Prostate cancer is the second most common cancer among men in the United States. In many cases, the cancer develops slowly and is generally not accompanied by symptoms at the early stages. An estimated one in six U.S. men will be diagnosed with this disease. The good news is that early detection improves outcomes, and more than 2 million US men alive today have survived prostate cancer. The prostate is a gland exclusive to men, about the size of a walnut and located under the bladder. The prostate grows as a man reaches his adult years and is maintained at adult size for as long as male hormones are being produced.
Men (and the women in their lives) can help reduce prostate cancer's risks by knowing when to get screened and seek treatment. The American Urological Association (AUA) recommends that early detection and risk assessment for prostate cancer should be offered to men 40 years of age or older who have a life expectancy of at least 10 years. Men who wish to be screened should have both a blood test (Prostate Specific Antigen—PSA) and a prostate exam (Digital Rectal Exam—DRE).
Symptoms and Diagnosis
Early prostate cancer usually has no symptoms, so most prostate cancers are diagnosed through the routine screenings mentioned above.
Symptoms of a more advanced disease may include:
- Weak or interrupted urine flow
- Inability to urinate
- Difficulty starting or stopping the flow of urine
- Increases need to urinate, especially at night
- Blood in the urine
- Pain or burning with urination.
It is important to note that these symptoms occur frequently as a result of non-cancerous conditions as well, such as prostate enlargement (Benign Prostate Hyperplasia or BPH) or infection. If routine screenings indicate a potential problem, a biopsy may be recommended by your doctor.
When prostate cancer is suspected, a core needle biopsy is frequently performed to confirm the diagnosis. By examining the biopsied tissue under a microscope, experts can determine whether cancer is present, its stage, rate of growth and susceptibility to treatment options. Additional tests may be required to determine if the cancer has spread beyond the prostate.
Causes and Risk Factors
Many studies have investigated the causes of prostate cancer. They include:
- Age: Prostate cancer rates increase until about age 70, declining thereafter.
- Family history: Men with a father or brother with prostate cancer are two to three times more likely to develop the disease themselves.
- Race/ethnicity: Prostate cancer rates reflect genetic factors that vary across different parts of the world. High risk of prostate cancer is found in many populations with sub-Saharan African ancestry, while low risk is found in many populations with Asian ancestry.
- Physical inactivity or a sedentary lifestyle
As with many cancers, there are a variety of treatment options for men who develop prostate cancer. Speaking with doctors who specialize in different kinds of treatment may be helpful. You will want to weigh the benefits of each treatment against its possible outcomes, side effects and risks. There are four typical treatments for prostate cancer.
- Active surveillance monitors the course of your disease and intervenes if the cancer progresses. Active surveillance is often offered to men who are at low risk for the disease or have a life expectancy shorter than the speed of the cancer growth. Monitoring involves PSA blood testing every three to six months and digital rectal exams every six to 12 months. It also may include regular biopsies.
- Prostatectomy is a surgery that removes of the prostate along with nearby tissues. Lymph nodes may also be removed to determine whether the disease has spread. Several approaches can be used for prostatectomy, including Holland Hospital's minimally invasive da Vinci Robotic Assisted Surgery.
- Radiation therapy for prostate cancer includes external beam radiation and brachytherapy.
- Androgen deprivation therapy (ADT), or hormone therapy, alters the effects of male hormones on the prostate through antiandrogen medications and/or surgery. By reducing the effect of male hormones in the prostate, androgen deprivation therapy can slow the rate of tumor growth.
There's no proven method for preventing prostate cancer, but there are several ways to lower your risk:
- Have annual screenings beginning at age 50 (or age 40 if high-risk)
- Eat a healthy diet
- Increase your activity level
- Lower stress.