Prostate cancer incidence has been increasing and currently affects approximately 200,000 men each year in the United States. Even so mortality rates* have declined since the early 1990s and survival rates continue to improve. Early detection and high-tech treatments, like IMRT (Intensity Modulated Radiation Therapy) and the da Vinci Surgical System, have contributed to these improved outcomes.
Other than skin cancer, prostate cancer is the most common type of cancer in men in the United States. Of all the men who are diagnosed with cancer each year, more than one-fourth have prostate cancer.
Research is increasing our understanding of prostate cancer and men with prostate cancer now have a lower chance of dying from the disease. One significant advancement was the widespread use of prostate-specific antigen (PSA) testing, which received initial Food and Drug Administration approval in 1986.
About The Prostate
The prostate is a gland in a man's reproductive system that makes and stores seminal fluid to nourish sperm and is released to form part of semen.
The prostate, about the size of a walnut, is located below the bladder and in front of the rectum. It surrounds the upper part of the urethra, which empties urine from the bladder. If the prostate grows too large, the flow of urine can be slowed or stopped.
To work properly, the prostate needs male hormones (androgens). Male hormones are responsible for male sex characteristics. The main male hormone is testosterone, which is made mainly by the testicles. Some male hormones are produced in small amounts by the adrenal glands.
Benign prostatic hyperplasia(BPH) is the abnormal growth of benign prostate cells. In BPH, the prostate grows larger and presses against the urethra and bladder, interfering with the normal flow of urine. More than half of the men in the United States between the ages of 60 and 70 and as many as 90 percent between the ages of 70 and 90 have symptoms of BPH. For some men, the symptoms may be severe enough to require treatment.
Malignant tumors are cancer. Cells in these tumors are abnormal. They divide without control or order, and they do not die. They can invade and damage nearby tissues and organs. Also, cancer cells can break away from a malignant tumor and enter the bloodstream and lymphatic system. This is how cancer spreads from the original (primary) cancer site to form new (secondary) tumors in other organs. The spread of cancer is called metastasis.
When prostate cancer spreads (metastasizes) outside the prostate, cancer cells are often found in nearby lymph nodes. If the cancer has reached these nodes, it means that cancer cells may have spread to other parts of the body such as other lymph nodes organs such as the bones, bladder, or rectum.
When cancer spreads from its original location to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if prostate cancer spreads to the bones, the cancer cells in the new tumor are prostate cancer cells. The disease is metastatic prostate cancer; it is not bone cancer.
Prostate Cancer Factors
The causes of prostate cancer are not well understood and your NEIU physician cannot explain why one man gets prostate cancer and another does not.
Studies have found that the following risk factors are associated with prostate cancer:
- Age - In the United States, prostate cancer is found mainly in men over age 55. The average age of patients at the time of diagnosis is 70.
- Family history of prostate cancer - A man's risk for developing prostate cancer is higher if his father or brother has had the disease.
- Race - This disease is much more common in African American men than in white men. It is less common in Asian and American Indian men.
- Diet and dietary factors - Some evidence suggests that a diet high in animal fat may increase the risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk.
Although a few studies suggested that having a vasectomy might increase a man's risk for prostate cancer, most studies do not support this finding. Scientists have studied whether benign prostatic hyperplasia (BHP) obesity, lack of exercise, smoking, radiation exposure, or a sexually transmitted virus might increase the risk for prostate cancer. There is little evidence that these factors contribute to an increased risk.
Screening for and Detecting Prostate Cancer
At NEIU, we recommend that men have a baseline screening in their 40s. If you have any of the risk factors described above, ask your NEIU physician about screening for prostate cancer. Also, what tests to have, and how often to have them. Your physician may suggest either of the tests described below.
Digital rectal exam -- the physician inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall to check for hard or lumpy areas.
Prostate-Specific Antigen (PSA) is a blood test that measures the levels of PSA in a blood sample. The level of PSA may rise in men who have prostate cancer, BPH, or infection in the prostate.
If any abnormality is felt or the blood test is abnormal, the physician may recommend a biopsy. A biopsy is done with guidance from an ultrasound image and several tiny samples are taken at the same time. The procedure is performed under local anesthesia.
Preparing for Treatment
Your NEIU physician develops a treatment plan to fit your personal needs. Treatment depends on the stage of the disease and the grade of the tumor, indicated by how abnormal the cells look and how likely they are to grow or spread. Other important factors in planning treatment are age, general health and your feelings about the treatments and their possible side effects.
Prostate cancer can be managed in a number of ways. Your physician may recommend watchful waiting, with your health monitored closely, with treatment only if symptoms occur or worsen.
We would want you to consider both the benefits and possible side effects of each option, especially the effects on sexual activity and urination, and other concerns about quality of life.