Prostate Cancer

Basic Information About Prostate Cancer

Cancer is a disease in which abnormal cells in the body grow out of control. Cancers are usually named after the part of the body where the abnormal cell growth begins. Prostate cancers are cancer cells from the prostate. When prostate cancer cells spread to other parts of the body, they are called metastases.

What Is the Prostate?

The prostate is a part of the male reproductive system, which includes the penis, prostate, and testicles. The prostate is located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). The job of the prostate is to produce fluid that makes up a part of semen. As men age, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow.


This diagram shows the location of the prostate, in front of the rectum and just below the bladder.

Symptoms
Different people have different symptoms for prostate cancer. Some men do not have symptoms at all.

Some symptoms of prostate cancer are—

* Difficulty starting urination.
* Weak, or interrupted flow of urine.
* Frequent urination, especially at night.
* Difficulty emptying the bladder completely.
* Pain or burning during urination.
* Blood in the urine or semen.
* Pain in the back, hips, or pelvis that doesn't go away.
* Painful ejaculation.

If you have any symptoms that worry you, be sure to see your doctor right away. Keep in mind that these symptoms may be caused by conditions other than prostate cancer.

Risk Factors

Research has found risk factors that increase your chances of getting prostate cancer. These risk factors include—

* Age: The older a man is, the greater his risk for getting prostate cancer.1
* Family history: Certain genes (the functional and physical units of heredity passed from parent to offspring) that you inherited from your parents may affect your prostate cancer risk. Currently, no single gene is sure to raise or lower your risk of getting prostate cancer. However, a man with a father, brother, or son who has had prostate cancer is two to three times more likely to develop the disease himself.1
* Race: Prostate cancer is more common in some racial and ethnic groups than in others, but medical experts do not know why.

Researchers are trying to determine the causes of prostate cancer and whether it can be prevented. They do not yet agree on the factors that can influence a man's risk of developing the disease, either positively or negatively. Some of the factors under study include—1 2 3 4

* Vitamins, minerals, and herbal supplements.
* Diets high in animal fat, especially polyunsaturated fat.
* Men's hormone levels.
* Environmental agents (pesticide residues on foods, and industrial and occupational exposures).

Screening

Prostate cancer screening means looking for cancer before it causes symptoms. This helps to find cancer at an early stage when it may be easier to treat.

Tests that are commonly used to screen for prostate cancer are—

* Digital rectal exam (DRE): A doctor or nurse will insert a gloved, lubricated finger into the rectum to feel the prostate. This allows the examiner to estimate the size of the prostate and feel for any lumps or other abnormalities.
* Prostate specific antigen test (PSA): The PSA test is a blood test that measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands produce more PSA than others. PSA levels also can be affected by—

* Certain medical procedures.
* An enlarged prostate.
* A prostate infection.

Because many factors can affect PSA levels, your doctor is the best person to interpret your PSA test results.

Should I Get Screened for Prostate Cancer?

Not all medical experts agree that screening for prostate cancer will save lives. Currently, there is not enough evidence to decide if the potential benefits of prostate cancer screening outweigh the potential risks.

Potential benefits of prostate cancer screening include—

* Screening can detect cancers early.
* Treatment for prostate cancer may be more effective when it is found early.

Potential risks of prostate cancer screening include—

* False positive test results (indicating that you have prostate cancer when in fact you do not) that lead to further tests and can cause anxiety.
* Treatment of some prostate cancers that may have never affected a man's health even if left untreated.
* Treatment may lead to serious side effects such as impotence (inability to keep an erection) and incontinence (inability to control the flow of urine, resulting in leakage).

CDC and other federal agencies follow the prostate cancer screening guidelines set forth by the U.S. Preventive Services Task Force,External Web Site Icon which state that there is insufficient evidence to recommend for or against routine screening for prostate cancer using PSA or DRE.

Informed Decision Making

Given the uncertainty about the benefit of screening, CDC supports informed decision making. Informed decision making occurs when a man—

* Understands the nature and risk of prostate cancer.
* Understands the risks of, benefits of, and alternatives to screening.
* Participates in the decision to be screened or not at a level he desires.
* Makes a decision consistent with his preferences and values.

CDC has developed materials about prostate cancer screening which are designed to promote discussions between men and physicians and to help men make informed decisions about prostate cancer screening.

Diagnosis

If your prostate specific antigen test (PSA) or digital rectal exam (DRE) is abnormal, doctors may do additional tests to find or diagnose prostate cancer.

* Transrectal ultrasound: A probe the size of a finger is inserted into the rectum, and high-energy sound waves (ultrasound) are bounced off the prostate to create a picture of the prostate called a sonogram. This test may be used during a biopsy.
* Biopsy: A small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells.
o Gleason score: This score is determined when the biopsy is looked at under the microscope. If there is a cancer, the score indicates how likely it is to spread. The score ranges from 2–10. The lower the score, the less likely it is that the cancer will spread. For more information, visit the National Cancer Institute's (NCI) Prostate Cancer.

For more information about diagnosis, visit NCI's Prostate Cancer Detection and Diagnosis.

Staging

If prostate cancer is diagnosed, tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. This process is called staging. Whether the cancer is only in the prostate, or has spread outside the prostate, determines your stage of prostate cancer. The stage of prostate cancer tells doctors what kind of treatment is needed.

Treatment

Different types of treatment are available for prostate cancer. You and your doctor will decide which treatment is right for you. Some common treatments are—

* Active surveillance (watchful waiting): This consists of closely monitoring the patient's prostate cancer by performing the PSA and DRE tests regularly, and treating it only if and when the prostate cancer causes symptoms or shows signs of growing.
* Surgery (radical prostatectomy): Prostatectomy is surgery to remove the prostate completely. Radical prostatectomy removes the prostate as well as the surrounding tissue.
* Radiation therapy: Radiation destroys cancer cells, or prevents them from growing, by directing high-energy X-rays (radiation) at the prostate. There are two types of radiation therapy—
o External radiation therapy: A machine outside the body directs radiation at the cancer cells.
o Internal radiation therapy (brachytherapy): Radioactive seeds or pellets are surgically placed into or near the cancer to destroy the cancer cells.
* Hormone therapy: This treatment uses drugs, surgery, or other hormones to remove male sex hormones or block them from working, which prevents cancer cells from growing.

Other therapies used in the treatment of prostate cancer that are still under investigation include—

* Cryotherapy: Placing a special probe inside or near the prostate cancer to freeze and kill the cancer cells.
* Chemotherapy: Using special drugs to shrink or kill the cancer. The drugs can be pills you take or medicines given through an intravenous (IV) tube, or, sometimes, both.
* Biological therapy: This treatment works with your body's immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments. Biological therapy is different from chemotherapy, which attacks cancer cells directly.
* High-intensity focused ultrasound: This therapy directs high-energy sound waves (ultrasound) at the cancer to kill cancer cells.

For more information, visit the National Cancer Institute's (NCI) Prostate Cancer Treatment Option Overview.External Web Site Icon This site can also help you find a doctor or treatment facilityExternal Web Site Icon that works in cancer care. Visit Facing Forward: Life After Cancer TreatmentExternal Web Site Icon for more information about treatment and links that can help with treatment choices.
Clinical Trials

If you have prostate cancer, you may want to take part in a clinical trial. Clinical trials are research studies that help find new treatment options. Visit the NCI and National Institutes of Health (NIH) sites listed below for more information about finding clinical trials.

* Introduction to Clinical TrialsExternal Web Site Icon (NCI)
* Search for Clinical TrialsExternal Web Site Icon (NCI)
* ClinicalTrials.govExternal Web Site Icon (NIH)

Complementary and Alternative Medicine

Complementary medicine is a group of medicines and practices that may be used in addition to the standard treatments for cancer. Alternative medicine means practices or medicines that are used instead of the usual, or standard, ways of treating cancer. Examples of complementary and alternative medicine are meditation, yoga, and dietary supplements like vitamins and herbs.

Complementary and alternative medicine does not treat prostate cancer, but may help lessen the side effects of the cancer treatments or of the cancer symptoms. It is important to note that many forms of complementary and alternative medicines have not been scientifically tested and may not be safe. Talk to your doctor before you start any kind of complementary or alternative medicine.

For more information about complementary and alternative medicine, visit NCI's Complementary and Alternative Medicine.External Web Site Icon
Which Treatment Is Right for Me?

Choosing which kind of treatment is right for you may be hard. If you have prostate cancer, be sure to talk to your doctor about the treatment options available for your type and stage of cancer. Doctors can explain the risks and benefits of each treatment and their side effects.

Source : www.cdc.gov