Prostate Cancer

The prostate is the gland below a man's bladder that produces fluid for semen. Prostate cancer is common among older men.

It is rare in men younger than 40. Risk factors for developing prostate cancer include being over 65 years of age, family history, and being African-American.

Symptoms of prostate cancer may include

  • Problems passing urine, such as pain, difficulty starting or stopping the stream, or dribbling
  • Low back pain
  • Pain with ejaculation

To diagnose prostate cancer, you doctor may do a digital rectal exam to feel the prostate for lumps or anything unusual. You may also get a blood test for prostate-specific antigen (PSA). These tests are also used in prostate cancer screening, which looks for cancer before you have symptoms. If your results are abnormal, you may need more tests, such as an ultrasoundMRI, or biopsy.

Treatment often depends on the stage of the cancer. How fast the cancer grows and how different it is from surrounding tissue helps determine the stage. Men with prostate cancer have many treatment options. The treatment that's best for one man may not be best for another. The options include watchful waiting, surgery, radiation therapy, hormone therapy, and chemotherapy. You may have a combination of treatments.

 

Talk with your provider about possible ways to lower your risk of prostate cancer. These may include lifestyle measures, such as diet and exercise.

There are no medicines approved by the FDA for preventing prostate cancer.

 

Prostate cancer is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40.

People who are at high risk include:

  • African American men, who are also more likely to develop this cancer at every age
  • Men who are older than 60
  • Men who have a father or brother with prostate cancer

Other people at risk include:

  • Men who have been around Agent Orange
  • Men who use too much alcohol
  • Farmers
  • Men who eat a diet high in fat, especially animal fat
  • Obese men
  • Tire plant workers
  • Painters
  • Men who have been around cadmium

Prostate cancer is less common in people who do not eat meat.

A common problem in almost all men as they grow older is an enlarged prostate. This is called benign prostatic hyperplasia, or BPH. It does not raise your risk of prostate cancer. But, it can increase your prostate-specific antigen (PSA) blood test result.

 

With early prostate cancer, there are often no symptoms.

The PSA blood test may done to screen men for prostate cancer. Often, PSA level rises before there are any symptoms.

The symptoms listed below can occur with prostate cancer as it grows larger in the prostate.

These symptoms can also be caused by other prostate problems:

  • Delayed or slowed start of urinary stream
  • Dribbling or leakage of urine, most often after urinating
  • Slow urinary stream
  • Straining when urinating, or not being able to empty all of the urine
  • Blood in the urine or semen

When the cancer has spread, there may be bone pain or tenderness, most often in the lower back and pelvic bones.

 

An abnormal digital rectal exam may be the only sign of prostate cancer.

A biopsy is needed to tell if you have prostate cancer. A biopsy is a procedure to remove a sample of tissue from the prostate. The sample is sent to a lab for examination. 

Your doctor may recommend a biopsy if:

  • You have a high PSA level
  • A digital rectal exam reveals a hard or uneven surface

The biopsy result is reported using what is called a Gleason grade and a Gleason score. The Gleason grade tells you how fast the cancer might spread. 

The following tests may be done to determine whether the cancer has spread:

  • CT scan
  • Bone scan
  • MRI scan

The PSA blood test will also be used to monitor your cancer after treatment.

 

Treatment depends on many things, including your Gleason score and your overall health. Your doctor will discuss your treatment options with you.

If the cancer has not spread outside the prostate gland, common treatments include:

  • Surgery
  • Radiation therapy

If you are older, your doctor may recommend simply monitoring the cancer with PSA tests and biopsies.

Hormone therapy is mainly used for cancer that has spread beyond the prostate. It helps relieve symptoms and prevents further growth and spread of the cancer. But it does not cure the cancer.

If prostate cancer spreads even after hormone therapy, surgery, or radiation has been tried, treatment may include:

  • Chemotherapy
  • Immunotherapy

Surgery, radiation therapy, and hormone therapy can affect your sexual performance. Problems with urine control are possible after surgery and radiation therapy. Discuss your concerns with your health care provider.

After treatment for prostate cancer, you will be closely watched to make sure the cancer does not spread. This involves routine checkups, including PSA blood tests.

 

How well you do depends on whether the cancer has spread outside the prostate gland and how abnormal the cancer cells are (the Gleason score) when you are diagnosed.

A cure is possible if the cancer has not spread. Hormone treatment can improve survival, even if a cure is not possible.