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The REAL Guide to Prostate Cancer

Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male reproductive system located just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder). The prostate gland produces fluid that makes up part of semen. Prostate cancer is found mainly in older men. As men age, the prostate may get bigger and block the urethra or bladder. This may cause difficult urination or problems with sexual function.



What is Prostate Cancer?

Prostate cancer happens when cells in the prostate begin to grow out of control and can then invade nearby tissues or spread throughout the body. Large collections of this out of control tissue are called tumors. However, some tumors are not really cancer because they cannot spread or threaten someone's life. These are called benign tumors.

The tumors that can spread throughout the body or invade nearby tissues are considered cancer and are called malignant tumors.

Usually, prostate cancer is very slow growing. However, sometimes it will grow quickly and spread to nearby lymph nodes. Lymph nodes are small, pea-sized pieces of tissue that filter and clean lymph, a clear liquid waste product.

If prostate cancer has spread to your lymph nodes when it is diagnosed, it means that there is higher chance that it has spread to other areas of the body.



What Causes Prostate Cancer?

The cause of prostate cancer is unknown, but the cancer is thought not to be related to benign prostatic hypertrophy (BPH). The risk (predisposing) factors for prostate cancer include advancing age, genetics (heredity), hormonal influences, and such environmental factors as toxins, chemicals, and industrial products.

The chances of developing prostate cancer increase with age. Thus, prostate cancer under age 40 is extremely rare, while it is common in men older than 80 years of age. As a matter of fact, some studies have suggested that among men over 80, between 50 and 80 percent of them may have prostate cancer!

Genetics (heredity), as just mentioned, plays a role in the risk of developing a prostate cancer. For example, black American men have a higher risk of getting prostate cancer than do Japanese or white American men.

Environment, diet, and other unknown factors, however, can modify such genetic predispositions. For example, prostate cancer is uncommon in Japanese men living in their native Japan. However, when these men move to the United States, their incidence of prostate cancer rises significantly. Prostate cancer is also more common among family members of individuals with prostate cancer. Thus, a person whose father, grandfather, or even uncle has prostate cancer is at an increased risk for also developing prostate cancer. To date, however, no specific prostate cancer gene has been identified and verified.

Testosterone, the male hormone, directly stimulates the growth of both normal prostate tissue and prostate cancer cells. Not surprisingly, therefore, this hormone is thought to be involved in the development and growth of prostate cancer. The important implication of the role of this hormone is that decreasing the level of testosterone should be (and usually is) effective in inhibiting the growth of prostate cancer.

Symptoms of Prostate Cancer

Many men with early prostate cancer have no symptoms, and occasionally even men with quite advanced tumors have no symptoms of disease. When symptoms occur they can be related to growth of the prostate causing urinary symptoms such as:
Frequency of urination particularly at night
Difficulty or delay in starting urination, or delay in emptying the bladder
Blood in the urine or urinary infection

Prostate cancer may also effect a man's ability to have intercourse and cause:
Erectile dysfunction (loss of or diminished erections)
Blood in the seminal fluid
Painful ejaculation

It must be emphasized that in most cases these symptoms are not caused by prostate cancer. Many of these symptoms can also occur with benign enlargement of the prostate (BPH), urinary infections or other medical conditions such as diabetes. Though, there are no symptoms unique to prostate cancer, a man with these symptoms should see his doctor to allow appropriate and timely investigations and treatment to take place.

Advanced prostate cancer may cause:
Pain the in the lower back, pelvic area, or upper thighs
Sudden inability to pass urine which is usually painless
Weakness or inability to move legs (and rarely arms), often associated with numbness
Severe bone pain

These symptoms can also be caused by conditions such as arthritis, lumbar disc disease and other types of tumors. Nevertheless anyone experiencing these latter complaints should seek immediate medical attention.

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Treatment Choices for Prostate Cancer

Current treatment methods include:

Urologic surgery, including a new nerve identification device that minimizes the risk of post-surgical impotence

Radiation oncology, including radioactive "seeds," or brachytherapy, neutron therapy, high-dose conformal radiotherapy, and intensity modulated radiation therapy (IMRT) are options that allow physicians to more precisely target the cancer

Medical oncology, including hormone therapy, chemotherapy, immunotherapy, new drugs, and vaccines.

Radiation treatment of prostate cancer is one of the preferred ways of managing localized prostate cancer. At the time that a patient is first diagnosed with prostate cancer, a number of tests are performed to determine whether the tumor appears to be localized to the prostate or to have spread beyond the prostate. These studies may include ultrasound imaging of the prostate, CAT scans of the pelvis, or bone scans.

Once it is determined that the prostate cancer appears localized, treatment may involve the implantation of radioactive pellets into the prostate, a procedure referred to as "prostate brachytherapy." Alternately, treatment may be delivered using a series of outpatient X-ray treatments. This latter approach focuses multiple radiation beams on the prostate, contouring the dose to the tumor and avoiding adjacent normal tissues and organs. This type of treatment is also referred to as intensity modulated or "IMRT." There are clinical situations when it may be desirable to use a combination of external beam radiation as well as a prostate seed implant for specific patients. Additionally, there are times when it is advantageous to combine hormonal treatment with radiation

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This site does not provide medical or any other health care advice, diagnosis or treatment. The site and its services, including the information above, are for informational purposes only and are not a substitute for professional medical advice, examination, diagnosis or treatment. Always seek the advice of your physician or other qualified health professional before starting any new treatment or making any changes to existing treatment. Do not delay seeking or disregard medical advice based on information on this site. Medical information changes rapidly and while we make efforts to update the content on the site, some information may be out of date. The information should not be used to diagnose, treat, cure or prevent any disease without the supervision of a medical doctor.




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