The surveillance policy, after surgery or radiation, is to check PSA quarterly for the first two years, biannually for the next three, and annually thereafter. For radiation patients, a yearly digital rectal examination is also recommended. After treatment with TIP, some men will be left with chronically suppressed testosterone. Several studies suggest that properly-supervised administration of testosterone is safe. In addition to the need for post treatment surveillance, these ongoing doctor visits offer an good opportunity to screen men for issues unrelated to prostate cancer by important for their overall general good health.
Every man age 40 and above should have an annual physical, including a skin exam, an eye exam, and blood tests. Annual flu vaccines are advisable. Prevnar-13 and Pneumovax are once-in-a-lifetime vaccines recommended for patients over 65 to reduce the risk of pneumonia. The Zostavax vaccine is recommended to prevent shingles in men who have previously had chickenpox. Men over 50 should strongly consider obtaining a CT scan to check for plaque on the coronary arteries. If there is significant plaque, aspirin, cholesterol pills, and an annual stress test needs to be discussed. Men who smoke, or who have quit smoking in the last 15 years, should have annual CT of the chest. Lung cancer can only be cured if it is detected early. Men over age of 50 (or earlier with a family history) can dramatically reduce their risk of dying from colon cancer by doing a colonoscopy or a Cologuard stool test. Lastly, men over age 70, or men who have undergone previous treatment with testosterone inactivating pharmaceuticals, are at risk for osteoporosis. Osteoporosis can only be detected by doing a bone density scan.
Many problems (including prostate cancer) don’t cause symptoms until the condition becomes advanced. Waiting until “something hurts” is the old-fashioned way to do medical care. Modern technology is changing the game. Live longer by diagnosing problems early, before they create symptoms and get out of control.
Jeffrey Turner, MD is a board-certified internist and medical oncologist specializing full time in prostate cancer since 2009. Dr. Turner is an active member of the American Society of Clinical Oncology, American Society of Hematology, and American College of Physicians-Internal Medicine. He was a research associate at UCLA in infectious diseases and molecular biology. He then earned his medical degree in Canada at Memorial University of Newfoundland. He completed his internal medicine residency at the University of British Columbia and fellowship in medical oncology at the Medical University of South Carolina.