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Prostate Cancer

The Causes, Symptoms, Treatment, and Prevention of Prostate Cancer

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Updated July 01, 2014

Prostate cancer is a type of cancer that affects the prostate gland in men. The prostate is located beneath the bladder, in front of the rectum, and wraps around part of the urethra.

Causes and Risk Factors of Prostate Cancer

We have yet to discover the exact causes of prostate cancer, but researchers have identified risk factors. Prostate cancer risk factors include:

  • Age. As men age, the risk of developing prostate cancer naturally increases. At age 50, the risk dramatically increases.

  • Race. The risk of prostate cancer is higher among African Americans, intermediate among Caucasians, and lowest among Asian and Hispanic males. The reason behind risk inequalities among the races has not been found.

  • Family History. Having a father or brother with prostate cancer increases your risk. Studies show that prostate cancer can run in families and inherited genetic mutations may be the cause. You don't need a family history to be at risk. However, most diagnosed men do not have a family history of the disease.

  • Diet. Ongoing studies question how diet affects prostate cancer development. Some studies suggest that a diet high in animal and dairy fats may slightly raise a man's risk. Other studies suggest a diet low in fruits and vegetables may also increase the risk.

  • Symptoms of Prostate Cancer

    Prostate cancer symptoms do not usually appear until the disease has spread beyond the prostate gland. As prostate cancer advances, the prostate constricts the urethra, causing difficulties in urination -- a common symptom. Prostate cancer symptoms include:
    • burning or pain during urination
    • inability to urinate even though you feel the urge to
    • frequent urination, especially during the night
    • weak urine stream
    • blood in urine or semen
    • lower back pain, ache, or stiffness; may also occur in hips and upper thighs
    • painful ejaculation

    Symptoms related to urination may be common with prostate cancer, but are also symptoms related to other prostate conditions like an inflamed or enlarged prostate.

    Diagnosis of Prostate Cancer

    Because prostate cancer commonly doesn't have symptoms in the early stages, it is usually a screening test that reveals a prostate abnormality that may indicate cancer. The American Cancer Society recommends that men who are at average risk of prostate cancer be offered a prostate specific antigen (PSA) test and digital rectal exam (DRE) annually beginning at age 50. Men who are at a higher risk should begin screening earlier, at age 45, or at their doctor's recommendation. Routine screening tests include the DRE and PSA test.

    If screening test results are suspicious, further examination of the prostate may be required. This can be done through a transrectal ultrasound and/or a prostate biopsy. A transrectal ultrasound is a small probe that is inserted through the rectum that provides images of the prostate. It can detect prostate abnormalities that could indicate prostate cancer, but it is ultimately a prostate biopsy that confirms the presence of the disease.

    During a prostate biopsy, small samples of prostate tissue are removed that are screened for cancer by a pathologist. With the aid of a transrectal ultrasound, the doctor uses a special spring-loaded biopsy instrument to remove several small tissue samples. If the biopsy samples reveal cancer, then the pathologist further examines the cells to determine the grade of the tumor and the Gleason score.

    Staging is also a necessary step in assessing prostate cancer and planning a course of treatment. Staging refers to how far the disease has spread. Screening test results and biopsy findings determine if further testing are required for staging. There are four stages of prostate cancer: stage I, stage II, stage III, and stage IV.

    Treatment of Prostate Cancer

    Treatment for prostate cancer heavily relies on the stage of the disease, the aggressiveness of the tumor, and overall general health.

    Watchful Waiting. Watchful waiting is a type of treatment where the prostate cancer is monitored, but no treatment is provided to remove the cancer. This option is sometimes recommended for older men whose prostate cancer is slow-growing and is confined to the prostate.

    Surgery. A prostatectomy (surgical removal of the prostate) is a common treatment method in men whose cancer has not spread beyond the prostate, but may also be performed on later stages, as well.

    Radiation Therapy. Radiation therapy uses certain types high energy beams of radiation to shrink tumors or eliminate cancer cells. Radiation therapy works by damaging a cancer cell's DNA, making it unable to multiply. Two primary types of radiation therapy are external beam radiation therapy and (EBRT) internal beam radiation, also called brachytherapy.

    Chemotherapy.The organs in our body are made of cells that divide and multiply as the body needs them. When these cells continue to multiply unnecessarily, the result is a mass or growth, also called a tumor. Chemotherapy drugs work by eliminating these rapidly multiplying renegade cells.

    Chemotherapy may be a treatment option for men whose prostate cancer is advanced and has spread to other parts of the body.

    Cryotherapy. During cryotherapy, prostate cancer is treated by freezing prostate tissue. This type of treatment is ideal for men whose tumors are contained within the prostate.

    Hormone Therapy. Hormone therapy works by suppressing hormone levels that can fuel prostate cancer cells to multiply. Types of hormone therapy include
    • an orchiectomy: the surgical removal of the testicles to lower hormone levels
    • luteinizing hormone-releasing hormone (LHRH) agonists: drugs that help prevent the testicles from producing testosterone
    • antiandrogens: drugs that inhibit androgen activity

    Source:

    "General Information About Prostate Cancer." Prostate Cancer Treatment PDQ. National Cancer Institute. 23 May 2008. Accessed 09 July 2008.

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