Download About Prostate Cancer

About Prostate Cancer
About the prostate gland
A small gland the size of a walnut, the prostate is exclusive to men. Located underneath the bladder and in front
of the rectum the prostate is part of the body’s semen
making process. It’s triggered by testosterone, a male
hormone, which can influence the behavior of the prostate
gland and prostate cancer. Nerves to the penis important
in producing and maintaining an erection run very close to
the prostate. The urethra runs through the prostate, if the
prostate enlarges, it can block the flow of urine from the
bladder making it difficult for a man to urinate.
About prostate cancer
A complex and usually slow growing cancer, prostate
cancer is the most common non-skin cancer and the
second leading cause of cancer death in men in the
US today. Most prostate cancers grow very slowly so
other medical illness will cause the affected man’s death.
However some prostate cancers are more aggressive
and at this time it can be difficult to differentiate between
them. There are different types of tumors and not all are
cancerous. Those that cannot spread or threaten a life are
benign. Those that invade surrounding tissue and even
spread throughout the body are malignant tumors. Since
most prostate cancer is very slow growing it will never
endanger or affect quality of life. However, sometimes
these cells grow quickly and spread to nearby tissue
and lymph nodes. If prostate cancer has spread to the
patient’s lymph nodes when it is diagnosed, it means that
there is a higher chance that it has spread to other areas
of the body.
What are the Risk Factors?
Researchers believe every man over the age of 45 is at
risk for prostate cancer. One man in six will develop prostate cancer and one in 35 will die from it. In between are
men whose quality of life will be changed by it.
Age is most often a factor as 70% of men diagnosed
with prostate cancer are over the age of 65. Incidence of
prostate cancer rises quickly after the age of 50 and the
majority of men will have some form of prostate cancer
after the age of 80. It is said that men over age 80 die
with prostate cancer not from prostate cancer. It means
that many men have developed the slow growing micro-
scopic form of prostate cancer but it is not life threatening. Current screening is not perfect in discerning which
type of cancer is developing.
Another risk factor is ethnicity. Men of African-American
descent tend to have a higher risk of developing prostate
cancer. Men of Asian, Latin or Native American descent
have a lower risk. Caucasian men fall in the middle. This
risk factor is not well understood. While genetics may be
a factor, there is some evidence that diet may be a factor.
Some studies indicate that a diet high in animal fat and/
or low in fruits and vegetables may also raise risk.
Family history A father or brother with prostate cancer
more than doubles a man’s risk of developing prostate
cancer. With a family history of prostate cancer developed at a younger age the risk increases even more.
Certain mutations in genes may carry an increase in
prostate cancer risk as well as men with high levels of
testosterone.
Prevention
Little is known about this complex disease and much
research is underway. Because so many men will develop
prostate cancer there is a lot of interest in prevention with
drug therapy and/or the consumption of certain foods
or nutrients. Although certain foods and nutrients are
being researched more data is needed. Studies including
supplements of selenium, lycopene, vitamin A or other
retinoids, vitamin D, and vitamin E found no reduction
in prostate cancer risk. Several studies are now looking at possible effects of soy or isoflavones on prostate
cancer risk however results are not yet available. At this
time prevention includes the patient taking control over
his own health and a low fat diet that is rich in fruits and
vegetables is suggested. Drug research is also underway.
Currently none are available to the mass market.
Screening
Prostate cancer shows a wide spectrum of behavior so
screening for it begins with annual check-ups with your
doctor. Any changes in your health and well-being should
be discussed with your physician. Screening of men 50
and older is currently the only method of determining the
health of the prostate gland and is the first step for many
men as they may have an enlarged prostate and be symp-
tom free. The American Cancer Society, the American
Urological Society, and many medical communities’
experts agree: being informed and in tune with your body
is important.
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The role of screening is being reevaluated, based in part
on cost, potential toxicity of treatment, and the fact that
some men do well without treatment. Most physicians
begin the conversation with their patients regarding
prostate cancer and offer screening at age 50. AfricanAmerican men, who are at a higher risk of death from
prostate cancer than white men should begin screening at age 45. The same is true for any man with a first
degree relative who has had prostate cancer. For men
with more than one first degree relative with prostate
cancer, screening begins at age 40 or even earlier.
All of the symptoms listed here can be caused by a
number of things besides prostate cancer. If the patient
experiences any of these symptoms further screening
should be discussed.
Two methods are used: a digital rectal exam (DRE) and
a prostate specific antigen (PSA) blood test. The digital
rectal exam is done in the primary care physician’s office.
Because the prostate is so close to the rectum, a doctor
can feel it by inserting a gloved, lubricated finger into
the anus. Lumps, asymmetries, or an enlarged prostate
can be detected this way though some small cancers
can be missed. A PSA looks for a protein that the prostate makes. Normal prostate tissue makes a little bit of
PSA, but prostate cancer usually makes much more. An
elevated PSA may suggest that a malignant tumor is
present. False positive tests exist. For that reason doctors
really on the combination of a PSA blood test and a DRE.
If there is doubt, the physician may recommend a sample
of prostate tissue from a biopsy be taken for further study.
The Annals of Internal Medicine, established by the
American College of Physicians is now recommending
men 75 and older not be screened for prostate cancer.
Symptoms
Most early prostate cancers are detected with PSA tests
or digital rectal exams before they cause any symptoms.
More advanced prostate cancers can cause a variety of
symptoms including:
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pain during urination or ejaculation
blood in your urine or semen
impotence
bone pain
Diagnosis
If the patient experiences symptoms, the doctor will do a
digital rectal exam and a PSA blood test. If either of those
two tests is abnormal, the doctor will probably recommend a biopsy. Once the tissue is removed, a pathologist
will review the specimen. The pathologist can tell if it is
cancer or not; and if it is cancerous, then the pathologist
will characterize it by what type of prostate cancer it is
and how abnormal it looks (known as the grade).
Treatment
There are many different ways to treat prostate cancer,
and patients may consult with multiple types of doctors
before making a final decision. Physicians are not always
in agreement as to the way to proceed because there
haven’t been enough large trials that compare the different treatment modalities. A second opinion is standard.
Talking with both urologists and radiation oncologists to
discuss the benefits and risks of surgery, hormonal therapy, and radiation treatment including 3D-CRT and IMRT
(Intensity modulated radiation therapy), brachytherapy,
chemotherapy, and cryosurgery is suggested. “Watchful
Waiting” may be recommended for some patients in the
hopes they have a slow growing cancer. Once a patient
has been treated for prostate cancer follow up visits are
done on a regular schedule, often at first then less often
as the patient is free of the disease.
trouble starting urination
urinating much more frequently than usual
the feeling that you can’t release all of your urine
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