By Dara Mormile

Even though prostate cancer remains a disease that affects older men, the medical world is constantly evolving when it comes to screening, diagnosis and treatment. This is the journey that former President Joe Biden began last year when he publicized that he has an aggressive form of the cancer which metastasized to his bones. 
   As he undergoes hormone therapy and radiation, millions of men around the world could be in the dark about their own health and what to expect if something concerning appears during a standard screening. 
   Urologist Michael Borofsky, MD, is passionate about sharing the latest medical advancements across all aspects of prostate cancer care. Prostate cancer remains the second leading cause of cancer-related death among men, underscoring the importance of education, early detection, and innovation.
   According to the National Cancer Institute, prostate cancer develops in the tissues of the prostate—a gland in the male reproductive system located below the bladder and in front of the rectum. The prostate surrounds the urethra, the tube responsible for carrying urine out of the body.
   A healthy prostate is approximately the size of a walnut. When the prostate enlarges, it can compress the urethra, potentially slowing or obstructing normal urine flow—often one of the earliest signs that something may be wrong.

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“Prostate cancer itself is the most common non-skin cancer that a man is most likely to be diagnosed with. Even though 1 in every 8 men will be diagnosed with prostate cancer - and those 55 to 70 years old remain the most at-risk - the way the medical world delegates treatment has completely evolved compared to decades ago and that, in turn, increases survival rates,” the urologist told Preferred Health Magazine. “Now, you have teams of doctors involved in the decision-making process if the cancer has metastasized.” 
   Dr. Borofsky believes screening is a somewhat controversial topic; historically, doctors have not been able to distinguish low-risk cancer (unlikely to spread) from the high-grade cancers that can spread and become fatal. There was a time when all prostate cancers were treated the same, he noted. He also said in the past doctors may have been too aggressive with biopsies, which caused complications. 
   Since he specializes in enlargement prostate screening, distinguishing between one that’s enlarged for benign reasons or the presence of more serious complications, he spends a lot of time ruling out cancer.  As an affiliate with the University of Minnesota and Northstar Prostate Center, Dr. Borofsky said it’s critical to find out if the cancer is only confined to the prostate or has metastasized (metastatic indicates its spread to the lymph nodes and bones). 

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One of the ways prostate cancer is screened is with a blood test called PSA, which has been met with controversy. “It’s led to over-diagnosis and over aggressive treatment,” he said. “The guidelines, including government guidelines and those from different countries, have drastically changed and everyone has a different take on whether you should get a PSA check as a part of routine screening.” 
   Dr. Borofsky, who has been practicing for 10 years said, “Urologists, for the most part, have supported a more proactive, individualized approach and have been encouraged by the utility of modern diagnostic tools such as prostate MRI to help risk stratify (sort patients by risk) people and help guide personalized decision making in an effort to balance the risks of overtreatment and those of underdiagnosis.” 

    With a five-year survival rate of 97.9 percent, the future of prostate cancer monitoring and treatment is increasingly hopeful. Dr. Borofsky emphasizes that there is no “one-size-fits-all” approach to screening or care. Today, unlike decades past, prostate cancer management is often guided by a multidisciplinary team of specialists, working collaboratively to ensure each patient receives the most appropriate, personalized treatment.

   “Now, you have a urologist, a surgeon, a radiologist and an oncologist helping the patient - all making shared decisions for one patient,” he said. “Surgery also used to be more invasive with long stays in the hospital. 
    Thanks to advancements like robotics, most removals require a keyhole incision and one overnight stay in the hospital.” 
   While there are no proven preventative measures to decrease one’s risk for prostate cancer, the urologist said being active, mobile, staying fit and being in good general health could help in the long run. 

 

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