The following describes the symptoms, diagnosis and treatment of prostate cancer. For specific information regarding your health and treatment options, please contact your Hurley physician or medical professional.
What is prostate cancer?
Prostate cancer affects the prostate gland in men, a small organ that is part of the reproductive system and is located near the base of the abdomen. In recent years, due to improvements in early screening, diagnostic testing and treatment options, prostate cancer has become one of the cancers that can be treated most effectively. More than 90% of all prostate cancers are discovered while they are still affecting only the prostate or nearby tissues, and the five-year survival rate of men found to have early stage tumors is close to 99%. Over the past several decades, the combined five-year survival rate for prostate cancers found at any stage has also improved greatly.
Since early-stage prostate cancer is virtually symptom-free, men should have regular prostate examinations performed by their physicians. Fear and anxiety should not keep you from having this simple procedure; a few seconds could literally save your life.
What causes prostate cancer?
The exact causes of prostate cancer, as with most cancers, are unknown. While all men are at risk of developing prostate cancer, there are certain factors that increase the possibility of being diagnosed with the disease. Men age 50 and older are more likely to develop prostate cancer, and African-American men are at greater risk than Caucasian or Asian-American men. Diets high in fat and low in fiber increase prostate cancer risk, as does obesity (which is often found in men who eat high fat/low fiber diets). A family or personal history of prostate cancer can also increase the likelihood of prostate cancer. Exposure to certain toxins (such as cadmium used in welding), a history of sexually transmitted diseases (STDs), and having had a vasectomy have been linked to prostate cancer by some scientists, but additional research is required in these areas.
What are the symptoms of prostate cancer?
Since the symptoms of prostate cancer vary across individuals and may appear similar to symptoms of other illnesses and disorders, you should always speak to your Hurley physician about any symptoms you are experiencing.
Prostate cancer typically develops for a period of time with no symptoms, which is why regular screenings by your physician are so important. A digital rectal examination and a prostate-specific antigen (PSA) blood test offer the best chance of identifying prostate cancer early in its development.
Other symptoms of prostate cancer include the following:
- Frequent urination or difficulty holding back urine
- Weak or interrupted urine flow
- Inability to urinate
- Pain when urinating
- Difficulty having or sustaining an erection
- Pain or weakness in the back, hips or pelvis
- Unexplained fever not due to a cold or the flu
As men get older, the prostate may grow larger and cause difficulties with urination or sexual function. Your Hurley physician can determine whether these and other symptoms are caused by an enlarged prostate (benign prostatic hyperplasia) or by prostate cancer. Benign prostatic hyperplasia can be treated with medication or surgery in order to reduce symptoms, but this non-life threatening condition should not be confused with prostate cancer, which requires more aggressive treatment.
How is prostate cancer diagnosed?
During your appointment, your Hurley physician will ask you questions about your medical history and conduct a complete physical examination. Laboratory tests may be ordered, including blood, urine and other tests. The American Cancer Society and National Cancer Institute recommend that physicians perform a digital rectal examination (DRE) annually for men over 50. Men over 50 should also have an annual PSA test. Men under the age of 50 but with risk factors for prostate cancer should consult with their Hurley physician about the frequency of these tests.
Your physician may conduct a lymph node or prostate biopsies, in which small samples of tissue are removed and analyzed by a trained pathologist for the presence of abnormal cells. Imaging technology may also be used to detect cancer of the prostate and to determine the location and spread of such cancers. These imaging tests include transrectal ultrasound, CT scans, MRI scans and bone scans (to detect whether the prostate cancer has spread to the bones).
How is prostate cancer treated?
Part of the diagnostic testing process involves grading and “staging” the prostate cancer. In this step, your oncologist will determine the type of cancerous cells or tumors present, the rate of tumor growth, and the degree to which the cancer has spread to other organs and systems of the body. Your oncologist will then recommend a course of treatment that takes this information into account, as well as your age, overall health, and personal and family circumstances, and your unique needs and objectives for treatment.
In some cases, usually involving older men with very small cancers, your physician may recommend expectant therapy, in which the cancer is observed for a period of time before beginning more aggressive treatment. Transurethral resection of the prostate (TURP), a minimally invasive procedure, may be used to reduce symptoms. The decision to follow expectant therapy should only be made in consultation with your physician and when it is accompanied by regular follow-up examinations.
More direct treatment options include surgery to remove the cancerous cells, tumors and affected areas of the prostate. For smaller tumors and less aggressive cancers, minimally invasive procedures such as cryosurgery (in which the cancer cells are killed by freezing) or laparoscopic surgery (using a thin, lighted tube with a viewing device to guide the surgeon) may be effective. In other cases, more extensive surgery may be required, including removal of part of the prostate or the entire prostate. New nerve-sparing surgical procedures have significantly reduced the side effects associated with surgery; however, there is the possibility of temporary or permanent incontinence or erectile dysfunction as a result of surgery, so men should consult with their doctors about these issues.
Chemotherapy, external and internal radiation therapy, and hormone therapy may also be used alone, in combination with each other, or in addition to surgical techniques. There are also a number of new drugs and innovative therapies that have been developed recently to target and treat prostate cancer. These include medications that block the formation of blood vessels that would otherwise provide the tumor with needed oxygen, and various forms of complementary medicine.
Research on prostate cancer is ongoing; you may wish to speak with your Hurley physician about clinical trials that are testing new, emerging treatment options.