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What is Prostate Cancer?
The prostate is a walnut-sized gland that produces and stores seminal fluid.
The prostate encircles the upper part of the urethra, the tube that empties
urine from the bladder. Located below the bladder and in front of the
rectum, this gland helps regulate both bladder control and normal sexual
functioning. Cancer cells can form on the surface or inside the prostate
gland.
One theory believes prostate cancer begins with very small changes in the
size and shape of the prostate gland cells.
According to the American Cancer Society and National Cancer Institute:
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Prostate cancer is the second-leading cause of cancer deaths in men,
second to lung cancer
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While one man in six will get prostate cancer during his lifetime,
only one man in 33 will die of this disease
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More than 85 percent of all prostate cancer is found in the local or
regional stages - while it is still confined to the prostate, or after
it has spread to pelvic lymph nodes but not to other organs or bones
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Nearly 100 percent of these patients will survive at least five
years, while 34 percent of men with the most advanced stages of the
disease will survive at least five years
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African-American men are twice as likely to develop and die from
prostate cancer as Caucasian men
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Risk Factors
Risk factors are attributes that intensify the likelihood that an individual
will develop cancer. They can include certain kinds of behavior such as
smoking, genetic traits, and exposure to cancer-causing agents in the
environment. Some of these risk factors include:
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Age: More than 70 percent of men diagnosed with prostate
cancer each year are age 65 or older
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Family History: According to the National Cancer
Institute, a genetic link for prostate cancer may exist in some
families, particularly those with men who were diagnosed with the
disease before age 60.
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Diet: Some studies suggest a link between prostate cancer and
high-fat diets (especially those high in animal fat)
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Common Symptoms
The importance of early detection cannot be stressed enough. Because many
times there are initially no symptoms, the cancer might have spread beyond
the prostate by the time a male will notice something is wrong. In turn,
this makes treatment much more difficult. As a prostate tumor grows, one of
the following symptoms may occur:
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Dull pain in the lower pelvic area
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Urgency of urination
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Difficulty starting urination and/or pain while urinating
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Weak urine flow and dribbling
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Frequent sensation that the bladder is full
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Frequent nighttime urination
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Blood in the urine
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Painful ejaculation
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General pain in your lower back, hips or upper thighs
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Loss of appetite and weight
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Persistent bone pain
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Screening and Diagnosis
A physical examination with a general practitioner or internist every year
is strongly recommended. Screening for prostate cancer should begin no later
than at age 50-especially if a family history of the disease is evident.
Doctors use the following methods to diagnose prostate cancer:
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PSA: A simple blood test that measures protein levels
secreted by the prostate into the bloodstream. If the test shows an
elevated PSA level, additional urologic evaluation is needed, even
though it does not necessarily mean that cancer is present. The PSA
level could be elevated due to other conditions, such as benign prostate
enlargement or urinary tract infection.
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Digital rectal examination (DRE): By inserting a gloved,
lubricated finger into the rectum, doctors can feel for lumps on the
prostate.
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Biopsy: After an initial examination and blood test, a biopsy is
the following step in diagnosing prostate cancer. Doctors use
ultrasound-guided biopsy to collect samples from specific sites in the
prostate gland.
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Stages of Prostate Cancer
If a diagnosis is made, doctors perform additional tests to stage the
cancer, or verify if the cancer has spread and how far. Staging helps
doctors create an appropriate treatment plan for each patient.
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Stages I and II: Early prostate cancer is localized. This means
that it has not spread (metastasized) outside the prostate gland .
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Stage III: The tumors have grown outside the prostate into
the seminal vesicles. Doctors may describe this stage as locally
advanced disease
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Stage IV: The disease has spread to lymph nodes and possibly
other tissues or organ
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Common Treatment Options
Because males have increased the frequency of screening, earlier diagnosis
has increased. Therefore, breakthroughs in technology and treatment have
improved survival rates for many men with prostate cancer.
Treatment plans are individually based on the stage of the cancer, age,
overall health, life expectancy, and personal preferences of each patient.
Before agreeing on a course of treatment, it is vital that the patient
understands the risks and benefits of the different options to determine
what is right for him/her. Treatment plans may include:
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Watchful waiting: Doctors often recommend watchful waiting
or observation for elderly men or those with pre-existing medical
conditions who may be unable to tolerate surgery or radiation.
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Hormonal therapy: Hormonal therapy aims to lower the serum
testosterone level in men with prostate cancer. Testosterone is
considered to trigger the growth of cancerous cells in the prostate,
similar to the way estrogen is thought to stimulate the onset of breast
cancer in some women. Types of hormonal therapy include surgical removal
of the testicles, where testosterone is produced, and injections of
medicines that prevent the testicles from producing testosterone or
block testosterone from entering the prostate. Although hormonal therapy
cannot cure prostate cancer, it slows the progression of the disease,
shrinks the size of the tumors, or relieves the discomfort associated
with advanced prostate cancer.
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Radiation therapy: Radiation therapy is a non-surgical method of
treatment of cancer and other diseases using penetrating beams of
high-energy waves called x-rays or gamma rays. Radiation injures or
eliminates tumor cells by damaging their genetic material, making it
impossible for these cells to continue to grow. The two types of
radiation therapy are:
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Internal radiation therapy (also called Brachytherapy): Radioactive
material is placed in the body near the cancer cells (also called
implant radiation, seed therapy or brachytherapy).
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External beam radiation therapy: Specialized medical equipment is
used to deliver radiation to the tumor site from outside the body.
Intensity Modulated Radiation Therapy (IMRT) is a cutting-edge, precise
method of external beam radiation therapy that is generally used to
treat prostate cancer. Healthy tissue is spared while high doses of
radiation are delivered directly to the tumor. IMRT allows doctors to
customize the radiation dose by modulating the amount of radiation dose
given to different parts of the treatment area. This modulation is done
in highly accurate, three-dimensional detail, according to the shape,
size and location of the tumor.
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Surgery: There are surgical alternatives for prostate cancer.
These include a procedure called radical prostatectomy, which is removal
of the prostate gland. Pelvic lymph nodes may also be discarded if the
cancer has spread to this region. Prostatectomy is performed under
general anesthesia and requires a brief hospital stay. Patients are sent
home with a urinary catheter, which is typically removed a few weeks
after surgery.
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Surgery and radiation are excellent options for younger men, those with a
life expectancy of at least 10 years, and healthy men who can handle the
side effects of treatment and the recovery process. These are time-tested
treatments often used in combination or independently.
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