Prostate Cancer

The prostate is a gland only in men that wraps around the urethra, which is the tube that carries urine out of the bladder. Senior citizens are more likely to experience problems with the prostate because it enlarges over time, such problems include prostate cancer. This type of cancer typically develops slowly; many people do not have symptoms until they are in the advanced stages.  Symptoms that can occur include frequent need to urinate, difficulty in starting and maintaining urination, and painful or burning urination. Men can also experience difficulty in obtaining an erection, painful ejaculation, blood that appears in urine or semen, or pain and stiffness in the lower back, hips, and thighs.

These symptoms can indicate either a non-cancerous enlargement of the prostate or cancer. Your physician or urologist (genitourinary specialist) can diagnose your specific condition by evaluating your medical history, performing a rectal exam, or carrying out a blood test.

Prostate cancer is a serious health risk for men, especially for men who are African American and senior citizens over the age of 65. Asian and American Indian men seem to be less at risk than most men for this type of cancer.  There is also evidence that prostate cancer runs in families, but risk may also be influenced by poor diet (one high in fat) and previous issues with the prostate like benign prostatic hyperplasia (or an enlarged prostate).

Diagnosis

A rectal exam procedure involves the physician examining the prostate through the rectal wall to check for hard or lumpy growths that could indicate cancer. A blood test, however, will test for levels of an antigen called PSA. High levels of this antigen usually indicate problems with the prostate although not necessarily cancerous. Neither of these tests are completely effective when diagnosing cancer, which is why a doctor may perform a biopsy for men at risk. In a biopsy, prostate tissues is removed and evaluated directly for cancerous growth.

If prostate cancer is found, physicians then evaluate the grade of the tumor where a relatively higher grade usually indicates a more dangerous tumor. High grade tumors spread and grow more quickly than lower grade tumors.

Stages

Doctors must gather important information about a specific diagnosis of prostate cancer in a patient in order to evaluate the stage of development and spread. Doctors can employ imaging techniques in order to get a more accurate understanding of the cancer after initial diagnosis. Physicians then categorize the progression of cancer into one of the following stages:

• Stage 1 (A): This type has no symptoms, although a small tumor is present – this type is usually found through treatment of other prostate complications or high PSA levels.
• Stage 2 (B): While there is more cancerous growth around the prostate, there is no evidence of spread. This can usually be felt through the rectal wall.
• Stage 3 (C): The cancer shows signs of spreading, and some symptoms may be occurring.
• Stage 4 (D): Extensive spread of cancer to lymph nodes, bones, or other parts of the body. There may be more sever symptoms with urination as well as weight loss and fatigue.

Treatment

Treating prostate cancer is a team effort that involves various professions like cancer specialists or oncologists, surgeons, and radiation specialists. It is usually suggested that two doctors evaluate the diagnosis and suggested therapy of someone diagnosed with prostate cancer for verification purposes. The treatment for prostate cancer can vary from person to person depending on the stage of the cancer and personal preferences of the patient. Treatment can include radiation, surgery, or hormonal therapy.

Still, while a cure is the goal, patients and physicians must also consider the consequences of different types of treatments in a man’s life. Doctors and patients will both have the difficult task of weighing the benefits and negative attributes of treatment with the risks involved with the stage of cancer diagnosed. In men with other health concerns or cancer that is not spreading or growing at a rapid rate, watchful weighting is an option that can be considered.

Surgery to remove the cancerous tissue from the prostate or other affected areas is often used at early stages of developing cancer. The complete removal of the prostate is known as a prostatectomy and is sometimes required. Some risks of surgery include loss of sexual function or impotence or temporary to permanent loss of urine retention control.  Less developed cancer may allow for nerve-sparing techniques to be used in order to spare sexual function during surgery.

Radiation therapy can be used to kill cancer cells and shrink tumors as an alternative to surgery or in conjunction with it. Radiation is recommended for relieving pain in advanced stages of cancer although it may also cause impotence and disruption of bowel function. Patients can receive external radiation in a clinical setting for a few weeks, or they can receive internal radiation where radioactive seeds are placed near cancerous tissue.

Hormonal therapy regulates male hormones in the body that sustain prostate cancer and is often used when cancer has spread throughout the body or after surgery to reduce risk of later developing cancer again. The side effects can include impotence, hot flashes, loss of sexual desire, thinning bones, and increased risk of blood clots.

Treatment is coupled with monitoring techniques that evaluate PSA levels (an antigen associated with prostate problems), signs of bone cancer (which is sometimes associated with prostate cancer), anemia, and other symptoms that may indicate the cancer is still advancing.