Prostate cancer is an abnormal growth in the prostate gland, developing when cells divide out of control. This walnut-shaped gland in the male reproductive tract makes seminal fluid, which mixes with sperm. Early detection and treatment have led to better survival for all stages of prostate cancer in the past 20 years. Many prostate cancers don’t lead to death, but some can spread (metastasize) through blood and lymph nodes (glands) to bones and major organs. This is called extracapsular spread.
Treatment depends on age and health, how far the cancer spread (stage of disease), what the cancer looks like under the microscope, and response to first treatment. Standard treatments include watchful waiting, surgery, radiation therapy, and hormone therapy.
- Radiation therapy: Can be external beam radiation (x-rays to kill cancer cells) or proton beam therapy (special high-dose treatment). Also, tiny radioactive implant (seeds) can be put directly into the prostate.
- Hormone therapy: Affects testosterone production, so cancer cells shrink or grow more slowly.
- Surgery: Radical prostatectomy is used for localized cancer (one that hasn't spread).
- Other treatments: Sometimes, chemotherapy (drugs), cryosurgery (freezing), or some treatment combination may be tried.
Prostate cancer usually occurs in older men, who often die of other causes before slowly growing prostate cancer spreads or causes symptoms. When occurring in younger men, it tends to much more aggressive. Also, treatments generally have side effects, such as incontinence and erectile dysfunction, that may decrease quality of life. Choosing a treatment can be challenging. The decision whether to try to cure localized prostate cancer is a trade-off between survival and quality of life.
Your health care provider may suspect prostate cancer from a complete medical history and physical examination, including a digital rectal examination (DRE) and a blood test known as prostate-specific antigen test (PSA).
Your health care provider may recommend yearly DREs and PSA tests if you are over 50 years old. These tests may be helpful in making the diagnosis. Men in high-risk groups, such as African Americans, or those with a family history of prostate cancer may need testing at a younger age.
The diagnosis can be proved only by a biopsy, in which the urologist takes a sample of prostate tissue for study.
The following symptoms are not always due to prostate cancer and may have other less serious causes, including benign prostatic hypertrophy (BPH) and infections. Always see your health care provider for a diagnosis.
- Pain or burning when urinating.
- Erectile dysfunction.
- Weak or interrupted flow of urine.
- Having to urinate often (especially at night).
- Trouble holding back urine.
- Being unable to urinate.
- Blood in urine or semen.
- Nagging pain in the back, hips, or pelvis may occur as the cancer spreads.
- And other symptoms.
- Men over age 65.
- African-American men.
- Obese men.
- Have a family history of prostate cancer.
- Have a family history of breast cancer.
- Have a yearly DRE as recommended by your health care provider.
- Get a yearly PSA test as recommended by your health care provider.
- Remember that the majority of men who reach age 80 are found to have prostate cancer, but generally die from other causes unrelated to their prostate cancer.
- Do not ignore possible symptoms of prostate cancer such as pain or difficulty urinating.
- Avoid smoking.
This information is not intended to replace advice given to you by your health care provider.