Prostate cancer is the most common cancer in men over age 50. It is the cause of the most cancer deaths after lung cancer. One man in 10 in the United States will develop prostrate cancer, and perhaps one in 30 will die from it. Often there are no symptoms in the early stages.
The prostate is a cluster of small glands found at the base of the bladder in men. Cancerous cells can grow in this gland. Most prostate cancers are discovered during a routine physical exam. If they are not discovered early and are allowed to grow, they can make urination uncomfortable. Some prostate cancers spread, while others never do. If they spread, they can cause pain in the lower back or pelvis. Prostate cancer that spreads into the bones, bladder, or other organs can be fatal.
Every year an estimated 200,000 new cases of prostate cancer are diagnosed, and about 38,000 men die of it. The causes of this disease are not fully understood.
Risk factors include:
- aging (98% of cases are diagnosed in men over 55)
- family history of prostate cancer
- ethnicity (African-American men are at higher risk)
- smoking
- eating a high-fat diet
- occupation (welders, battery manufacturers, rubber workers, and those exposed to cadmium are at higher risk)
As men age, the prostate enlarges. As it grows, it may develop growths or nodules. Most of the time these growths are normal tissue; in this case, the condition is called benign prostatic hypertrophy (BPH). When the growth is cancerous, the cancer cells are often so small and grow so slowly that they are not life-threatening. If the cancer tumors do reach a certain size, they can spread from the prostate to bones or other organs. In such cases the cancer can be fatal.
Symptoms of prostate cancer include:
- frequent urination, especially at night
- difficulty stopping or starting urinating
- weak or interrupted urination
- painful or burning urination or ejaculation
- blood in urine or semen
- constant dull pain in the lower back, pelvis, or thighs
- arthritic pain in the lower back, pelvis, or thighs
- loss of weight, loss of appetite, fatigue, nausea, and vomiting
The most common way to screen for prostate cancer is through a rectal exam. The doctor sticks a gloved finger inside the rectum and feels for any abnormalities in the prostate. By itself, this method is not always reliable. Two-thirds of the growths found in this way are not cancerous, while quite a few cancers may go undetected.
The prostate-specific antigen test (PSA) is a blood test that has made diagnosis easier. This test measures a protein produced in the prostate that may increase when cancer is present. However, not all cancers cause this protein to increase, so a negative PSA test does not necessarily mean the patient is cancer-free. On the other hand, a positive PSA test may also be a false alarm. When the PSA blood test is combined with a rectal exam, it increases the chance of detecting prostate cancer by one-third.
If prostate cancer is suspected, a specialist (urologist or oncologist) may perform a biopsy on the prostate. A small sample of the prostate tissue will be removed to determine whether or not it is cancerous.
If the biopsy shows that a patient has prostate cancer, other organs, such as the kidneys and bladder, may need to be examined by X-ray or ultrasound. The doctor may also look inside the bladder with a viewing tube (cystoscope) to see if any cancer has spread, or use a CT scan to see if the cancer has spread into the bones.
Doctors are looking for ways to determine which cancers will spread and which will stay within the prostate. Testing for one protein called KAl-1 seems to be a reliable indication of the likelihood of the cancer spreading.
It is important to diagnose prostate cancer early! Men over age 50 should have a yearly rectal examination. Consider the PSA blood test as well if you have any of the stated risk factors.
Do what you can to prevent prostate cancer. Don’t smoke, and eat a well-balanced, high-fiber, low-fat diet. Be especially careful about eating red meat and animal fat. They are believed to increase risk of prostate cancer by stimulating hormone production. Cooking meat at high temperatures also produces carcinogens which affect the prostate directly. Poach or roast meat instead of frying or barbecuing. Or eat fish or poultry instead or red meat, and remove the skin from poultry.
Educate yourself. The various treatments for prostate cancer are controversial. More men live with prostate cancer than die from it, and some treatments have side effects. Treatments roughly divide into those that aim to cure the cancer, and those that aim to control the symptoms.
If prostate cancer is discovered, doctors will usually recommend surgery to remove the prostate gland and, possibly, the testes. This can be a cure if the cancer is found early enough. However, surgery may lead to impotence, incontinence, or other complications.
Radiation therapy may be recommended instead of surgery in the early stages. Possible side effects of radiation therapy include fatigue, diarrhea, discomfort when urinating, dry skin, and nausea.
If the cancer has already spread to other areas of the body, the patient may also receive hormone treatment. Hormone treatment aims to decrease the body’s level of testosterone, which stimulates the growth of prostate cancer. This can be done either by surgery or by using estrogen to block the production of testosterone. These treatments usually are able to control the symptoms of prostate cancer, avoid disability, and prolong the patient’s life. All survivors of prostate cancer should have regular physical examinations and monitor their PSA levels closely.
