Prostate cancer--screening saves lives.

• Author: SerVaas, Cory
• Position: Interview

Major advances in prostate cancer screening, treatments, and prevention over the last two decades have dramatically improved the overall survival rate and quality of life for all victims of prostate cancer.

The following are excerpts from our interview with a leading authority on prostate cancer, Dr. Patrick Walsh. A professor at Johns Hopkins Medical School, Dr. Walsh developed the nerve-sparing surgery that has significantly reduced incontinence and preserved potency in prostate cancer patients, and is author of the practical, highly readable Guide to Surviving Prostate Cancer.

On Screening for Prostate Cancer

"The current recommendation is to begin screening at age 50 or, if at high risk (African-American or with a strong family history, for example), age 40. Of course, along with the PSA, you need a rectal exam because 25 percent of men with prostate cancer will have a low PSA.

"For many men, the rectal exam is uncomfortable because doctors don't really position men correctly. In the right position, the musculature in the buttocks is relaxed, and the digital exam is not as painful. Also, when the patient is lying on his side, the physician can't feel the prostate very well. I describe the proper stance vividly in the book, with men bending at their hips and placing their abdomens on the examination table."

What Is the Difference Between a Total PSA and Free PSA Test?

"In the serum, PSA circulates in a bound form like scissors inside a case. When you measure total serum PSA, you are measuring bound PSA.

"If an arm of the scissors, for example, was broken, we can refer to that as 'free' PSA, which can't cut anything and circulates freely.

"For reasons that no one as yet understands, the higher the percentage of free PSA, the more likely you are free of cancer. Conversely, the lower the free PSA, the more likely you have cancer."

On Diet and Lifestyle

"Prostate cancer is probably caused by oxidative damage. Reducing oxidative damage can involve dietary measures, such as adding antioxidants--selenium, vitamin E, and lycopene--to your diet. It could also be something as simple as eating an apple. A study in Lancet showed that an apple contains more...