Udamin & Udamin SP
Prescribing Confidence for Prostate Health (RX)
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Resources: Educational Resources

Prostate Cancer : Overview | Risk Factors | Symptoms | Diagnosis | PSA Levels

Prostate Cancer


  • An estimated 220,000 new cases of prostate cancer will be diagnosed and 30,000 men died from the disease in 2003.
  • Death rates of prostate cancer have been on the decline since 1991. Many experts attribute this to earlier treatment of the disease made possible by PSA testing.
  • Prostate cancer is the most common form of cancer, other than skin cancer among men in the U.S. and is only second to lung cancer as a cause of cancer-related death.
  • Since PSA testing helps identify prostate cancer that is still confined to the gland, it is a valuable tool for catching the disease in its treatable stages. Before the advent of PSA, most prostate cancers were detected at advanced stages when the cure was not possible.

Risk Factors

  • Age - As man ages, his risk increases dramatically. The average age of diagnosis is 65 to 70 and average age of death is 77 to 80.
  • Race - More common is blacks. Jamaica has highest incidence of prostate cancer in the world. Death rates have declined primarily in whites, and remain twice as high in blacks as in whites.
  • Family History - Risk of prostate cancer grows with the number of additional affected relatives, and when prostate cancer is found in another family member before the age of 55. Having one brother all the way to having three first-degree relatives causes the risk of prostate to range from 2 to 11 times greater than a man with no affected relatives at all.
  • Environmental Factors - Even though the incidence of prostate cancer is similar from country to country, the mortality rates vary between countries. This suggests that environmental factors can influence the progression of prostate cancer.
  • Diet - Higher fat intake has been associated with an increased risk of prostate cancer. A high intake of vegetables may lower the risk of prostate cancer.

Things that may lower risk of prostate cancer:

  1. Nutrition -
    • Studies show that vitamin E, selenium, and lycopene may play a role in risk reduction.
  2. Physical activity -
    • Exercise lowers the production of testosterone, a hormone involved in the development of prostate cancer.
    • The benefit of exercise in prostate cancer has mixed reviews, but there is a consensus that exercise is good for overall health


  • No symptoms in early stages
  • As prostate enlarges, may experience:
    1. difficulty beginning urination
    2. nocturia
    3. urinary urgency
    4. frequency-symptoms indistinguishable from BPH
  • Erectile dysfunction caused by cancerous invasion of the nerves controlling the erectile process
  • Severe back pain may occur from cancer that has spread to the vertebrae


  • Abnormalities in digital exam( looking for solid mass)
  • Abnormalities in PSA test( looking for high PSA values)
  • Difficult to diagnose in early stage, because cancer cells spread diffusely through the prostate and into surrounding tissues instead of forming a solid mass as in most forms of cancer.
  • Most reliable way to detect prostate cancer is to use both digital exam along with PSA measurements.
  • Needle biopsies are used to obtain prostate tissue for microscopic diagnosis. Three quarters of all prostate cancers arise in the peripheral zone which account for 65% to 75% of prostate tissue.

PSA Levels

  • PSA stands for prostate-specific antigen. Screening for this antigen helps make a diagnosis of prostate cancer.
  • PSA levels are higher in men with large prostates.
  • Normal ranges:
    1. 2.5ng/ml or below for ages 40 to 49
    2. 3.5ng/ml or below for ages 50 to 59
    3. 4.5ng/ml or below for ages 60 to 69
    4. 6.5ng/ml or below for ages 70 to 79
  • PSA screening for prostate cancer should start at age 50 for white men and at age 40 for black men.
  • It is important to screen early for those with a history of prostate cancer.

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