Prostate Cancer

Prostate cancer is a disease that only affects men. It is a disease that develops in the prostate gland, which is a part of the male reproductive system.  Prostate cancer occurs when cells of the prostate mutate and begin to multiply out of control. Most of the time, prostate cancer grows slowly. It usually begins with very small changes in the size and shape of the prostate gland cells. These changes are known as PIN (prostatic intraepithelial neoplasia). These changes can be classified as either low-grade (almost normal) or high-grade (abnormal). As the disease develops, the abnormal cells may (metastasize) from the prostate to other parts of the body, especially the bones and lymph nodes.

Prostate cancer is the most common cancer found in American men, other than skin cancer.  The American Cancer Society estimates that approximately 218,890 new cases of prostate cancer will be diagnosed in the United States this year. Prostate cancer is the seconding leading cause of cancer death in men, exceeded only by lung cancer and it is estimated that over 27, 050 men will die of this disease this year.  The death rate of patients prostate cancer is decreasing as the disease is being detected earlier.

Q: What is the prostate?

A: The prostate is a gland found only in men. This walnut-sized sex gland is involved in producing the fluid (semen) that protects and nourishes the sperm.  It is located at the base of the bladder, in front of the rectum and surrounds the upper part of the urethra, the tube which empties the bladder through the penis.

Q: Am I at risk?

A: As men age, their risk for prostate cancer increases. Approximately 1 in 6 men will develop prostate cancer at some point in their lifetime. Although men of any age can develop prostate cancer, it most frequently occurs in men over the age of 50.  And 75% of all prostate cancers are diagnosed in men over the age of 65.  African-Americans have the highest incidence of prostate cancer. Some studies indicate a higher incidence rate in men with a family history of prostate cancer; however it is not clear whether this due to genetic, dietary or environmental factors.

Q: What are the symptoms?

A: Early prostate cancer usually has no signs or symptoms. It is often detected by an elevated PSA level during a routine check-up.  Sometimes, however, prostate cancer does cause symptoms which are similar to symptoms of other urologic disorders. These symptoms can include:
  • Frequent Urination
  • Increased urination at night
  • Difficulty starting and maintaining a steady stream
  • Blood in the urine
  • Painful urination
  • Problems with sexual function
When experiencing symptoms such as these, a physician should be consulted to determine if prostate cancer or some other condition could be the cause.

Q: How is prostate cancer detected?

A: As recommended by the American Cancer Society, all men 40 and over should have a digital rectal exam (DRE) as part of their regular annual physicial checkup. In addition, it is recommended that men age 50 and over have an annual prostate specific antigen (PSA) blood test.

The level of PSA in the blood may rise in men who have prostate cancer or another condition called Benign Prostatic Hypertrophy (BPH).  There is also a new tool that doctors are using to detect possible cases of prostate cancer, it is the PCA 3 ProfileRTM. The PCA 3 ProfileR is a molecular test that measures the presence of a gene called “PCA 3” in your urine. This gene is found in higher levels in prostate cancer cells in comparison to normal prostate cells.

Even though these procedures don’t provide a definitive diagnosis for prostate cancer, your doctor will take the test results into consideration when recommending whether further medical evaluation should be undertaken, such as a trasnsrectal ultrasound (TRUS) or prostate biopsy.

Q: How is a prostate cancer diagnosed?

A: The only definitive way to diagnose prostate cancer is by a prostate tissue biopsy. To obtain a biopsy, your physician will perform a surgical procedure using a very thin needle to remove small pieces of prostate tissue from the prostate gland. The tissue collected by the needle is then sent to a diagnostic laboratory for microscopic evaluation, which is conducted by a pathologist. If cancer cells are discovered, the pathologist can then assist your physician in determining the stage and extent of the disease.

Q: Do I have a choice of treatment?

A: Yes. Prostate cancer can be treated with surgery, radiation therapy, hormonal therapy, occasionally chemotherapy, proton therapy, or any combination of these. All of these choices are generally accepted options for treating prostate cancer, however they are dependant on a number of factors such as age, the stage of the disease, the grade of cancer, the patient’s general health, as well as any concerns you may have regarding the treatment process and potential side effects. Thus, it is important for you to thouroughly discuss your options with your doctor to develop an effective treatment plan designed specifically for you.