Prostate Cancer: An Introduction
It is estimated that nearly 221,000 men in the United States will be diagnosed with prostate cancer this year. Prostate cancer is the second most common type of cancer among men in this country. Only
skin cancer is more common. Out of every three men who are diagnosed with cancer each year, one is diagnosed with prostate cancer.
Prostate cancer is common in older men. By age 50, about one-third of American men have microscopic signs of prostate cancer. By age 75, half to three-quarters of men will have some cancerous changes in their prostate glands. Most of these cancers remain latent, producing no prostate symptoms or signs, or are so indolent (or slow-growing) that they never become a serious threat to health.
A much smaller number of men will actually be treated for prostate cancer. About 16 percent of American men will be diagnosed with prostate cancer during their lives; 8 percent will develop significant symptoms of prostate cancer; and 3 percent will die of the disease.
After a diagnosis of prostate cancer, a man and his family face several choices regarding
prostate cancer treatment. Decisions involve many factors, personal as well as medical. Before making these decisions, it is important that he learns about all the options available. With this knowledge, a newly diagnosed patient can participate more confidently with his doctor in planning his individual treatment.
What Is the Prostate Gland?
The prostate gland, a key part of the male reproductive system, is linked closely with the urinary system. It is a small gland that secretes much of the liquid portion of semen, the milky fluid that transports sperm through the penis during ejaculation.
The prostate is located just beneath the bladder, where urine is stored, and in front of the rectum. It encircles, like a donut, a section of the urethra. The urethra is the tube that carries urine from the bladder out through the penis. During ejaculation, semen is secreted by the prostate through small pores of the urethra's walls.
The prostate is made up of three lobes encased in an outer covering, or capsule. It is flanked on either side by the seminal vesicles, a pair of pouch-like glands that contribute secretions to the semen. Next to the seminal vesicles run the two vas deferens, tubes that carry sperm from the testicles. The testicles, in addition to manufacturing sperm, produce testosterone, a male sex hormone that controls the prostate's growth and function.
A diagnosis of prostate cancer means that cancer cells have formed in the tissues of the prostate. Prostate cancer tends to grow slowly compared with most other cancers. Cell changes may begin 10, 20, or 30 years before a tumor gets big enough to cause symptoms. Eventually, cancer cells may spread (metastasize) throughout the body. By the time symptoms appear, the cancer may be more advanced.
Most prostate cancer never poses a problem. There are either no signs or symptoms, or the disease never become a serious threat to a man's health. A much smaller percentage of men are actually treated for prostate cancer. Most men with the condition, however, do not die from this disease.
What Are the Risk Factors for Prostate Cancer?
There are some risk factors linked to prostate cancer. A risk factor is something that can raise your chances of having a problem or disease. Having one or more risk factors doesn't mean that you will get prostate cancer; it just means that your risk of getting it is greater.
- Age. Being 50 or older increases the risk of prostate cancer.
- Race. African-American men are at the highest risk of prostate cancer. It tends to start at younger ages and grows faster than in men of other races. After African-American men, it is most common among white men, followed by Hispanic and Native American men. Asian-American men have the lowest rates of prostate cancer. Aside from race, all men can have other risk factors (aging, family history, and diet).
- Family history. Prostate cancer risk is 2 to 3 times higher for men whose fathers or brothers have had the disease. For example, the risk is about 10 times higher for a man who has 3 immediate family members with prostate cancer. The younger a man is when he has prostate cancer, the greater the risk for his male family members. The risk also appears to be slightly higher for men whose mothers or sisters have had breast cancer.
- Diet. The risk of prostate cancer seems to be higher for men eating high-fat diets with few fruits and vegetables.
Causes of Prostate Cancer
As with many types of cancers, medical experts do not know what causes prostate cancer. They are studying several possible causes.
Preventing Prostate Cancer
Medical experts do not know exactly how to prevent prostate cancer, but they are studying many different factors. They do know that not smoking, maintaining a healthy diet, staying physically active, and seeing your doctor regularly contribute to overall good health.
Screening for Prostate Cancer
Your doctor can check you for prostate cancer before you have any prostate cancer symptoms.
Prostate cancer screening can help doctors find and treat cancer early. But studies so far have not shown that screening tests, such as the PSA test, reduce the number of deaths from the disease.
Neither of the screening tests for prostate cancer is perfect. Most men with mildly elevated PSA levels do not have prostate cancer, and many men with prostate cancer have normal levels of PSA.
You may want to talk with your doctor about the possible benefits and risks of being screened. The decision to be screened, like many other medical decisions, is a personal one. You should decide after learning the pros and cons.
Symptoms of Prostate Cancer and Diagnosis
If you have a symptom or test result that suggests prostate cancer, your doctor must find out whether it is due to prostate cancer or to some other cause. Your doctor will ask about your personal and family medical history. You will have a physical exam. You may have lab tests. Your visit may include a digital rectal exam (DRE), a urine test to check for blood or infection, and a blood test to measure PSA (prostate-specific antigen) level in order to make a diagnosis of prostate cancer.
No two men with prostate cancer are treated the same. Many factors affect the decision whether or not to treat the disease, including:
- The patient's age
- Whether the cancer has spread
- The presence of other medical conditions
- The patient's overall health.
Choosing a prostate cancer treatment option ideally involves the patient, his family, and one or more doctors. They will need to consider:
- The grade and stage of the cancer
- The man's age and health
- His values and feelings about the potential benefits and risks of each treatment option.
Often, it is useful to seek a second opinion for prostate cancer, and patients may hear different opinions and recommendations. Because there are several reasonable options for most patients, the decision can be difficult. Patients with prostate cancer should try to get as much information as possible and allow themselves enough time to make a decision. There is rarely a need to make a decision without taking time to discuss and understand the pros and cons of the various approaches.
Prognosis for Prostate Cancer
Some prostate cancers become a serious threat to a man's health by growing quickly, spreading beyond the prostate gland to other parts of the body, and causing death. Yet other prostate cancers grow slowly and never become a serious threat to health or affect how long a man lives. Doctors can't always be sure what type of cancer is present in your particular case.
Add this article to your Favorites
Email this article
Print