Prostate Cancer

What is prostate cancer?

Prostate cancer is the abnormal growth of cells in a man's prostate gland . The prostate sits just below the bladder. It makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. It usually grows larger as you grow older.

Prostate cancer is common in men older than 65. It usually grows slowly and can take years to grow large enough to cause any problems. Most cases are treatable, because they are found with screening tests before the cancer has spread to other parts of the body. Although most men may die with prostate cancer, most men do not die from it.

Experts don't know what causes prostate cancer, but they believe that your age, family history (genetics), and race affect your chances of getting it. What you eat, such as foods high in fats, may also play a part.

What are the symptoms?

Prostate cancer usually does not cause symptoms in its early stages. Most men don't know they have it until it is found during a regular medical exam.

When problems are noticed, they are most often problems with urinating. But these same symptoms can also be caused by an enlarged prostate (benign prostatic hyperplasia). An enlarged prostate is common in older men.

See your doctor for a checkup if:

• You have trouble starting your urine stream.
• You have a weaker-than-normal urine stream.
• You cannot urinate at all.
• You have to urinate often.
• You feel like your bladder is not emptying completely when you urinate.
• You have to get up at night to urinate.
• You have pain or burning when you urinate.
• You have blood in your urine.
• You have a deep pain in your lower back, belly, hip, or pelvis.

How is prostate cancer diagnosed?

The most common way to check for prostate cancer is to have a digital rectal exam, in which the doctor puts a gloved, lubricated finger in your rectum to feel your prostate, and a prostate-specific antigen (PSA) blood test. A higher level of PSA may mean that you have prostate cancer, but it could also mean that you have an enlargement or infection of the prostate.

If your PSA is high, or if your doctor finds anything during the rectal exam, he or she may do a biopsy to figure out the cause. A biopsy means your doctor takes a sample of tissue from your prostate gland and sends it to a lab for testing.

Because many men have regular checkups, about 9 out of 10 prostate cancers are found in the early stages, with a 5-year survival rate of almost 100%. The 5-year survival rate shows the percentage of men still alive 5 years or longer after diagnosis. It’s important to remember that everyone’s case is different, and these numbers may not show what will happen in your case.

Should you have regular tests for prostate cancer?

It is important to have regular health checkups, including a digital rectal exam. But experts disagree on whether regular PSA testing is right for all men. Testing could lead you to have cancer treatment that can cause other health problems, especially loss of bladder control and not being able to have an erection.

So talk with your doctor. Ask about your risk for prostate cancer, and discuss the pros and cons of PSA testing.

How is prostate cancer treated?

Your treatment will depend on what kind of cancer cells you have, how far they have spread, your age and general health, and your preferences.

You and your doctor may decide to treat your cancer with surgery, radiation, hormone therapy, or a combination. Or, if the cancer has not spread and you are around age 70 or older, you may be able to wait and watch to see what happens. During watchful waiting, you will have regular checkups with your doctor to see if your cancer has changed.

Choosing treatment for prostate cancer can be confusing. Talk with your doctor to choose the treatment that is best for you.

How can treatment affect your quality of life?

Your age and overall health will make a difference in how treatment may affect your quality of life. Any health problems you have before you are treated, especially urinary, bowel, or sexual function problems, will affect how you recover.

Both surgery and radiation can cause urinary incontinence (not being able to control urination) or impotence (not being able to have an erection). The level of urinary incontinence and how long it lasts and the quality of the erections a man has after treatment will depend on whether the cancer has spread. These also depend on what treatment is used.

Nerves that help a man have an erection are right next to the prostate. Surgery to remove the cancer may damage these nerves. Many times a special form of surgery, called nerve-sparing surgery, can preserve the nerves. But if the cancer has spread to the nerves, they may have to be removed during surgery.

These same nerves can also be damaged by the X-rays that are used in radiation therapy.

Medicines and mechanical aids may help men who are impotent because of treatment. Some men recover part or most of their ability to have an erection several months or even years after surgery.

References:

Bets Davis, MFA