September is prostate cancer awareness month.

Dr. Leonard Marks, a urologic oncologist and professor in the Department of Urology at UCLA, sat down with Daily Bruin science and health contributor Nick Mouchawar to discuss screening for prostate cancer, risk factors and management of the disease.

Marks received his medical degree from the University of Texas Medical Branch at Galveston in 1969 and went on to complete his residency in urology at UCLA in 1978. His work at UCLA focuses on improving prostate cancer diagnosis and treatment, including the development of MRI-ultrasound fusion biopsy and other surveillance strategies that reduce unnecessary procedures while improving patient outcomes.

This interview has been edited for length and clarity.

Daily Bruin: What inspired you to choose a specialty in urology?

Leonard Marks: When I became interested in urology, there was a lot of opportunity for more research. Urology had been a fairly dead specialty for a long time with limited treatment options and some new things were happening. I became interested in prostate cancer back in the 1980s, when the prostate-specific antigen blood test was first approved by the FDA. It was an wonderful time for research and many new cases of prostate cancer were being diagnosed that had not been diagnosed before. We learned how to treat this cancer several different ways, and started making great progress. The mortality rate dropped as a result of PSA testing, a simple blood test. It was just an exciting time for urology.

DB: What is prostate cancer, its primary risk factors and what populations are most at risk for prostate cancer?

LM: Prostate cancer is a potentially lethal cancer that begins in the prostate gland, a little walnut-sized structure underneath the bladder. It’s only found in men and exists in different forms. Some of it is very indolent and doesn’t cause metastases or effects on health, and then some of it is a very serious cancer with the second most common cause of cancer death in men, just behind lung cancer. Everyone knows someone with prostate cancer and it’s a cancer where death from it is largely preventable if it’s diagnosed early, so we are still preaching early diagnosis.

One primary risk factor is age, and it’s pretty hard to avoid that. The average age of diagnosis around late 60s. African American men also have a greater chance of dying from it than any other demographic.

DB: Screening typically isn’t recommended for college students. What should the UCLA community need to do or know right now?

LM: You’ve got to be sure your father gets screened. I should also mention that family history is the third risk factor for prostate cancer. If your father or your brother has prostate cancer, called your first filial relative, then you’ve got twice the risk of getting it as someone whose father or brother does not have it. So we need to record a careful family history. Regarding college students, this is for your parents. There are some genetics here that may become apparent to college age people, a gene called BRCA gene, which predisposes people to prostate cancer. But we don’t recommend screening even with this in mind until you’re in your mid to late 40s or early 50s.

DB: What long-term habits, such as exercising, dietary choices, or others, have been shown to be the most significant in prevention?

LM: I get this question asked a lot by people who get diagnosed with low grade prostate cancer: “What can I do, lifestyle wise, to make this not be too much of a problem for me?” And my answer is always the same: Take care of your heart. What’s good for the heart is also good for the prostate, so by association, eating a diet low in animal fat, consuming more of fresh fruits and vegetables, getting more sleep at night, trying to reduce stress, losing weight and exercising. These are all good things that are healthy for the heart, which makes them also healthy for the prostate.

DB: Are there any symptoms people should watch out for?

LM: Unfortunately, there are no symptoms of early prostate cancer. It’s only detectable by a PSA test or an examination of the prostate, which may show something, but normally by PSA test which is the most common way it is detected.

The thing that bothers older men about the prostate is enlargement of the prostate, which may encroach on the urine flow. Those urinary symptoms are usually caused by benign prostate enlargement, not cancer, but they’re often what bring men to the doctor. It can be very bothersome, and while they’re there for that, they should get a checkup for their PSA. PSA screening means giving the test to men who don’t have any symptoms. So when we have a 65-year-old man coming to the doctor for a checkup, we strongly feel a PSA test should be part of his overall evaluation.

DB: How does screening and early detection change patient outcomes?

LM: If patients are diagnosed early, on the basis of a PSA test and an early biopsy, and they’re found to have the typical, low-grade form of prostate cancer, then their chances of dying from this are small. They’re either going to be treated or they have an indolent cancer that will not affect their life. Life expectancy for men who are diagnosed early is over 90%, the mortality rate is less than 10%. If they’re diagnosed late and come in with metastatic disease where the cancer spreads to the lymph nodes, they are more likely to die from their condition.

DB: What are some common myths or misconceptions about prostate cancer?

LM: The word cancer is so ominous. The truth really is, early diagnosis leads to almost 100% survival, and the treatments don’t have to be life altering. That’s the current message we want to spread. The treatments can be very simple outpatient treatments.

DB: Are there any new treatments or technologies for prostate cancer people should know about?

LM: We have another UCLA product that we’re all very proud of called Prostate-Specific Membrane Antigen, which scans a radioisotope and helps identify prostate cancer anywhere in the body. It was approved by the FDA two or three years ago on the basis of a clinical trial done at UCLA, and now it’s available worldwide. It’s one of our great accomplishments of the past decade and we’re very, very proud of that. There’s also lots of new drugs that are available for advanced prostate cancer, but our mission is to not let advanced prostate cancer develop, treating it early and turning this into more of a chronic situation than an acute dramatic situation.

DB: If you want students to have one takeaway about prostate cancer awareness, what would it be?

LM: Get a PSA test. Be sure that you know what it is and get it every year. Following it over time is another way that we assess its importance. If it’s going up and up and up, you’ve got to pay attention to that.