What is Prostate Cancer?
Prostate cancer grows in the cells of the prostate, a gland in the male reproductive system that makes fluid for semen. The prostate is in front of the rectum, just below the bladder. It’s a walnut-sized gland that grows around the urethra, the tube that moves urine and semen out of the body.
Prostate cancer is the second most common cancer in men, affecting nearly 1 in 8. Treatment is often very successful when it’s diagnosed early before it has a chance to spread.
Prostate Cancer Symptoms
In the early stages of prostate cancer, there may no noticeable symptoms.
As it advances, symptoms may cause:
- Blood in the urine and semen
- Bone pain
- Burning or pain with urination
- Erectile dysfunction
- Pain in the back, hips, or pelvis
- Painful ejaculation
- Unexplained weight loss
- Urination problems, like:
- Weak stream
- Difficulty starting
- Frequent starts and stops
- Frequent urination day or night
These symptoms don’t always mean you have cancer. Many of these symptoms are also associated with non-cancerous prostate problems. If you’re experiencing any of these symptoms, it’s important to see a urologist for a proper diagnosis.
Prostate Cancer Causes
The exact cause of prostate cancer isn’t understood, but some factors increase your risk of developing it:
Age – Prostate cancer is more common after 50, and the risk increases with age.
Family history – Having a blood relative diagnosed with prostate cancer may increase risk, as does a strong family history of breast cancer and breast cancer genes (BRCA1 or BRCA2).
Race – It’s unknown why, but Black men are more at risk, with 73% more new cases than White men. They’re also more likely to get it younger and have more aggressive cancer.
Weight – People who are obese may be more at risk than people at a healthy weight. Obesity also seems to put men at risk for more aggressive cancer and cancer that returns after treatment.
Prostate Cancer Diagnosis
Men in their 50s should discuss screening with their doctor – earlier if they have risk factors. There are two standard screening methods and several diagnostic tests.
Digital rectal exam (DRE) – A DRE is a manual exam of the prostate gland. Your doctor uses a gloved and lubricated finger to feel for abnormalities in the shape, size, or texture of the prostate. If any are found, you may need further testing.
Prostate-specific antigen (PSA) test – A blood sample drawn from your arm is analyzed for PSA. High levels could indicate prostate cancer, enlargement, infection, or inflammation.
If a DRE or PSA finds an abnormality, you may have tests to look for cancer, including:
Transrectal ultrasound – A transrectal ultrasound uses sound waves to make a picture of the prostate from inside the rectum using a small probe.
Magnetic resonance imaging (MRI) – An MRI can scan your prostate to make a detailed image that can help your doctor plan for taking tissue samples.
Biopsy (tissue sampling) – A biopsy may be done using a thin needle to collect tissue samples from the prostate to look for cancer cells.
Prostate Cancer Treatment
Treatment depends on different factors, like whether the cancer has spread, the speed it is growing, and your overall health. You may also consider the side effects and benefits of treatment.
Observation – Some cancer may not need immediate treatment or any at all. If the cancer isn’t causing symptoms, is confined to a small section, and isn’t likely to grow quickly, your doctor may wait and monitor the situation. This may include treating symptoms or scheduling regular tests, exams, or biopsies to monitor cancer.
Prostatectomy – Surgery called a prostatectomy may be required to remove the prostate gland with some surrounding tissue and lymph nodes. It may be an option for cancer that hasn’t spread or in combination with other treatments for more advanced cancer.
Radiation therapy – Radiation kills cancer cells with high-powered energy. It can be administered through a beam outside your body or by placing radioactive seeds into your prostate.
Ablative therapy – These treatments use heat or cold to destroy the cancer cells. Cryoablation destroys tissue with cycles of freezing and then thawing it. High-intensity focused ultrasounds (HIFU) heat the tissue until it dies.
HIFU - High-intensity ultrasound waves are used to destroy tumor cells.
Hormone therapy – Prostate cancer needs testosterone to thrive. Hormone therapy blocks the cells from getting testosterone in different ways. Some medications stop testosterone production, and others keep it from reaching the cancer cells. Surgery to remove the testicles also decreases the testosterone in your body but is permanent.
Chemotherapy – Cancers that have spread or haven’t responded to hormone therapy may respond to chemotherapy. Chemo pills or infusions target cells that are growing rapidly, like cancer, and kills them.
Immunotherapy – Cancer can grow and spread because it hides from your body’s immune system. Immunotherapy interferes with their ability to hide. It can help your body’s cells identify and attack cancer cells.
Targeted drug therapy – The medications used in targeted therapy target specific abnormalities in the cancer cells, resulting in the cancer cells dying.
What are the signs of prostate cancer?
Prostate cancer doesn’t always have symptoms, but when it does, they include problems with urination, pain in the lower back, pelvis, or hips, and painful ejaculation.
What causes prostate cancer?
Science hasn’t found the cause of prostate cancer yet but has identified characteristics that put some men at a higher risk than others. Men who are over 50, obese, Black, or have a family history of prostate cancer have a higher risk of getting it.
Is prostate cancer curable?
There’s no cure for prostate cancer yet, but it’s often treated successfully when caught and treated early. The 5- and 10-year survival rates are both 98%. When prostate cancer hasn’t spread to other areas of the body, the 5-year survival rate is almost 100%. Early detection and treatment can save lives.
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