Fall 1997 Volume 2Number 4

General H. Norman Schwarzkopf and Jerry Lewis have battled it, and so did John Wayne, Hubert Humphrey and, perhaps, a man you know. The truth is of the estimated 1.4 million people in the United States who will be diagnosed with cancer this year, 57 percent will be male. Men's lifetime risk for developing invasive cancer is one in two; for women the risk is one in three.

Lung, colorectal and prostate cancer are the most common male malignancies, but men are also touched by breast and testicular cancer. Here's a look at some common-and not-so-common-male malignancies and what can be done to detect and prevent them.

Prostate Cancer
Prostate cancer is the most prevalent male malignancy-and the second most common cause of cancer death in American men. The incidence of prostate cancer is increasing, primarily because men are living longer. Most cases occur in men older than 50, with 80 percent found in men over 65.

Risk factors: Family history of prostate or breast cancer; high-fat diet; incidence increases with age. Symptoms: Weak or interrupted urine flow; inability to urinate; the need to urinate frequently, especially at night; blood in the urine; pain or burning on urination; painful ejaculation; frequent pain in the lower back, hips or upper thighs. Detection: Experts recommend that men 40 years or older have a digital rectal exam (DRE) as part of a regular annual checkup. For Caucasian men over 50, the American Cancer Society recommends an annual PSA (prostate-specific antigen) blood test along with the annual DRE. African American men, or men with a family history of prostate cancer, should begin PSA testing at 40. Prevention: A low-fat diet, healthy weight and regular exercise are recommended.

Lung Cancer
The fact that smoking causes cancer isn't a news flash, but a lot of American men (and women) are still not getting the message. Lung cancer kills more people than any other type of cancer and is one of the least curable. Smoking causes 90 percent of lung cancer in men.

Risk factors: Cigarette smoking; exposure to industrial substances such as asbestos; radon exposure; secondhand cigarette smoke. Symptoms: Persistent cough; sputum streaked with blood; chest pain; recurring pneumonia or bronchitis. Detection: Chest X-ray; sputum cell analysis; fiber-optic examination of the bronchial passages. Prevention: Don't smoke; avoid asbestos and radon exposure; eat a variety of fruits and vegetables daily.

Colorectal Cancer
A high-fat, low-fiber diet is linked to colorectal cancer, as is a sedentary lifestyle. A 1996 Harvard University report suggests that lack of exercise doubles the risk of colon cancer. Although experts say that a majority of colorectal cancers are preventable, the American Cancer Society estimates that 66,400 new cases will be diagnosed in men this year.

Risk factors: High-fat, low-fiber diet; family history of cancer or polyps of the colon or rectum; inflammatory bowel disease. Symptoms: Rectal bleeding; blood in the stool; change in bowel habits. Detection: Digital rectal exam annually after 40; annual stool blood test after 50; proctosigmoidoscopy every three to five years after age 50. Prevention: Low-fat, high-fiber diet with adequate calcium and fruits and vegetables daily; healthy weight; regular exercise.

Rare but Real
Testicular and breast cancer are rare in men. Still, cancer of the testes is the most common cancer in young men, and breast cancer poses a serious threat to the fewer than 1,400 men who are diagnosed with it annually.

Breast cancer symptoms include a painless lump; nipple indrawing and/or discharge or ulceration; pain and enlarged lymph glands under the arm. Perhaps because men aren't looking for breast cancer, or are embarrassed about a disease that primarily afflicts women, nearly half of male patients have fairly advanced cancer by the time they seek help, making treatment more difficult.

The outlook is much better for the 7,200 new cases of testicular cancer the American Cancer Society estimates will be diagnosed this year. Found mostly in men ages 15 to 35, testicular cancer often is completely curable, especially if found and treated early. In fact, according to the National Cancer Institute, about 70 percent of men with advanced testicular cancer can be cured. Men most at risk have an undescended or partially descended testicle. Symptoms include a lump in either testicle; enlargement of a testicle; a feeling of heaviness in the scrotum; a dull ache in the lower abdomen or groin; sudden collection of fluid in the scrotum; pain or discomfort in a testicle or in the scrotum; and enlargement or tenderness of the breasts.

Seeds of Healing
Radioactive seed implantation is an innovative outpatient procedure used in the treatment of prostate cancer. Tiny pellets containing radioactive medication are precisely implanted in the prostate gland, where they give off low-level radiation continuously for several months.

Radioactive seed implantation provides a higher radiation dose without increasing side effects, explains David Catalano, M.D., radiation oncologist at RVMC's Dubs Cancer Center. Typically, 50 to 150 seeds are implanted, delivering two to three times more radiation to the prostate gland than external radiation therapy.

"It has a lower risk of impotence or incontinence in some patients than surgery or external radiation," says Dr. Catalano. "In addition, it is performed on an outpatient basis and requires little recovery time. A man can resume normal activities within a few days."

Because the procedure works best on small, early tumors confined to the prostate gland, early detection through regular physician checkups is vital to ensure effective treatment.