Prostate and Prostate Cancer

What is the prostate?

The prostate is a walnut-sized gland that only men have. It is part of the reproductive system that makes the fluid that carries sperm. As you can see in the picture below, the prostate is located in front of the rectum and just below the bladder. The urethra (the tube that carries urine from the bladder to outside the body) runs through the center of the prostate. As men age, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow.

What is prostate cancer?

Prostate cancer is made up of cells that do not grow normally. The cells divide and create new cells that the body does not need, forming a mass of tissue called a tumor. These abnormal cells sometimes spread to other parts of the body, multiply, and cause death.

What causes prostate cancer?

As with many types of cancers, medical experts do not know what causes prostate cancer. They are studying several possible causes.

Can prostate cancer be prevented?

Medical experts do not know how to prevent prostate cancer, but they are studying many factors. They do know that not smoking, maintaining a healthy diet, staying physically active, and seeing your doctor regularly contribute to overall good health.

Who is at increased risk for prostate cancer?

While all men are at risk for prostate cancer, some factors increase risk:
Family history. Men with a father or brother who has had prostate cancer are at greater risk for developing it themselves.
Race. Prostate cancer is more common in some racial and ethnic groups than in others, but medical experts do not know why. Prostate cancer is more common in African-American men than in white men. It is less common in Hispanic, Asian, Pacific Islander, and Native American men than in white men.

Is prostate cancer serious?

Some prostate cancers become a serious threat to health by growing quickly, spreading beyond the prostate gland to other parts of the body, and causing death. Yet other prostate cancers grow slowly and never become a serious threat to health or affect how long a man lives. Doctors can't always be sure what type of cancer is present in your particular case.

What are the symptoms of prostate cancer?

Many men with prostate cancer often have no symptoms. If symptoms appear, they can include
Blood in the urine
The need to urinate frequently, especially at night
Weak or interrupted urine flow
Pain or burning feeling while urinating
The inability to urinate
Constant pain in the lower back, pelvis, or upper thighs

If you have any of these symptoms, see your doctor as soon as possible. Keep in mind that these symptoms are also caused by other prostate problems that are not cancer, such as an infection or an enlarged prostate.

Prostate Cancer Screening

What does "screening" mean?

Screening means looking for signs of disease in people who have no symptoms. So screening for prostate cancer is looking for early-stage disease when treatment may be more effective. The main screening tools for prostate cancer are the digital rectal examination (DRE) and the prostate-specific antigen (PSA) test. The DRE and PSA test cannot tell if you have cancer; they can only suggest the need for further tests.

What is the DRE?

The DRE or digital (finger) rectal examination is a quick exam for checking the health of the prostate. For this test, the doctor inserts a gloved and lubricated finger into the rectum. This allows the doctor to feel the back portion of the prostate for size and any irregular or abnormally firm areas.

What is the PSA test?

PSA stands for "prostate-specific antigen." PSA is a substance produced by cells from the prostate gland and released into the blood. The PSA test measures the PSA level in the blood. A small amount of blood is drawn from the arm. The doctor checks the blood to see if the PSA level is normal. The doctor may also use this test to check for any increase in your PSA level compared to your last PSA test.

Treating Prostate Cancer

What happens if prostate cancer is found?

No two men with prostate cancer are the same. Many factors affect the decision whether or not to treat the disease: The patient's age, whether the cancer has spread, the presence of other medical conditions, and the patient's overall health.

When prostate cancer has been found in its early stages and has not spread beyond the prostate, a doctor and his patient may decide upon Watchful waiting: Monitoring the patient's prostate cancer by performing the PSA test and DRE regularly, and treating it only if and when the prostate cancer causes symptoms or shows signs of growing

Surgery (radical prostatectomy): Removing the prostate

External radiation therapy: Destroying cancer cells by directing radiation at the prostate

Internal radiation therapy (brachytherapy): Surgically placing small radioactive pellets inside or near the cancer to destroy cancer cells

Hormone therapy: Giving certain hormones to keep prostate cancer cells from growing

Cryotherapy: Placing a special probe inside or near the prostate cancer to freeze and destroy the cancer cells

More advanced prostate cancers that have spread beyond the prostate can be complex to treat and may be incurable. Patients should discuss with their doctor the best course of action.

Do these treatments have side effects?

Side effects from prostate cancer treatment depend mainly on the type of treatment, the patient's age, and his overall health. Men can experience pain, discomfort, and other mild to severe side effects that may be temporary or may last a long time. Two important side effects are impotence and incontinence. When a doctor explains the treatment options, he or she can discuss how mild or severe side effects might be, and how long they might last. Also, a doctor may be able to perform surgery or prescribe drugs to relieve some side effects.