DESCRIPTION
Prostate cancer is a life-threatening tumor that develops in the prostate. The
prostate is a gland in men within the pelvis at the base of the penis. It
surrounds the bottom part of the bladder and urethra, the tube that carries
urine from the bladder to the outside. The prostate produces a fluid that
nourishes sperm and is ejaculated with semen, the fluid that carries sperm.
INCIDENCE
Prostate cancer is the most common cancer in men in the United States and is
more prevalent in African-American men. It is the second most common cause of
cancer death.
RISK FACTORS
The risk for prostate cancer increases with age, usually after age 50. It is not
known how prostate cancer occurs. There may be a relationship with increased fat
in the diet and prostate cancer. Under continuing investigation are the
following possible risk factors; however, none of these factors have been
definitely linked to prostate cancer:
- Previous vasectomy
- Cadmium exposure
- Exposure to high levels of male hormones
- Cigarette smoking
SYMPTOMS
Prostate cancer often has no symptoms. When there are symptoms, they can be
similar to the symptoms of noncancerous growth of the prostate (benign prostatic
hypertrophy, or BPH, which can occur as men age). The symptoms of a tumor in the
prostate are also often the same as the symptoms of an infection of the prostate
or other blockage.
Possible symptoms are:
- The need to urinate frequently and with urgency
- Difficulty beginning a stream of urine
- Decreased force in the stream of urine
- Increased need to urinate at night
- Inability to urinate
- Bone pain or back pain if the cancer has spread
DIAGNOSIS
Because prostate cancer may not have symptoms, the disease is usually found as
part of a routine physical exam or an exam for some other health problem. A lab
test is now available to help detect prostate cancer. It is a blood test for
prostate specific antigen, or PSA; however, like other cancer screening tools,
it is not perfect. For this reason there is some controversy about when PSA
tests should be done. The test is most useful when done in conjunction with a
physical exam and medical history.
When the rectal exam and/or the PSA result is abnormal, a transrectal ultrasound
may be done to look at the prostate gland tissue. If the ultrasound scan is
normal, your doctor will tell you how often you should be screened with an exam
and PSA testing based on your age, family history or heritage. If the ultrasound
shows one or more abnormal areas, those areas will be sampled (biopsied),
usually with a hollow needle. After you are given anesthesia, a needle may be
inserted through the urethra, the rectum or the skin between the rectum and the
scrotum (the perineum). A sample of the abnormal area in the prostate is removed
and examined under a microscope for cancer.
TREATMENT
Treatment depends on the size of the tumor, if the tumor has spread to other
parts of your body and your overall physical condition. There are many treatment
options.
- Surgical removal of the prostate, called radical prostatectomy, which
often results in loss of ejaculation with orgasm and sometimes impotence
(inability to have or keep an erection) and incontinence (trouble holding your
urine)
- Radiation therapy, which can cause the urethra, rectum and anus to become
inflamed and may also lead to chronic diarrhea
- Treatments to eliminate the stimulating effect of testosterone (male
hormone) on the prostate cancer; for example, by removing the testicles or
prescribing female hormones
- Chemotherapy
TAKING CARE OF YOURSELF
Have regular checkups with your doctor. Rectal exams of the prostate can be
embarrassing and slightly uncomfortable, but it is important for men to have one
every year. The yearly rectal exam also screens for cancers of the colon and
rectum.
