When Caldwell resident Noel McFarland received a diagnosis of prostate cancer nine years ago, he immediately thought, "This is the end."
"When you hear that word 'cancer,' you think you're dead," said McFarland, 75.
But McFarland's doctor told him that knowing what he had meant they knew how to treat it. After hormone shots, radiation treatments and seed implants, McFarland is cancer-free and working in his barber shop daily.
Prostate cancer survivor Noel McFarland, standing, trims the hair of Caldwell resident Martin Horn Wednesday at McFarland’s Barbershop in Caldwell. September is prostate cancer awareness month.
Photo submitted by Lisa Cowgill
It was a prostate-specific antigen (PSA) blood test that alerted McFarland's doctor to the situation. McFarland said he'd been getting the screening for years, starting in his early 50s.
"I went every year. I had a friend or two who had it, so I was listening to them," he said.
September is prostate cancer awareness month but McFarland spreads the word all year round, recommending the test to any man over 50.
By the numbers
90 - Number of prostate cancer deaths in America each day.
30,000 - Projected prostate cancer deaths this year.
240,000 - New cases of prostate cancer expected to be diagnosed this year.
2.5 million-plus - Number of American men living with prostate cancer.
Near 100 percent - Five-year survival rate for men with prostate cancer.
91 percent - Relative 10-year survival rate.
76 percent - 15-year survival rate.
Source: The End of Prostate Cancer, www.zerocancer.org
Because the exact cause of prostate cancer is not known, at this time it is not possible to prevent most cases of the disease. But based on what is known, there are some things a man can do that might lower his risk of prostate cancer.
Eat at least two-and-a-half cups of a wide variety of vegetables and fruits each day.
Be physically active.
Stay at a healthy weight.
Taking any supplements can have both risks and benefits. Before starting vitamins or other supplements, talk with your doctor.
Some medicines may help reduce the risk of prostate cancer.
Although two 5-alpha reductase inhibitors are currently used to treat a non-cancerous growth of the prostate, they aren't approved by the FDA to prevent prostate cancer. Right now, it isn't clear that taking finasteride or dutasteride just to lower prostate cancer risk is very helpful. Men who want to know more about these drugs should discuss them with their doctors.
Source: American Cancer Society.
Is it a risk factor?
Age - YES. Prostate cancer is very rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50. About six in 10 cases of prostate cancers are found in men over the age of 65.
Race/ethnicity - YES. Prostate cancer occurs more often in African-American men and Jamaican men of African ancestry than in men of other races. African-American men are also more likely to be diagnosed at an advanced stage, and are more than twice as likely to die of prostate cancer as white men. Prostate cancer occurs less often in Asian-American and Hispanic/Latino men than in non-Hispanic whites.
Family history - YES. Having a father or brother with prostate cancer more than doubles a man's risk of developing this disease. The risk is much higher for men with several affected relatives, particularly if their relatives were young at the time the cancer was found.
Genes - MAYBE. Scientists have found several inherited gene changes that seem to raise prostate cancer risk, but they probably account for only a small number of cases overall. Genetic testing for most of these gene changes is not yet available. More studies to determine whether testing for some common gene variants will be useful in predicting prostate cancer risk.
Diet - MAYBE. The exact role of diet in prostate cancer is not clear, but several factors have been studied. Men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. They also tend to eat fewer fruits and vegetables, and doctors are not sure which of these factors is responsible for raising the risk.
Obesity - MAYBE. Most studies have not found that being obese is linked with a higher risk of getting prostate cancer overall. However, some studies found that obese men have a higher risk of getting more aggressive prostate cancer, having more advanced prostate cancer and dying from prostate cancer, but not all studies have found this.
Smoking - MAYBE. Most studies have not found a link between smoking and the risk of developing prostate cancer, but some recent research has suggested a possible small increase in the risk of death from prostate cancer. More study is needed.
Inflammation of the prostate - MAYBE. Some studies have suggested that prostatitis may be linked to an increased risk of prostate cancer, but other studies have not found such a link. This is an active area of research.
Sexually transmitted infections - UNKNOWN. Infections like gonorrhea or chlamydia could increase cancer risk because they may lead to inflammation of the prostate. So far, studies have not agreed, and no firm conclusions have been reached.
Vasectomy - NO. Some earlier studies had suggested that men who have a vasectomy, especially those younger than 35, may have a slightly increased risk for prostate cancer. But most recent studies have not found any increased risk among men who have had this operation.
Source: American Cancer Society.
"I don't care if you're healthy as heck," he said.
The American Cancer Society recommends men discuss the prospect of a prostate cancer screening with their doctor to learn about "the uncertainties, risks and potential benefits."
That discussion should take place at age 50 for men who have an average risk of prostate cancer and are expected to live at least 10 more years, according to information provided by Amy Magorien, health initiatives representative for the Cancer Society's East Central Division. For men at high risk - including African Americans and men with a father, brother or son diagnosed with the disease before age 65 - screening should be discussed at 45. If a man has more than one close relative who was diagnosed at an earlier age, 40 is the recommended starting point.
The ACS emphasizes that the decision of actually getting screened should be made on an individual basis by a man and his doctor. According to the Mayo Clinic website, www.mayoclinic.com, there is a "lack of firm evidence that screening can prevent deaths from prostate cancer."
In 2012, the United States Preventive Services Task Force actually advised against having the PSA blood test done because there was no significant benefit and the risks outweigh the benefits. An elevated PSA count can be caused by factors other than cancer, so a false-positive could result, causing anxiety and unnecessary follow-up tests, that may result in complications. If prostate cancer is correctly diagnosed, there is no way to tell whether it is one that is aggressive or one that won't cause a problem. That, the task force said, could result in overtreatment.
Diane Mayle, registered nurse and patient navigator with Camden Clark Medical Center's Comprehensive Community Cancer Center, said most men don't die from prostate cancer, but from other causes. However, some forms of the cancer can spread to other parts of the body.
"If it's left untreated and it's what they call aggressive, it can metastisize," she said.
According to The End of Prostate Cancer, a national nonprofit organization, prostate cancer found when still contained in the gland itself has a 99 percent survival rate. Once it spreads beyond that, it is more dangerous.
Mayle agrees with the ACS recommendation to make the decision on testing with a physician.
"I think a good relationship with your primary care physician is important to any of our health care needs," she said.
According to the Cancer Society, the causes of prostate cancer are still unknown, making prevention difficult. Still, there are some steps men can take that may lower their risk and will benefit their overall health anyway.
"We can't change our age or family history or race, so that's something we have to deal with," Mayle said. "Diet and exercise and weight, we can control those."
According to the Cancer Society, research has suggested overweight men may have slightly less risk of developing prostate cancer overall, but a higher risk of the type of prostate cancers that are likely to be fatal. Regular physical activity, meanwhile, lowers the risk of prostate cancer slightly.
There appears to be a link to diet with men who eat a lot of red meat or high-fat diary products having a higher chance of developing prostate cancer. But the actual reason might be that these men tend to eat less fruits and vegetables.
Some studies suggest consuming a high amount of calcium could increase the risk, but other studies have found no link with calcium in the average diet, and the Cancer Society notes calcium is known to have other positive health effects.