Prostate Cancer: What You Need to Know

Written by Kimberly Holland and Valencia Higuera | Published on March 10, 2015
Medically Reviewed by The Healthline Medical Team on March 10, 2015

Overview

It’s estimated that more than 2.5 million men are living with prostate cancer in the United States. It’s the second leading cause of cancer-related deaths among men.

Read through this article to learn who’s at risk, warning signs, latest treatments, discussion topics for you and your doctor, and more.

What Is Prostate Cancer?

The prostate is a small, walnut-sized gland that sits just below a man’s bladder. One in seven men in the United States will be diagnosed with prostate cancer in in their lifetimes. It’s the second most common cancer in the United States, and each year almost 30,000 men die from it, according to the American Cancer Society.

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 tissues, organs, lymph nodes, 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 its level can be measured through a simple blood test. When the gland is affected by cancer, infection, inflammation, or enlargement, it releases higher than normal levels of the enzyme.

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. An ultrasound may be needed to check for the presence of a tumor.

What’s a Gleason Score?

PSA and DRE test results are reported as a Gleason score. The higher the Gleason score, the more likely the prostate cancer has spread into nearby tissue, organs, or bones.
 
How to read a Gleason score:

  • 2 through 5: Early-stage prostate cancer. The cancer probably hasn’t 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
  • increased frequency of urination
  • decreased force when urinating
  • blood in the urine and semen
  • swelling in the legs
  • discomfort in the pelvis or rectal region
  • pain with ejaculation

Prostate cancer can develop for months or years before it begins causing symptoms for some men.

Who’s 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 increases after 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. These tests are seldom beneficial, according to the Prostate Cancer Foundation. 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 increased PSA level isn’t always a sign of cancer. It can indicate an infection, inflammation, or enlargement, too. Before undergoing a PSA test, you should consult with your doctor about your risks and make your decision accordingly.

What Are Traditional Treatments?

Men with prostate cancer have several treatment options. These 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 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 immunotherapy vaccine, Provenge. The Provenge vaccine has been found to extend the lives of men with advanced-stage prostate cancer. Researchers are also developing newer forms of treatment for prostate cancer, such as high-intensity focused ultrasound therapy to destroy cancer cells, and targeted therapy drugs to stop the growth of cancerous cells. Doctors are also looking into the use of radio frequency ablation to reduce pain in men with prostate cancer.

Talk to Your Doctor

The earlier prostate cancer is found, the better. Early-stage prostate cancers can often be treated, 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 at what age those screenings should start.

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