced stage when they are diagnosed.” White men, who are more likely to be diagnosed at an early stage, rank second in prostate cancer prevalence. Hispanic men are at a lower risk of being diagnosed with the disease than either African-American or white men, but it is still the most commonly diagnosed cancer among Latino men. Prostate cancer is least common in Asian and Native American men.

5. Diet and supplements can help reduce the risk of prostate cancer development.

“To reduce prostate cancer risk, the American Cancer Society recommends limiting intake of foods from animal sources, especially saturated fats and red meats,” says Colleen Doyle, MS, RD, director of nutrition and physical activity for the ACS. The ACS also advocates a diet high in fruits, vegetables, grains and beans. In addition, exercise and maintaining a healthy weight are crucial in keeping prostate troubles at bay.

Nutritional supplements may also be a strategic weapon in the war against prostate cancer, and the National Cancer Institute is banking on the ability of selenium and vitamin E to fight off the disease. Previous studies indicate that both nutrients help control cell damage that can lead to prostate cancer, and the Selenium and Vitamin E Cancer Prevention Trial (SELECT) will assess the effects of these supplements on prostate cancer risk. More than 32,000 men from the US, Puerto Rico and Canada are taking part in the long-term study. In addition to SELECT, smaller trials are being conducted on a variety of nutrients and their impact on prostate cancer, including vitamin D, lycopene, licorice root and soy isoflavones.

6. A healthy lifestyle may prevent prostate cancer recurrence.

Based on a breakthrough study of 1,117 men with localized prostate cancer (cancer that is confined within the prostate), researchers discovered that those who kept body weight down, exercised regularly to the point of sweating and underwent routine screenings were less likely to experience a cancer recurrence. Patients with a high risk of progression were more likely to be obese, exercise less than twice a week and avoid annual prostate screenings. The findings, published by the American Association for Cancer Research, are among the first to quantify the risk that lifestyle factors have on whether prostate cancer will recur in patients.

7. Sexual activity influences your risk of developing prostate cancer.

Since research suggests that sexually transmitted diseases multiply cancer risk, men with a high number of sexual partners increase their chances of developing prostate cancer by up to 40%. But on the other side of the bed, researchers have also found that frequent ejaculation prevents carcinogens, such as the chemicals from cigarette smoke, from building up in the prostate gland.

“The more you flush the ducts out, the less there is to hang around and damage the cells that line them,” explains Dr. Graham Giles of The Cancer Council Victoria in Melbourne, Australia. A study of more than 2,300 men concluded that the more men ejaculate between the ages of 20 and 50, the less likely they are to develop prostate cancer. So if you’re in a committed relationship, an active love life may impart significant health benefits.

8. There are many effective treatments for sexual dysfunction resulting from prostate cancer.
Since the prostate produces fluid for semen, cancer patients know all too well that the range of symptoms can include sexual dysfunction. The situation may be either temporary or psychological. “I see a lot of guys who, only after they are diagnosed, begin to experience sexual dysfunction,” says Berger. In other cases, “it’s more the treatment than the disease that causes the dysfunction.” With so many therapies available, it’s likely that function can be regained. The key is to discuss the problem with a healthcare professional, since embarrassment of both patient and provider often means the problem goes untreated.

If aggressive treatment is used to treat the cancer and the unwelcome side effect is more permanent, a surgical procedure called a sural nerve graft can provide cancer control and preserve erectile function. Studies show that 30% to 40% of men regain potency using this technique with no side effects other than a scar on the calf where the section of sural nerve is removed and a numb area the size of a half-dollar coin.

9. Urinary problems are a common sign that prostate cancer has advanced.

In its early, most treatable stage, prostate cancer usually does not cause any symptoms. If prostate cancer develops and is not treated, however, symptoms can include difficult, frequent or painful urination; sexual problems; and pain or stiffness in the lower back, hips or upper thighs. Following a PSA and a manual exam, a physician should order an ultrasound and X-rays to determine the cause of the symptoms, according to the National Institutes of Health. To confirm the presence of cancer, needles are used to remove small tissue samples from the prostate. If a biopsy confirms cancer, a rating system called the Biopsy Gleason score is used to measure the aggressiveness of the cancer before a treatment plan is determined.

10. In men under 65, prostate surgery can save lives.

When it comes to treating prostate cancer, one question prevails: To have surgery or not to have surgery? Since many cancers are slow growing, doctors often suggest that patients take a wait-and-see approach, opting to monitor tumor growth instead. While this gamble can pay off, those with faster-growing cancers may not be so fortunate. A new study, published in the New England Journal of Medicine, determined that when men under age 65 opt for surgery, the odds of surviving prostate cancer increase while chances of the cancer recurring decrease.

At a glance, the findings may seem to contradict research that urges men to watch and wait, but the study targeted patients with localized tumors large enough to be felt during a manual rectal exam. Following radical prostatectomy, when surgeons remove the prostate, surrounding tissue and lymph nodes, cancer was less likely to spread locally or to distant sites. After 10 years, 19.2% of the men in the surgery group had local progression, compared to 44.3% in the watchful waiting group.

Among the surgery group, 15.2% experienced distant cancer progression, while 25.4% of those who eschewed surgery had their cancer spread.

Now that you know the ins and outs of this complex but treatable disease, there’s really no good excuse to avoid getting regular screenings and following prevention guidelines. Being proactive about your prostate could save your life.