Prostate Cancer: What All Men Must Know

Prostate cancer is the second most common cancer in American men after skin cancer. African-American men have the highest rate of prostate cancer in the world. Men with family histories of the disease are also at greater risk. In addition, the risk for prostate cancer increases with age. It most often appears after age 50.

The prostate gland is part of the male reproductive system. It produces semen, the fluid that carries sperm. The prostate gland is found below the bladder and in front of the rectum. Normally, the prostate is about the size of a walnut. As a man gets older, the prostate often becomes enlarged. More than one-half of American men over the age of 60 have some enlargement of the prostate. This is not usually caused by cancer but could possibly cause other problems.

What is Cancer of the Prostate?

Prostate cancer is a cancer that starts in the prostate gland. Cancer causes cells in the body to change and grow out of control. Most types of cancer form a lump or a growth called a tumor. If there is a cancerous tumor in the prostate, a man may not know it. Most cases of prostate cancer develop very slowly. However, in some men, it can grow quickly and spread to other parts of the body.

What Causes Prostate Cancer?

While the exact causes of prostate cancer are not known, certain risk factors have been linked to prostate cancer. A risk factor is something that increases a person's chance of getting a disease. Aging is the greatest risk factor for prostate cancer. Family history also plays a role. If a man's father or brother has cancer of the prostate, his risk is two to three times greater than average. Diet may also be a factor. Men who eat large amounts of animal fat, particularly fats from red meat, may face a greater risk of prostate cancer than men who eat less animal fat.

What are the Symptoms Of Prostate Cancer?

Often, there are NO symptoms in the early stages of prostate cancer. If symptoms DO occur, they can vary, depending on the size and exact location of the lump or the growth in the prostate. Since the prostate surrounds the urethra, the tube that carries urine and semen, any change in the prostate can cause problems with urination and ejaculation. However, similar symptoms can be caused by a number of things, including an infection or a non-cancerous condition called benign prostatic hyperplasia (BPH).

If a man has any problems with weak or interrupted flow or pain while urinating, painful ejaculation, blood in the urine or semen, or, a nagging pain in the back, hips or pelvis, he should see a health care provider or an urologist to find out what's going on. A health care provider may order tests to determine the cause of the symptoms.

What Type of Exam is Used to Detect Prostate Cancer?

Your health care provider may feel for any unusual lumps or growths on the prostate by pressing on it or using a gloved finger inside the rectum (digital rectal exam or DRE). Your health care provider may also order a blood test. This blood test measures the level of prostate-specific antigen (PSA), a protein that is produced by the prostate. Higher than expected levels of PSA may mean that a tumor is present. However, high PSA levels may also be caused by an infection or an enlarged prostate. Talk with your health care provider about the tests that are right for you.

What Happens if They Find Something?

If your health care provider finds something suspicious, more tests may be needed. Often, the problem may be just an enlarged prostate or a simple infection. Further tests, including urinalysis, blood tests, x rays, ultrasound or a biopsy, may help diagnose your problem. Your health care provider may refer you to an urologist or other specialists for some of these tests and for any needed treatments.

What if I am Told That I Have Prostate Cancer?

You should get a second opinion before undergoing any treatment. Second opinions are covered under most health insurance plans in New York State, including Medicare and Medicaid. Seek advice from a specialist (urologist, surgeon, radiologist or oncologist) who has extensive experience in the diagnosis and treatment of prostate cancer.

Not all treatments work for everyone. However, you have the right to know all the choices you have and to play an active part in treatment decisions.

Additional information is available to the public through the American Cancer Society 1-800-ACS-2345 and the National Cancer Institute's (NCI) Cancer Information Service 1-800-4-CANCER. Many communities offer prostate cancer education and support programs that can provide you with help as you make your decisions and undergo treatment.

What is the Treatment?

The earlier prostate cancer is detected, the more options that are available. Surgery, radiation therapy (either external beam or internal seed implants), hormone therapy or some combination of these are all commonly used. Depending on your age and condition, and your wishes, your health care provider may recommend only that you be watched and tested several times a year. Some urologists feel that, for men over age 70, the risks of surgery or radiation treatment outweigh any benefits. Therefore, they recommend "watchful waiting". If you are younger and in good health, your health care provider will be more likely to recommend that the cancer be treated. Any treatment may have side effects. Talk with your health care providers about your treatment options. Make sure you understand the risks, benefits and chances of success.

For More Information

For more information about prostate cancer or for an examination, see your health care provider. To learn more about any kind of cancer, call the NCI's Cancer Information Service at 1-800-4-CANCER (or, visit their web site at www.nci.nih.gov) or the American Cancer Society at 1-800-ACS-2345 (or, visit their web site at www.cancer.org).