Medical Mondays: News Notes
Raoul Concepcion, MD, urologist
TOPIC: Prostate Cancer Awareness
August 30, 2010
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Saturday, September 11, 2010
7:30 am Rain or Shine
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Prostate Cancer - Topic Overview
Prostate cancer is common among men older than 65. Most cases are treatable because they are found with screening tests before the cancer has spread to other parts of the body. Most men do not die from it.
Prostate cancer is the abnormal growth of cells in a man's prostate gland. The prostate sits just below the bladder. It makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. It usually grows larger as you grow older.
Prostate cancer is common in men older than 65. It usually grows slowly and can take years to grow large enough to cause any problems. Most cases are treatable, because they are found with screening tests before the cancer has spread to other parts of the body.1 Although most men may die with prostate cancer, most men do not die from it.
Experts don't know what causes prostate cancer, but they believe that your age, family history (genetics), and race affect your chances of getting it. Eating a high-fat diet may also play a part.2
Prostate cancer usually does not cause symptoms in its early stages. Most men don't know they have it until it is found during a regular medical exam.
When problems are noticed, they are most often problems with urinating. But these same symptoms can also be caused by an enlarged prostate (benign prostatic hyperplasia). An enlarged prostate is common in older men.
See your doctor for a checkup if:
The most common way to check for prostate cancer is to have a digital rectal exam, in which the doctor puts a gloved, lubricated finger in your rectum to feel your prostate, and a prostate-specific antigen (PSA) blood test. A higher level of PSA may mean that you have prostate cancer, but it could also mean that you have an enlargement or infection of the prostate.
If your PSA is high, or if your doctor finds anything in the rectal exam, he or she may do a biopsy to figure out the cause. A biopsy means your doctor takes a sample of tissue from your prostate gland and sends it to a lab for testing.
Because many men have regular checkups, about 9 out of 10 prostate cancers are found in the early stages. The 5-year survival rate is almost 100%.1 The 5-year survival rate shows the percentage of men still alive 5 years or longer after diagnosis. It's important to remember that everyone's case is different, and these numbers may not show what will happen in your case.
It is important to have regular health checkups, including a digital rectal exam. But experts disagree on whether regular PSA testing is right for all men. Testing could lead to cancer treatment that can cause other health problems, especially loss of bladder control and not being able to have an erection.
Talk with your doctor about the reasons for and against having a PSA test for prostate cancer. The decision to have a PSA test depends on your doctor's opinion and your preferences.
Your treatment will depend on what kind of cancer cells you have, how far they have spread, your age and general health, and your preferences.
You and your doctor may decide to treat your cancer with surgery, radiation, hormone therapy, or a combination. Or, if the cancer has not spread and you are around age 70 or older, you may be able to wait and watch to see what happens. During watchful waiting, you will have regular checkups with your doctor to see if your cancer has changed.
Choosing treatment for prostate cancer can be confusing. Talk with your doctor to choose the treatment that is best for you.
Both surgery and radiation can cause urinary incontinence (not being able to control urination) or impotence (not being able to have an erection).
Nerves that help a man have an erection are right next to the prostate. Surgery to remove the cancer may damage them. Many times a special form of surgery, called nerve-sparing surgery, can be used to try to avoid damaging the nerves. But if the cancer has spread to the nerves, they may have to be removed during surgery.
These same nerves can also be damaged by the X-rays that are used in radiation therapy.
Drugs and mechanical aids may help men who are impotent because of treatment. Many men recover their ability to have an erection several months or years after surgery.