Prostate Cancer is one of the most common malignancies in men, and it affects nearly one in six in the United States. The prostate is a small, walnut-shaped gland, that surrounds the neck of the bladder and the urethra (ie, the tube that carries urine), which runs through the prostate. Found only in men, the prostate’s main function is to produce seminal fluid, which transports and nourishes sperm.
The growth of the prostate gland begins before birth, continuing until a man reaches adulthood. Male hormones called androgens cause this growth, and if the body does not produce enough of them the prostate gland will not grow to its full size. In older men, however, the part of the prostate gland surrounding the urethra may keep growing, surpassing normal size. This can cause benign prostatic hyperplasia (or BPH) which often results in problems passing urine. It must be treated, but it is not cancer.
Prostate Cancer is often asymptomatic as well as slow growing. Autopsy studies have demonstrated that many older men who died from other causes also had Prostate Cancer that never exhibited symptoms or caused any problems. These studies also found that roughly 7 to 9 out of 10 men had prostate cancer by age 80, although neither the men nor their doctors were aware of it.
Prostate Cancer rarely produces noticeable symptoms in its early stages. Some early signs and symptoms for the disease are urinary problems, including starting and stopping while urinating, a weaker stream of urine, and trouble urinating. Signs of more severe disease include blood in the urine or semen, discomfort in the pelvic area and swelling in the legs. When Prostate Cancer becomes advanced, it can spread to the bones and cause persistent bone pain, fractures and compression of the spine.
There are several risk factors that affect a man’s likelihood of developing Prostate Cancer. The most common are diet, family history, high testosterone levels, ethnicity, and age. Of these, the strongest risk factor is age. A man’s chances of having Prostate Cancer rise dramatically after 50, and nearly 2 of 3 Prostate Cancers are diagnosed in men over 65.
Obesity and a high fat diet may increase the risk of Prostate Cancer. It is theorized that fat increases the body’s production of the hormone testosterone, which may induce the development of Prostate Cancer cells.
High testosterone levels have been linked to an increased risk of Prostate Cancer. Because testosterone induces growth of the prostate gland, men who undergo any type of testosterone therapy are more likely to develop this type of cancer.
African-American men are at a greater risk for Prostate Cancer, although the reasons have not yet been determined.
Family history has a bearing on one’s risk for developing Prostate Cancer. A man who has a brother or father with the disease has a greater risk than the average man.
The two most common tests used to detect Prostate Cancer are the PSA blood test and the digital rectal examination (DRE). The PSA test checks levels of prostate-specific antigen (PSA) in the blood. PSA is a protein produced by the prostate, and it is normally found in small amounts. When Prostate Cancer develops, the prostate begins to release greater amounts of PSA into the blood. A PSA amount of under 4 ng/mL is generally considered “normal,” 4-10 ng/mL is generally considered “intermediate,” and anything over 10 ng/mL is generally considered “high.”
During the DRE, the physician inserts a gloved, lubricated finger into the rectum, and feels the prostate gland, checking for any abnormalities in shape, size and texture. Generally, malignant tissue is hard and often irregularly shaped. Although the DRE is an effective diagnostic tool, sometimes other methods are necessary. This is due to the fact that of all patients with Prostate Cancer, roughly one-third will have a normal DRE.