About Prostate Cancer

Prostate

Other than lung cancer, prostate cancer is the leading cause of cancer related deaths in American men. More importantly, prostate cancer is the type of cancer commonly diagnosed in American men. It accounts for around 30% of all cancers diagnosed in men. Last year, roughly 234,460 men in the United States were diagnosed with prostate cancer and at least 27,350 died from the disease. None of which is to say that there isn't good news in the statistics as well. For many of those men, early diagnosis and treatment of prostate cancer resulted in a full return to health.

Increased awareness of the disease has resulted in earlier diagnosis and declining mortality rates. These facts, coupled with new medical treatment options, offer hope to victims of prostate cancer, the majority of whom will be able to go on to live active and productive lives after treatment. If you've been diagnosed, your outlook is better than the numbers above suggests.

Probing Your Prostate Health: What Every Man Should Know (PowerPoint presentation opens in new window.)

The Prostate is a Walnut-Sized Gland Found Only in Men. Here are the Basic Facts:

Located underneath the bladder and in front of the rectum, a prostate contains glandular cells that produce a variety of fluids that protect and nourish sperm cells. The urethra (the tube that carries semen and urine through the penis) runs through the prostate and located just behind the prostate are the vesicles that produce seminal fluid.

The prostate gland keeps growing until men hit adulthood then it stays about the same size until men stop producing testosterone. Unfortunately, in certain older men, the portion of their prostate around the urethra may continue to grow, a condition known as BPH (Benign Prostatic Hyperplasia), which causes a variety of urinary problems because this growth squeezes the urethra.

Over Ninety-Nine Percent of Prostate Cancers Develop in the Glandular Cells

If you're a man and over the age of 45, you're at risk for prostate cancer. It's that simple. Even though prostate cancer occasionally occurs in younger men, risk frankly increases with age and more than seventy percent of the men diagnosed with one form of prostate cancer or another are over 65. Some urologists believe that prostate cancers start with a condition known as PIN (Prostatic Intraepithelial Neoplasia) characterized by microscopic changes in the prostate's appearance; but true the cause of the disease is unknown.

However, as with other types of cancer, prostate cancer's risk factors are believed to include an assortment of nutritional, environmental, genetic and even certain hormonal factors.

For example, the influence of genes on prostate cancer development has been suggested by the fact that the disease tends to occur in men related to one another and by the fact that a gene, associated with thirty-percent of prostate cancers, has been identified. As for causal environmental factors, there are reports that indicate that men working with rubber, sheet metal or cadmium (a component of many commercial fungicides) have higher rates of prostate cancer than the general population. Nutritional factors are believed to contribute to prostate cancer rates primarily because the disease occurs more frequently in men who immigrate to the United States than it does among men from their native countries, the result of switching to an American diet high in saturated fats.

  • Incidence of prostate cancer rise quickly after age 60, and most men will be diagnosed with some form of prostate cancer once they pass age 80.
  • Elevated testosterone levels may play a role in prostate cancer development.
  • High fat diets, particularly diets high in animal fats, are the most common dietary culprits, in an increased risk of prostate cancer. A number of studies have even suggested that any diet low in vegetables will result in an increased risk of prostate cancer. Conversely, certain are foods believed to decrease the risk of prostate cancer, diets high in lycopene (tomatoes) and diets high in fish like salmon and mackerel (and their accompanying omega-3-fatty acids) have both been shown to decrease the risk of developing the disease.
  • If you have a family history of prostate cancer it will impact your chances of developing the disease. If you have either a father or a brother (or both) who've been diagnosed with prostate cancer, you'll be at greater risk, especially if either relative developed the disease at a younger than average age.
  • There are prostate cancer risk factors related to ethnicity. No one knows why, at least not precisely, but prostate cancer is more common in Latino and African-American men than Caucasians. Native American and Asian men have the lowest risk of developing prostate cancer.

In its Earliest Stages, Prostate Cancer Often Won't Cause Symptoms

Since the advent of PSA testing (the test that measures the amount of prostate-specific antigen in the blood), prostate cancer is often found before it causes symptoms. However, those who have the disease may experience some of the following:

  • Difficulty urinating or trouble holding back urine.
  • Needing to urinate frequently, especially at night.
  • Inability to urinate.
  • Weak or interrupted urine flow.
  • Burning or pain during urination.
  • Erectile dysfunction.
  • Painful ejaculation.
  • The presence of blood in urine or semen.
  • Stiffness or frequent pain in the hips, lower back or upper thighs.

Any of those symptoms may be the result of a less serious health problem. However, all men experiencing any of the above or simply over 50 should have an annual PSA blood test and a Digital Rectal Exam.

Treatments for Prostate Cancer Depend on the Stage of the Disease

The treatment options for prostate cancer vary depending on the nature of the tumor in question. Generally speaking however, surgery (Open, Laparoscopic, or Robotic Prostatectomy), radiation (external-beam, internal, implant or brachytherapy) or hormone therapy are the most common methods of treating the disease. Chemotherapy may also be put to use, but only in certain cases, and "watchful waiting" may be an option. If the cancer is detected early, the treatment will typically involve either radiation therapy or surgical removal of the prostate. More advanced cases of the disease (once the cancer has spread beyond the prostate), call for hormone-based therapies and medications.

If a patient is over 70 and has a slow-growing tumor, urologists sometimes adopt a strategy known as "watchful waiting," which calls for frequent check-ups and treatment only if the patient's cancer spreads or worsens. During "watchful waiting" a patient's diet is adjusted to include fruits, vegetables, selenium, soy and fiber that can work to slow prostate cancers growth.

A nomogram is a predictive tool for patients and physicians designed to help decide which treatment options are most suitable for the patient. It is a series of computerized devices which can be used in men who are at risk for prostate cancer, as well as those already diagnosed with the disease. For more information, visit Nomogram.org.

Many prostate cancer patients hear about a variety of "alternative" treatment methods from family or friends and give them a try. These include techniques ranging from Traditional Chinese Medicine to vitamin therapy, herbal cures, acupuncture (which can actually relieve the pain and the side effects of surgery), massage and more.

Before altering their treatment or adding any of such method, patients should talk to their primary care doctor or a urologic oncologist. Certain methods can be used safely alongside standard medical treatment. Others, however, may interfere with standard treatments or result in serious side effects.

For more information about prostate cancer, its diagnosis and treatment or advice on complementary or alternative methods of care, please don't hesitate to contact Dr. Scherr.