For Dr. Christopher Ferari, returning to the South Hills has been about more than coming home.

Dr. Ferari, who grew up in Mt. Lebanon and graduated from Mt. Lebanon High School in 2013, recently joined St. Clair Medical Group Urology.  Now, he cares for patients in the same community that helped shape him.

One of the issues Dr. Ferari hopes to raise awareness about is prostate cancer, a disease that can often be detected before a man experiences any symptoms.

“Prostate cancer is not like other cancers you may have heard about,” Dr. Ferari said.  “It’s usually very, very slow growing.”

Because many prostate cancers grow slowly and may not affect a man’s life for some time, Dr. Ferari said the goal of screening is to identify cancers that are more likely to become significant during a person’s lifetime and could benefit from treatment.

One of the most useful tools available is the prostate-specific antigen, or PSA, blood test.

Dr. Ferari said current guidelines allow screening to begin as early as age 40 to 45, with earlier screening particularly important for men at higher risk.  For men at average risk, he said a baseline PSA in the range of 45 to 50 can be a good starting point.

Men with a family history of prostate cancer should consider talking with their doctors about screening earlier, particularly in their early 40s, Dr. Ferari said.  African American men also can face a higher risk of prostate cancer and may benefit from earlier screening, particularly when combined with a family history.

“Family history is especially important in prostate cancer,” Dr. Ferari said.

PSA testing, however, does not diagnose prostate cancer.

Dr. Ferari said one of the biggest misconceptions he encounters is that an elevated PSA automatically means a man has cancer.  It does not.

PSA stands for prostate-specific antigen, not prostate cancer antigen.  The test helps identify men who may be at higher risk and need additional evaluation.

PSA levels also can fluctuate for reasons unrelated to cancer.  An enlarged prostate, which becomes more common as men age, can contribute to an elevated PSA. Infections and other factors also can cause the number to rise.

For that reason, an elevated PSA generally is followed by another test to confirm whether the elevation persists or represents a trend.

If the PSA remains concerning, physicians may recommend additional evaluation, including a prostate MRI or a biopsy.  MRI technology has become particularly important in recent years, Dr. Ferari said, because it can provide detailed information about the size of the prostate and identify areas that may warrant further investigation.

MRI-guided fusion biopsy technology can then allow physicians to target suspicious areas more precisely when obtaining tissue samples.

The approach to prostate cancer treatment also has changed.  Dr. Ferari said not every prostate cancer requires immediate treatment.

Patients with very low-risk or low-risk prostate cancer may be candidates for active surveillance.  Rather than immediately undergoing surgery or radiation, these patients are monitored over time with PSA testing, imaging and, when appropriate, repeat biopsies.

Studies following men with low-risk prostate cancer have shown that carefully selected patients who undergo active surveillance can have outcomes comparable to those who receive immediate surgery or radiation, Dr. Ferari said.

For patients who do require treatment, the decision is individualized.

Depending on the cancer, treatment options can include focal therapy, surgery or radiation. Dr. Ferari said St. Clair offers focal ultrasound therapy for select patients, while surgery and radiation remain highly effective options for many patients with localized disease.

The potential effects of treatment on quality of life also are part of the discussion.

Robotic prostate surgery has allowed surgeons to be more precise when attempting to preserve nerves and the urinary sphincter, Dr. Ferari said.  While side effects involving sexual function or urinary control can still occur, treatment options are available for patients who experience them.

Ultimately, Dr. Ferari said men should not wait for symptoms to begin thinking about prostate health. Early prostate cancer typically does not cause symptoms.

Changes such as blood in the urine or problems with urinary flow should prompt a conversation with a primary care physician or urologist, but PSA screening can help identify potential problems before cancer becomes advanced enough to cause symptoms.

His advice to men in the South Hills is straightforward: maintain a healthy lifestyle and talk to a primary care physician about PSA screening.

“It starts with your primary care doctor and living a healthy lifestyle,” Dr. Ferari said.

For Dr. Ferari, the opportunity to deliver that message to the community where he grew up makes his return to the area particularly meaningful.

After graduating from Mt. Lebanon High School, Dr. Ferari attended the University of Notre Dame for undergraduate studies and West Virginia University for medical school.  He completed his five-year urology training at Indiana University before returning to the Pittsburgh area.

His parents still live in Mt. Lebanon, and Dr. Ferari said returning to the South Hills has been a welcome experience.

“It’s great to be back and to be able to treat the South Hills community that I grew up in and that gave me so much growing up,” he said.  “I’m really excited to be able to offer expert urologic care to the patients that are from the community I grew up in.”

St. Clair Medical Group Urology will also offer a free prostate cancer screening event Sept. 28 as part of Prostate Cancer Awareness Month.  The screening is scheduled for 4 to 5 p.m. and will include PSA testing and prostate exams.  Free parking will be available in the Dunlap Outpatient Center garage.

For men who have never had their PSA checked, Dr. Ferari’s message is simple: Start the conversation with your primary care doctor.