Prostate Cancer

What is prostate cancer?
The prostate is a gland the size of a walnut located below the bladder and in front of the rectum in men. Prostate cancer is cancer of this gland. Most prostate cancers begin in the gland cells of the prostate.

What are risk factors for prostate cancer?
Although the exact causes of prostate cancer are unknown, researchers have found several factors that increase the risk of developing this disease.
>Age – Age is the greatest risk factor for prostate cancer. The majority of prostate cancers are diagnosed in men over the age of 65.
>Race – African American men have a higher incidence of prostate cancer than any other race in the United States.
>Family history – Men who have a family member with prostate cancer, especially a brother or father, have a higher risk of getting prostate cancer.
>Diet – Research indicates that a diet high in fat may contribute to a higher risk of prostate cancer.

What are prevention strategies for prostate cancer?
Age, race and family history cannot be changed to help reduce risk factors. Therefore, it is important to follow screening guidelines and discuss this with your healthcare provider. It is also important to maintain a healthy diet, which includes low-fat foods and at least nine servings of fruits and vegetables a day. Adding a routine of physical activity will help to maintain a healthy body weight and lifestyle.

Is screening available?
Screening for prostate cancer is done through the digital rectum exam (DRE) and prostate-specific antigen (PSA) blood test. The DRE allows the doctor to check for enlargement or lump of the prostate gland by inserting a lubricated gloved finger into the rectum. The PSA is a protein produced by the prostate and the PSA test checks for the level of PSA in the blood.
Click here to learn more about prostate cancer screening guidelines.

What are the symptoms of prostate cancer?
Prostate cancer often does not have symptoms in its early stages. Men with prostate cancer may experience the following:
> Weak or interrupted flow of urine;
> Inability to urinate;
> Urinating often;
> Difficulty urinating or holding back urine;
> Pain or burning when urinating;
> Blood in the urine or semen
> Pain in the back, hips, pelvis or upper thighs

How is prostate cancer diagnosed?
Early stages of prostate cancer often do not have any symptoms. Following screening guidelines using DRE and PSA detect most early stage prostate cancers. An elevated PSA or abnormal DRE requires further evaluation. A core needle biopsy is the main diagnostic procedure used to detect prostate cancer. This procedure entails a doctor inserting several narrow needles into the prostate gland using transrectal ultrasound for guidance. The needles are inserted and removed in a fraction of a second. It typically produces a stinging sensation and local anesthesia is frequently given.

What is staging?
Staging describes the extent of the cancer. It determines if the cancer has spread and if so, what parts of the body are affected. Staging a cancer is important to assist the doctor with determining the appropriate course of treatment and assessing an accurate prognosis.The most common staging system is the TNM.
> T – size of the tumor
> N – degree to which regional lymph nodes are involved
> M – the absence or presence of distant metastasis
Once the TNM has been determined, then a stage of I, II, III or IV is assigned.
> Stage I – cancers are small and local and usually curable
> Stage II x III – typically these are locally advanced and could involve the lymph nodes
> Stage IV – cancer has usually metastasized and can be inoperable.

What are treatment options?
Treatment may include one or a combination of options, depending on factors such as age and stage of the tumor. The doctor will discuss treatment options. The five major treatment options for prostate cancer include:
> Surgery
> Radiation
> Chemotherapy
> Hormonal Therapy
> Watchful waiting

What clinical trials are available?
Clinical trials are studies that seek to find better ways to prevent, screen, diagnose and treat a disease such as cancer. Clinical trials test new approaches to treatment such as, new drugs, new approaches to surgery or radiation therapy or a combination of treatments.

Learn more about clinical trials.

What questions should I ask my doctor?
It is often helpful to make a list of questions before an appointment. This will help to remember what the doctor says. Sometimes it is helpful to have a family member or friend at the appointment to take notes, ask questions or just listen. Below are a few suggested questions a patient may ask their doctor.

Will you please write down the type of cancer that I have?
What stage is my cancer and what does that mean?
What are my treatment options?
What treatment do you recommend and why?
What are the risks and benefits of each treatment?
What are possible side effects of treatment?
How will you help manage my side effects?
How will treatment affect my normal activities?
Are there specific things I must do to get ready for treatment?
Are there other things I can be doing to help with my treatment, such as diet and exercise?
What resources can I use to learn more about my cancer and help me deal with it?

Make an appointment

Resources
American Cancer Society – 1-800-ACS-2345
American Foundation for Urologic Disease
American Prostate Society
Cancer Care, Inc. – 1-800-813-HOPE
International Cancer Alliance (ICARE) – 1-800-ICARE-61
National Cancer Institute – 1-800-4CANCER
Prostate Cancer FAQ
Prostate Cancer Foundation – 1-800-757-CURE
Prostate Cancer Research and Education Foundation (PC-REF) – 619-461-8181
Prostate Cancer Research Institute – 310-743-2110
Us Too! International, Inc. – 1-800-808-7866