Prostate cancer is the growth of malignant cells in the prostate gland, one of the male sex glands. The prostate, which produces a fluid that becomes semen, is walnut-sized, lies below the bladder, and surrounds the urethra. Prostate cancer is the most common cancer found in men and usually occurs after age fifty, with the vast majority of cases diagnosed after age sixty-five. This cancer is usually slow growing; however, it can be aggressive, especially in younger men.
Although the cause of prostate cancer is unknown, several risk factors are associated with the disease: age; African-American heritage; family history (especially a brother or father diagnosed and especially if the cancer occurred at an early age); high fat diet; and frequent exposure to rubber or cadmium. In addition, high plasma testosterone levels may be associated with increased risk.
Although prostate cancer may present no symptoms and may be found in routine physical exams, common symptoms include: problems with urination (e.g., frequent, difficult, or painful); difficulties with erection or ejaculation; blood in semen or urine; and stiffness or pain in thighs, hips, or back. However, these symptoms are associated with other noncancerous conditions as well.
Prostate cancer is curable if detected early, but a lack of symptoms can lead to later detection. The two most common screening methods are digital rectal exams (physician inserts finger in rectum) and blood tests (checking prostate-specific antigen or prostatic acid phosphatase). Other testing methods include urine tests (checking for blood or infection), transrectal ultrasonography (using rectal probe producing sound waves to try to locate tumors), intravenous pyelogram (X-rays of urinary tract), cystoscopy (examining the urethra and bladder with a lighted tube), and biopsy (removing and examining prostate tissue sample). A biopsy is the most definitive test.
Treatment recommendations vary based on the extent of the cancer, a person's age and health, and the amount of risk involved in the procedure. For cancer that is detected early and growing slowly, watchful waiting (periodic assessment of the cancer growth without actively treating it) may be the best approach—particularly for older patients and those with other medical problems. Removing the cancer, adjacent tissue, and possibly close lymph nodes through surgery is another option. This treatment is usually reserved for those under seventy and in good health. Risks involved in surgery include impotence and compromised stool and urine control.
Radiation, which targets malignant cells and shrinks tumors, is another common combatant to prostate cancer. It can be external (targeted from outside of the body) or internal (implanted into the prostate) and may also result in impotence and problems with urination. Hormone therapy is a fourth option that lowers male hormone levels, which can slow cancerous growth and shrink tumors. It can involve surgery (the removal of one or both testicles), taking drugs to help lower or prevent male hormone production, or both. Side effects for this type of procedure include hot flashes, bone weakening, impaired sexual function, heart attacks, and strokes. Among the other options to choose from are chemotherapy, cryosurgery, focused ultrasound, experimental radiation therapies, herbal treatment, and biological therapy.
Generally, agencies recommend that men have yearly digital rectal exams and blood tests after the age of fifty. Men with greater risk factors should begin screening earlier.
American Cancer Society. Available from http://www.cancer.org.
National Cancer Institute. "Prostate Cancer." Available from http://www.cancer.gov/cancertopics/types/prostate.
Prostate Cancer Foundation. Available from http://www.prostatecancerfoundation.org.
Joy L. Hart