September was Prostate Cancer Awareness Month, and most hospitals, whether they are community hospitals, for-profit hospitals, or university hospitals, were offering free prostate cancer screening examinations throughout the month. This is not only a good deal but a big deal, as more than 240,000 new cases of prostate cancer will be diagnosed in the United States in 2011, according to the National Cancer Institute. In this country, prostate cancer is the most common cancer diagnosed in males and the second most common cause of death in men from all cancers. The importance of screening and early diagnosis cannot be emphasized enough. Early diagnosis and treatment are the key to a cure and long-term survival.

The prostate cancer screening examination is simple and straightforward. It requires a blood test called the prostate-specific antigen (PSA) test and a digital rectal examination (DRE), in which a doctor gently inserts a gloved finger into the rectum and examines the prostate for nodules, firmness, irregularities, asymmetry, lumps, or bumps. This screening examination should be done annually for all men over 40 years of age. It is especially important for African Americans because the incidence of prostate cancer is highest among this group.

At the time of diagnosis, if the prostate cancer is confined to the prostate gland itself and has not spread to any adjacent or distant organs, the treatment of choice today is laparoscopic da Vinci robot-assisted nerve-sparing prostatectomy, as long as the patient has an actuarial life expectancy of greater than ten years and no other significant diseases such as severe hypertension, atherosclerosis, or diabetes mellitus.

In addition, many small, localized prostate cancers can be treated by watchful waiting or active surveillance. This requires no surgical, chemotherapeutic, or radiation therapy intervention but merely meticulous follow-up, including yearly exams and perhaps biopsies, to be certain that the disease is not progressive. Indeed, many small, early-diagnosed cancers remain completely localized, innocuous, and nonprogressive. But in order to ensure that we do not “close the barn door after the horse has run out,” meticulous surveillance and follow-up are mandatory.

As we often hear on television advertisements, “Take advantage of the free offer.” I strongly advise all men over age 40 to find a local hospital that is offering a free prostate cancer screening examination this month and make an appointment as soon as possible. It may save your life.

Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).

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