June is Men's Health Awareness Month, and prostate cancer is one of the most common cancer diagnoses for men in the U.S. Dr. Jon LaPook joins to discuss symptoms, screenings and treatments.

Prostate cancer remains one of the most prevalent cancers among men and is the second leading cause of cancer-related deaths in men in the United States. Medical professionals highlight the importance of understanding the prostate's role, recognizing symptoms such as changes in urination, and the value of early screening. Screening recommendations vary, but typically begin for average-risk men between the ages of 45 and 50, and earlier for those at higher risk, such as Black men.

Rising levels of prostate-specific antigen (PSA) can indicate prostate enlargement or cancer, but require careful evaluation before proceeding to more invasive diagnostics like biopsies. Most men diagnosed with prostate cancer do not die from the disease, but early detection and open communication with healthcare providers about screening options are crucial for effective management and treatment.

How early detection of prostate cancer can save lives

All right, now to today's health watch. June is Men's Health Awareness Month, and today we're talking about prostate cancer. It is one of the most common cancers among men in the United States, and the second leading cause of cancer deaths in men. Last month, former President Biden revealed he is battling an aggressive form of the disease, raising awareness and also questions about the diagnosis in general. So we scheduled an appointment with CBS News Chief Medical Correspondent, Dr. John LaPouf, to help us out. And full disclosure, John is my doctor. He took a look at my prostate, and you know, it is important for me to come to see him because of the time- I thought you were a GI doctor. I'm an internist, so head to toe, and a gastroenterologist. Okay. That's right. So it was incredibly important for me, and through the education that you've always provided us, John, but also to me, because prostate cancer has become more prevalent in men. Why is that? Yeah, well, first of all, Prostate 101. What is the prostate, right? I have no idea. Really, and you do not have one. I was gonna say, you don't need to worry about that. It is a gland that sits in the pelvis, and it adds nourishing fluid to sperm before it leaves the body. Now, going right through the middle of the prostate is a thin tube called the urethra. That brings urine from the bladder to the outside. And what can happen as people get older, is like, as men get older, is the prostate enlarges, and it can pinch off the urethra, like narrowing a straw. And that's why Billy Crystal has joked that as people get older, they start to pee in Morse code, right? They're like, start and stop, right? I got the crew laughing. All right, good then. Adriana was like, what? Okay. So, that's- I had no idea, that makes sense. So, the issue then is, okay, as it gets older, there's something called PSA, prostate-specific antigen, and that is a protein that the prostate makes. As the prostate enlarges, the PSA can go up, and it can just be benign. It's because there's a bigger prostate, more PSA. However, it also can be a sign of prostate cancer. And that brings up the whole issue of how do you screen for prostate cancer? And the different societies have slightly different recommendations. In general, you start it for people at average risk, for men at average risk, you start screening at, or discussion about whether to screen at, say, 45 to 50. And if you're at increased risk, for example, black men are at increased risk of prostate cancer, then maybe start it earlier at, say, 40 to 45. Do we know why black men are at increased risk? I was just reading last night about that. There's a lot of theories, and maybe some genetic reasons, and who knows if it's environment or what it is, but no, the answer is no, we don't know. But then you have the problem of, okay, your PSA is rising, what do you do? And in the olden days, you'd say, oh, it's rising, let's go right in and do a biopsy. And now, really, you need expertise. This is something that's not so easy to figure out. You can follow it for a while and sort of see what's going on. You can do imaging, an MRI can see if there's a nodule in there, and you can eventually even do a prostate biopsy, and then if it turns out that there's cancer, there's all sorts of options for treatment. All right, so men historically have struggled to make doctor's appointments for things like this. There's a sort of, I think, for a lot of guys, they think to themselves, well, I don't need to, I feel fine, there's no reason to do this. But what happens if you have not been screened? What kind of a symptom would require you to then call a doctor? Well, you can have hesitancy, so your P is a less, yeah, it's on and off, a less forceful stream. And remember, I don't want people to forget that it turns out that with prostate cancer, about 80% of men who are diagnosed with prostate cancer end up dying of something else. So there are rabbits and then there are turtles. You know, that's what I was taught. You know, there are the prostate cancers that go really quickly, okay, and that's one of the reasons why it's the second leading cause of cancer death in men. There's lung, prostate, colon. Did he have prostate cancer? He had colon cancer. Colon cancer, okay, right, yeah. But look, this is part of, you know, men do not, in general, go for their routine exams as often as they should. There's been a whole literature about that, and I think, you know, you have to, like anything else, you take your car in to get service, you gotta take yourself in to get service, and you gotta go head to toe, which I do in internal medicine. Part of that is taking a look at the prostate, and importantly, having a discussion with the patient and saying, okay, what are the pros and cons of screening? Do you wanna screen? Okay, if you do, we may find this abnormality. If there's an abnormality, here's what we're gonna do. It's all about communication. All right, Dr. John LaPook, so great at communication, always. Thank you so much for being here. I learned so much. Right, you didn't even know you had, you didn't have one. I didn't, that I knew, that I knew. I didn't know, I didn't know what purpose it served, or that the urethra went right through it. Dr. John LaPook, thank you so much.

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