Prostate cancer is a serious disease that affects thousands of men during middle and late age, with most prostate cancers occurring in men over age 65. In 2013, the National Cancer Institute (NCI) estimates that 239,000 American men will be diagnosed with this condition (NCI, 2013).
The prostate is a small gland that is found in a man’s pelvic cavity. It is located under the bladder, and surrounds the urethra. This gland, which is regulated by the hormone testosterone, produces seminal fluid, also known as semen, which is the substance containing sperm that exits the urethra during ejaculation. When an abnormal, malignant growth of cells or tumor forms in the prostate, this is called prostate cancer. This cancer can spread to other areas of the body, but even if it does, it is still called prostate cancer.
Types of Prostate Cancer
Abnormal growth in the prostate is not necessarily prostate cancer. It can, for instance, be a benign prostatic hypertrophy (BPH). As for growths that actually are prostate cancer, there are two types: aggressive (fast-growing) or nonaggressive (slow-growing). For those with non-aggressive prostate cancer, the tumor doesn’t grow or grows very little over time. For those with aggressive prostate cancer, the tumor can grow quickly, potentially spreading to other areas of the body, such as the bones.
Who Is at Risk?
Prostate cancer usually occurs in men over the age of 65. Other risk factors for developing prostate cancer include:
- a family history of prostate cancer
- ethnicity or race (for instance, African American males are at a greater risk for developing prostate cancer)
- genetic changes
Symptoms of Prostate Cancer
Because some forms of prostate cancer are nonaggressive, you may not have any symptoms. However, advanced prostate cancers often have symptoms. Because the prostate is beneath the bladder and surrounds the urethra, it is not uncommon to have urinary problems, such as the frequent need to urinate or a slower-than-normal stream. Bleeding while urinating, also called hematuria, can happen as well.
Sexual dysfunction may also be a symptom of prostate cancer. Impotence, or an inability to maintain an erection, and blood in the semen may also be symptoms of prostate cancer.
When prostate cancer metastasizes, it often spreads to the bones. This can cause pain in the pelvic area, back, or chest. If the cancer spreads to the spinal cord, it can result in a loss of sensation in the lower limbs and even the bladder.
If you have any of these signs or symptoms, don’t hesitate to call your doctor. Some of these symptoms happen with other conditions. If you are worried that you may have prostate cancer or a related condition, it is best to see a doctor to make sure you receive the correct diagnosis and treatment.
Diagnosing Prostate Cancer
A diagnosis of prostate cancer is made based on a physical exam, your health history, and other tests, such as:
- Digital rectal exam (DRE): This is an exam in which your physician will inspect your prostate through the rectum with a gloved finger to feel if there are any hard lumps on your prostate gland that could be tumors.
- Prostate biopsy: Your physician may order a biopsy to confirm a prostate cancer diagnosis. In a biopsy, a small piece of the prostate gland is removed and examined.
- Other tests: Magnetic resonance imaging (MRI), a bone scan, or a computed tomography (CT) scan may be performed as well.
The American Urological Association and the U.S. Preventive Services Task Force no longer recommend the formerly widely used prostate-specific antigen (PSA) blood test for screening for prostate cancer. This is because the risks of unnecessary follow-up procedures outweigh the benefits. The PSA blood test checks the amount of prostate-specific antigen that is in your blood. However, there are many reasons why you could have a high amount of PSA in your blood, so this can lead to a misdiagnosis and unnecessary treatment. However, if you already a confirmed case of prostate cancer, this test is still approved for staging or grading the cancer. Before you consider having a PSA blood test, consult with your physician about the potential risks.
Treating Prostate Cancer
If you are diagnosed with prostate cancer, your treatment will depend on how severe your cancer is and whether it has spread. If the cancer is not aggressive, your physician may recommend watchful waiting, or active surveillance. Surgery, radiation, cryotherapy, hormone therapy, and chemotherapy are also treatment options. Your physician will find the correct treatment for your cancer based on your age, health status, and the stage of your cancer.
If prostate cancer is diagnosed early on and has not metastasized from the origin tumor, the survival rates are favorable. Early detection and treatment are key to a positive outcome. If you think you have symptoms of prostate cancer, don’t hesitate to schedule an appointment with your doctor.
Recently the guidelines for screening for prostate cancer have changed. Screening for prostate cancer is recommended every two years for men ages 55 to 69, with an emphasis on weighing the risks and benefits with your care provider. Those who are at high risk (family history, African American descent) should talk with their doctor about the risks and benefits of screening before 55. Studies have suggested an increased risk for prostate cancer in men who eat high amounts red meat and high-fat dairy, eating more fruits and vegetables and reducing the amount of red meat you consume can help.