PROSTATE CANCER

PROSTATE CANCER

PROSTATE CANCER

Prostate cancer is the most common cancer in men and the second leading killer
of men behind lung cancer. Prostate cancer generally grows slowly and most
men die with prostate cancer rather than from it (meaning that they die of some
other cause). Still, prostate cancer kills approximately 30,000 men each year. But
detected early, it can be cured.
P rostate and skin cancer continue to be the most common cancers
in American men.
In its early stages, prostate cancer has no apparent symptoms. However, as the
disease progresses, the patient may develop symptoms that are the same as for
prostatitis and/or BPH (see above). Additional symptoms include:
• Chronic pain in the hips, thighs, or lower back.
• Blood in the urine or semen.
The lack of early symptoms and the overlap of symptoms with non-cancerous
conditions make prostate cancer difficult to diagnose. That’s why it’s essential
that you get screened regularly. (See Appendix B for an age-adjusted schedule.)

RISK FACTORS

There are a handful of factors that could put you at risk of developing prostate
cancer:
• Age: The risk increases for men age 40
or over with a family history of
prostate cancer and African-American
men. It increases for men over age 50
o t h e rwise. Prostate cancer is most
often diagnosed in men over the age
of 65, but it is becoming more common
in men between the ages of 55
and 65.
• Family history : Your risk of developing
prostate cancer is doubled if your
f a t h e r, brother or close male blood
r e l a t i v e has had the disease.
• Race: African-Americans have the
highest rate of prostate cancer in the world, at least twice as high as white
m e n .
• Diet: Eating a diet low in fiber and high in fat and red meat, has been
shown to increase prostate cancer risk.
If you don’t have any symptoms, prostate cancer is often discovered during a r e gularly
scheduled checkup with a DRE and a blood test for PSA (prostate specific
antigen), which is often an indicator of prostate-related problems. An abnormal
test may mean that you need more testing. These include:

• Urinalysis: Often used to rule out BPH or prostatitis.
• Imaging: Ultrasound uses sound waves to produce an image of the
prostate. MRI and CT scans use computers to produce images. Also, bone
scanning can look for prostate cancer that might have spread to the skeletal
s y s t e m .
• Biopsy: Taking a number of small pieces of prostate tissue following local
anesthesia and examining them under a microscope. This is performed
using trans-rectal ultrasound.
• Lymph node biopsy: Examination of small samples from the lymph nodes
can determine whether the prostate cancer has spread to other parts of the
b o d y.

TREATING PROSTATE CANCER

There are a number of options in treating early-stage prostate cancer:
• Complete surgical removal of the prostate. Side effects include urinary
incontinence (bladder control problems) that can last for weeks, and
erectile dysfunction. Options include:
– Nerve-sparing retropubic radical prostatectomy (NS-RRP).
– Radical perineal prostatectomy (RPP).
– Robotic and/or laparoscopic prostatectomy.
– Nonnerve sparing wide excision radical prostatectomy (RP).
• Radiation therapy. There are two options:
– High-powered x-rays are used to kill the cancer cells. Side effects
include reduced sexual function, urinary troubles, intestinal difficulty,
loss of appetite and hair.
– Radioactive seeds. Your doctor will use a special needle to implant
80 to 120 pellets the size of a grain of rice directly into the prostate.
There are fewer sexual side effects but more urinary ones, and there
can be damage to the rectum and lower intestines.
• H o rmone therapy. Because the male sex hormone, testosterone, stimulates
cancer cells to grow, you can take drugs to block testosterone production.
Hormone therapy is usually not a cure, it’s just a way of stopping the
tumor from growing. Side effects include breast enlargement, reduced
sex drive, weight gain and reduction in muscle mass. One side effect of
hormone therapy may be a reduction in testosterone (hypogonadism)
which may lead to osteoporosis, which reduces bone mass and may lead
to increased risk of bone fractures.
• C ry o s u r g e ry(also called cry o t h e rapy). This treatment involves freezing t h e
prostate gland in order to destroy the cancer within it. Cry o s u r g e ryis an
FDA-approved treatment for localized and locally recurrent prostate
c a n c e r. It may cause more sexual side effects than other local therapies,
but if you’re interested, ask your doctor for more information.
• O b s e rvation. This can be a good option if your doctor believes your cancer
is growing very slowly and won’t spread to other parts of the body. The
advantages are that you avoid all the risks associated with the various treatment
options above. Disadvantages are that you’ll need regular monitoring
in case something changes for the worse. This is also called “watchful waiting”
or “active surv e i l l a n c e .

“Prostate cancer can be devastating to an individual,
but does not affect men in isolation. It also has, often overlooked,
effects on wives, partners, and entire families. We promote regular
screenings and early detection of the disease in order to help ensure
the best chance of recovery and highest quality of life.”

PREVENTION

• Get your prostate checked yearly after age 40.
• Eat right. Studies show that people who eat a high fat diet have a greater
risk of developing prostate cancer. On the other hand, fiber, soy protein,
fruits, and cooked tomatoes have all been shown to reduce risk.
• Watch your weight. Obesity may be a contributing factor to a number of
cancers, including prostate.
• Exercise regularly.
• Don’t smoke.
• Limit alcohol and avoid caffeine.
• Drink a lot of water. This can help flush out your bladder. Urine should
be almost clear.
• Have regular sex.
• Consult your doctor about other prevention tips.