Prostate Cancer: What You Need to Know
Prostate cancer affects as many as 250,000 men in the United States every year, and it is the second leading cause of cancer-related deaths. Learn who is at risk, warning signs, discussion topics for you and your doctor, latest treatments, and more.
What is prostate cancer?
Prostate cancer occurs in the small, walnut-sized gland called the prostate that sits just below a man’s bladder. One in six men in the United States will be diagnosed with prostate cancer in their lifetimes. It is the second most common cancer in the United States, and each year about 30,000 men die from it.
What causes prostate cancer?
Like other types of cancer, prostate cancer begins when cells in the prostate begin growing and dividing more rapidly than normal cells. When other cells complete their lifespan, they die off. Cancer cells continue living and reproducing. As these abnormal cells accumulate, they can develop into a tumor. This tumor can eventually spread (metastasize) to nearby tissue, organs, and eventually bones.
How do doctors screen for prostate cancer?
Prostate-specific antigen (PSA) screenings detect the amount of PSA in the blood. PSA is a protein produced by the prostate gland, and when the gland is affected by cancer, infection, inflammation, or enlargement, it releases higher than normal levels of the substance.
As part of a regular physical, doctors may begin performing a digital rectal exam (DRE) on men around the age of 50 or in those with risk factors for the cancer. If the doctor detects any changes or abnormalities, he may suggest an ultrasound to check for the presence of a tumor.
What’s a Gleason score?
The results of a PSA test and a DRE are reported as a Gleason score. The higher the Gleason score, the more likely it is that the prostate cancer has spread past the prostate into nearby tissue, organs, or bones.
How to read a Gleason score:
- 2 through 5 – Early-stage prostate cancer. This cancer has likely not progressed past the prostate.
- 6 or 7 – Intermediate-stage prostate cancer. Many prostate cancers are found when they have reached this category.
- 8 through 10 – Advanced-stage prostate cancer. It’s likely the cancer has spread outside the prostate.
What are the symptoms of prostate cancer?
The most common symptoms of prostate cancer include trouble urinating, decreased force when urinating, blood in the urine and semen, swelling in the legs, discomfort in the pelvis and hips, and pain with ejaculation. For some men, prostate cancer can develop for months or years before it begins causing symptoms.
Who is at risk?
The following factors increase a man’s risk of prostate cancer:
- Age. Prostate cancer is most common in men over 65, but the likelihood of developing prostate cancer begins increasing at age 50.
- Race. African American men have a higher risk while Asian men have the lowest risk.
- Family history. Men with a family history of prostate cancer have an increased risk of developing the cancer. The closer the relation, the higher your chances.
- Obesity. Overweight and obese men are more likely to have prostate cancer than men of a healthier weight.
Who should be checked?
Health-care professionals and doctors differ in their thoughts about who should have regular PSA screenings. According to the U.S. Preventive Services Task Force, the tests are seldom beneficial. Some men may receive a “false-positive” result and choose to have treatment that might not be necessary. It’s important to note that an increasing PSA level is not always a sign of cancer—it can indicate an infection, inflammation, or enlargement, too. Prior to having a PSA test, you could consult with your doctor about your risks for prostate cancer and make your decision accordingly.
What are traditional treatments?
Men with prostate cancer have several treatment options. These options include:
- Removal of the prostate gland (radical prostatectomy)
- Radiation therapy – high-energy radiation that can shrink and kill cancer cells
- Chemotherapy – drug treatment that uses chemicals to kill cancer cells
- Hormone therapy – stops the body from producing the hormone testosterone, which prostate tumors use to grow
- Brachytherapy – radioactive seeds are placed in or near the tumor to shrink and kill it
- Cryosurgery – freezing tissue to kill cancer cells
- Ultrasound therapy – heating the prostate tissue to kill cancer cells
Advances in treatment
In 2010, the U.S. Food and Drug Administration approved the first-ever cancer treatment vaccine, Provenge. The Provenge vaccine has been found to extend the lives of men with advanced-stage prostate cancer. Many researchers are unsure if the short addition to a man’s life (about four months) is the result of the vaccine or just an anomaly with the research. Additional research is being done to determine if this vaccine is as useful to the treatment of prostate cancer as was once hoped.
Talk to your doctor.
The earlier prostate cancer is found, the better. Early-stage prostate cancers can often be treated and cured, but advanced-stage prostate cancer becomes harder to treat. Plus, the treatments that are usually most effective for advanced prostate cancer tend to have the most negative side effects. These include urinary incontinence and erectile dysfunction. Based on your individual risk for the disease, your lifestyle, and your age, you and your doctor can decide how often you should be screened and when those screenings should start.