Prostate Cancer  

 

Definition

Cancer of the prostate gland, which surrounds the urethra, is very common in older men. In fact, it exists in as many as 50% of men over age 70. 

Because it is very slow-growing, prostate cancer sometimes causes no symptoms. If it has advanced enough to cause symptoms, a tumor of the prostate may cause a man problems similar to those of benign prostatic hyperplasia. These include:

• difficult or blocked urination

• frequent urination

• urine in the blood

• urinary tract infection

In very advanced stages, there may be anemia, weakness, weight loss, or pain. 

Some cases of prostate cancer are detected or at least suspected during the digital rectal examination (usually performed at every annual physical examination) or by a blood test that checks for a protein called prostate-specific antigen (PSA). 

To confirm the diagnosis and determine how far the tumor may have spread, the man must usually also undergo other tests such as an ultrasound scan and/or a biopsy. 

African-American men and those with a family history of the disease are at higher than average risk of prostate cancer. It’s currently recommended that they undergo screening examinations from age 40. In most other men, screening tests are first performed at about age 50. 

Treatment

Because prostate cancer grows so slowly, most physicians believe it does not always need to be treated. That decision is based on several factors, such as the patient’s age and state of health and the extent to which invasive treatment would disrupt his life. 

Especially in men over 75, a doctor may believe that the cancer can be “watched” with regular examinations and PSA tests to ensure it is not growing rapidly. 

When treatment is deemed necessary, there are numerous options available:

• The prostate and in some instances the testicles may be removed surgically. The latter operation is usually only necessary when the cancer has spread to other parts of the body.

• Radiation therapy helps kill tumor cells in the prostate and surrounding tissues.

• Hormone therapy, with drugs such as leuprolide or goserelin, may be used to help keep testosterone levels low.

Other types of treatment now being tested include cryotherapy, in which the prostate tissues are chemically frozen. 

Your doctor will discuss with you the most appropriate treatment options for your particular case and condition.