WRNMMC, Bethesda, Md.  –   Fred Cohrs is a prostate cancer good news success story. He was a high-risk patient, diagnosed by a biopsy performed at the Alexander T. Augusta Military Medical Center at Fort Belvoir, Virginia, then referred to the Prostate Center at Walter Reed National Military Medical Center (WRNMMC) for minimally invasive, laparoscopic surgery.

“My PSA is now completely undetectable,” Cohrs said, referring to the measurement of the amount of prostate-specific antigen (PSA) in his blood. The PSA level in men is used to help detect for possible prostate cancer. Cohrs now volunteers as a group leader for a prostate cancer patient support group, assisting people impacting by the disease, including those at Walter Reed. “Doctors [at Walter Reed] saved my life, and the support group saved my soul,” he shared.

September is Prostate Cancer Awareness Month, established to increase people’s knowledge about the disease, as well as to spread the word about the important role that screening plays in saving lives.

The Prostate Center, a component of the John P. Murtha Cancer Center at Walter Reed, leads the Department of Defense’s (DOD) in clinical care for Military Health System (MHS) beneficiaries diagnosed with prostate cancer and prostate-related diseases. Congress established. In addition, the Center for Prostate Disease Research, a program of the Uniformed Services University, leads DOD's research efforts into the research of prostate disease. The U.S. Congress established the CPDR in 1991 at the former Walter Reed Army Medical Center. In 2010, the Prostate Center was designated a DOD Prostate Center of Excellence for its care of military service members and their families diagnosed with prostate cancer and prostate-related disease.

The Prostate Center Director, U.S. Navy Cmdr. (Dr.) Gregory Chesnut, stressed the importance of early screening in fighting and treating prostate cancer, the most common cancer diagnosed among men in the U.S., accounting for 29 percent of all new cancer cases diagnosed among American men, according to the Centers for Disease Control and Prevention (CDC).

The PSA test is the most commonly used laboratory test to screen for prostate cancer. It measures the amount of PSA in the blood, which can help detect prostate cancer. PSA is a protein made by the prostate, which is part of the male reproductive and urinary systems. The PSA can be elevated for a number of reasons, not just prostate cancer, which is why Chesnut and his colleagues at the CPDR stress the need for early screening.

Chesnut recommends that African American men, who are at greater risk for prostate cancer, begin screening at age 40, also the age at which he recommends men with a first degree relative (parents, siblings, children) with cancer, get screened. Other men he recommends begin screening starting at age 50.

Once referred to as the “old man’s disease” because it was generally most detected older men, men in their 30s have now been diagnosed with prostate cancer because of better screening for the disease, Chesnut explained. He said that he has seen “patients of younger ages” who might be deployed and not know of their family history for the disease, only that someone in their family was sick or possibly died of cancer. He shared that a family history is one of the risk factors for prostate cancer, explaining that a man’s risk for the disease increases if his father, brother or son has had prostate cancer.

In addition to age and a family history of cancer, other risk factors for prostate cancer include race, diet, obesity and inherited gene mutations, Chesnut added.

Most men diagnosed with prostate cancer do not die of it, Chesnut stressed. “They universally feel like they are the only ones going through it, but then [I] show them a room with half a dozen patients who have gotten through it [their cancer treatment].”

In addition to the PSA test, other testing methods for prostate cancer include the digital rectal exam and a biopsy.

Once diagnosed with the disease, there are a number of treatments available for prostate cancer, Chesnut explained. “There are new treatments and refinements,” he said. These treatments include robotics, minimally invasive radical prostatectomy with better quality of life outcomes than [there were] 10 to 15 years ago. He explained that other treatments include the use of a certain hydrogel, hormone therapy, chemotherapy, targeted therapy, immunotherapy and a combination of therapies. “[Sometimes], we don’t need to treat every cancer because the cure can be worse than the disease,” he added, describing “active surveillance,” during which the health care team actively monitor each individual patient’s laboratory and imaging values, alongside biopsies.

Deborah Jolissaint, the Prostate Center's clinical research nurse practitioner, explained that the center “is unique in the military medical system.” She shared that the center is a multidisciplinary center of excellence, serving as a “one-stop shop” center for patients referred [to them from] around the world.”

Since it was established, the Prostate Center has spearheaded major advances in translational prostate cancer treatment reflecting the collaboration of expertise and resources of clinicians, nurse practitioners, social workers, nutritionists, statisticians, and scientists, and a recently added geneticist. The center also works in collaboration with the National Cancer Institute to advance research and treatment of prostate cancer.

Although it's not known exactly what causes prostate cancer, the health care professionals at the Prostate Center recommend avoid smoking and saturated fats to decrease the risk for the disease. They also recommend staying healthy as you age, including exercising regularly, eating a “heart healthy” diet (fruits, vegetables, fish, poultry, lean meat), and using unsaturated fats (small amounts of vegetable, olive, sunflower oil) rather than saturated fats. Lycopene, found in tomatoes, as well as soy products and isoflavones, might also prove beneficial to prostate health, they add.

MHS beneficiaries do not need a referral for an appointment to the Prostate Center. They can call the front desk at 301-319-2900 to make an appointment.

Upon diagnosis of prostate cancer, the Prostate Center's interdisciplinary team offers a weekly multi-disciplinary session, held from 7:45 a.m. until 2:15 p.m., every Monday, which includes one-on-one discussions and personal counseling with a radiation oncologist, surgical oncologist and social worker.

In addition, there are two group sessions where discussion focuses on prostate cancer pathology, recovery of sexual function after treatment for prostate cancer, nutrition, risk factors, genetics and treatment modalities.