Prostate cancer is a serious disease that affects thousands of men during middle and late age. Most prostate cancers occur in men older than age 65. It’s estimated that in 2017, 161,360 American men will be newly diagnosed with this condition.
The prostate is a small gland found in a man’s pelvic cavity. It’s located under the bladder and surrounding the urethra. This gland is regulated by the hormone testosterone. It produces seminal fluid, also known as semen. Semen is the substance containing sperm that exits the urethra during ejaculation.
When an abnormal, malignant growth of cells or a tumor forms in the prostate, it’s called prostate cancer. This cancer can spread to other areas of the body. In these cases, it is still called prostate cancer.
Types of prostate cancer
An abnormal growth in the prostate is not necessarily prostate cancer. For instance, it may be a benign prostatic hypertrophy.
Prostate cancer has two types of growths:
- aggressive (fast-growing)
- nonaggressive (slow-growing)
In nonaggressive prostate cancer, the tumor either doesn’t grow or grows very little over time. In aggressive prostate cancer, the tumor can grow quickly and may spread to other areas of the body, such as the bones.
Who’s at risk?
Prostate cancer usually occurs in men older than 65 years. Other risk factors for prostate cancer include:
- older age
- a family history of prostate cancer
- certain ethnicities or race (for instance, African American males are at a greater risk of prostate cancer)
- genetic changes
Symptoms of prostate cancer
Some forms of prostate cancer are nonaggressive, so you may not have any symptoms. However, advanced prostate cancers often cause symptoms.
If you have any of the following signs or symptoms, don’t hesitate to call your doctor. Some symptoms happen with other conditions. If you’re worried that you may have prostate cancer or a related condition, it’s best to see a doctor. They can make sure you receive the correct diagnosis and treatment.
Symptoms of prostate cancer include:
Urinary problems are a common symptom because the prostate is beneath the bladder and surrounding the urethra. Some urinary problems you may have include:
- the frequent need to urinate
- a stream that is slower than normal
- bleeding while urinating, also called hematuria
Sexual dysfunction may also be a symptom of prostate cancer. Other symptoms may include impotence (the inability to maintain an erection) and blood in the semen.
Pain and numbness
Metastatic cancer is cancer that has spread to other areas of the body. When prostate cancer metastasizes, it often spreads to the bones. It can cause pain in the pelvic area, back, or chest. If the cancer spreads to the spinal cord, you may lose sensation in the lower limbs and your bladder.
Diagnosing prostate cancer
Your doctor may diagnose prostate cancer based on a physical exam, your health history, and other tests. These may include:
- Digital rectal exam (DRE): In this exam, your physician will used a gloved finger to inspect your prostate through your rectum. They can feel if there are any hard lumps on your prostate gland that could be tumors.
- Prostate specific antigen (PSA) test: This is a blood test that detects your levels of PSA, a protein produced by the prostate. High levels may indicate prostate cancer, though other conditions can also cause high levels of PSA.
- Prostate biopsy: Your doctor may order a biopsy to help them confirm a prostate cancer diagnosis. For a biopsy, a healthcare professional removes a small piece of your prostate gland for examination.
- Other tests: Your doctor may also do magnetic resonance imaging (MRI), a bone scan, or a computed tomography (CT) scan.
If you’ve had a prostate biopsy, you’ll receive a Gleason score. This score is how pathologists classify prostate cancer cells. A score lower than six means that your cells do not show signs of cancer, so your risk is low.
A score of 7 with a PSA level between 10–20 ng/mL means that cancer cells have been identified, but the cancer is likely nonaggressive, with slow-growing cells.
A Gleason score of 8 or higher with PSA levels greater than 20 ng/mL indicate a more advanced tumor. That means your risk of an aggressive cancer is higher.
PSA test recommendations
The American Urological Association and the U.S. Preventive Services Task Force no longer recommend the PSA blood test for screening for prostate cancer. This is because the risks of unnecessary follow-up procedures outweigh the benefits. The PSA blood test checks the amount of prostate-specific antigen that is in your blood. However, there are many reasons why you could have a high amount of PSA in your blood, so the test results can lead to a misdiagnosis and unnecessary treatment.
However, the PSA test is still appropriate in certain cases. If you already have a confirmed case of prostate cancer, this test is still approved for staging or grading the cancer. Before you consider having a PSA blood test, consult with your physician about the risks.
Treating prostate cancer
If you’re diagnosed with prostate cancer, your treatment will depend on how severe your cancer is and whether it has spread. If the cancer is nonaggressive, your physician may recommend watchful waiting or active surveillance.
Other treatment options include:
- hormone therapy
Your physician will develop an appropriate treatment plan for your cancer based on your age, health status, and the stage of your cancer.
If prostate cancer is diagnosed early and has not metastasized from the origin tumor, your outlook is usually good. Early detection and treatment are key to a positive outcome. If you think you have symptoms of prostate cancer, schedule an appointment with your doctor right away.
Recently, the guidelines for screening for prostate cancer have changed. Screening is now recommended every two years for men ages 55 to 69. You should weigh the risks and benefits of screening with your care provider.
If you’re at high risk of prostate cancer, such as if you have a family history of the disease or are of African American descent, talk to your doctor. They can help you understand the risks and benefits of screening before age 55.
- lean meat
- whole grains
Regular exercise may also help reduce your risk. Aim for 30 minutes of exercise most days of the week.