Prostate Cancer

Prostate cancer is one of the most common forms of cancer among American men. About 80 percent of all cases occur in men over 65. For unknown reasons, prostate cancer is more common among African American men than white men.

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In the early stages of prostate cancer, the disease stays in the prostate and is not life threatening. But without treatment, cancer can spread to other parts of the body and eventually cause death. Some 40,000 men die every year from prostate cancer that has spread.

Diagnosis

To find the cause of prostate symptoms, the doctor takes a careful medical history and performs a physical exam. The physical includes a digital rectal exam, in which the doctor feels the prostate through the rectum. Hard or lumpy areas may mean that cancer is present.

Some doctors also recommend a blood test for a substance called prostate specific antigen (PSA). PSA levels may be high in men who have prostate cancer or BPH. However, the test is not always accurate. Researchers are studying changes in PSA levels over time to learn whether the test may someday be useful for early diagnosis of prostate cancer.

If a doctor suspects prostate cancer, he or she may recommend a biopsy. This is a simple surgical procedure in which a small piece of prostate tissue is removed with a needle and examined under a microscope. If the biopsy shows prostate cancer, other tests are done to determine the type of treatment needed.

Prostate Cancer Treatment

Doctors have several ways to treat prostate cancer. The choice depends on many factors, such as whether or not the cancer has spread beyond the prostate, the patient’s age and general health, and how the patient feels about the treatment options and their side effects. Approaches to treatment include:

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Watchful waiting. Some men decide not to have treatment immediately if the cancer is growing slowly and not causing symptoms. Instead, they have regular checkups so they can be closely monitored by their doctor. Men who are older or have another serious illness may choose this option.

Surgery usually removes the entire prostate and surrounding tissues. This operation is called a radical prostatectomy. In the past, impotence was a side effect for nearly all men undergoing radical prostatectomy. But now, doctors can preserve the nerves going to the penis so that men can have erections after prostate removal.

Incontinence, the inability to hold urine, is common for a time after radical surgery for cancer. Most men regain urinary control within several weeks. A few continue to have problems that require them to wear a device to collect urine.

Another kind of surgery is a transurethral resection, which cuts cancer from the prostate but does not take out the entire prostate. This operation is sometimes done to relieve symptoms caused by the tumor before other treatment or in men who cannot have a radical prostatectomy.

Radiation therapy uses high energy rays to kill cancer cells and shrink tumors. It is often used when cancer cells are found in more than one area. Impotence may occur in men treated with radiation therapy.

Hormone therapy uses various hormones to stop cancer cells from growing. It is used for prostate cancer that has spread to distant parts of the body. Growth of breast tissue is a common side effect of hormone therapy.

More detailed information on the pros and cons of these treatment options is available from the Cancer Information Service at 800-422-6237; ask for the prostate cancer “PDQ for Patients.”