Prostate Cancer

More than 248,000 new cases of prostate cancer are diagnosed annually in the United States.

Rarely occurring in younger men, prostate cancer is more likely to affect men 65 and older. Characterized by the growth of abnormal cells in the walnut-shaped prostate gland, prostate cancer is the most common cancer in men.

The prostate gland is what produces the fluid that allows sperm to travel to reproductive organs.
If detected early and limited to the prostate gland, treatment is more likely to be successful.

Causes and Symptoms

It’s not clear what causes the DNA mutations that cause prostate gland cells to become cancerous. Some abnormal cells stay within the affected area, while others travel, or metastasize, to other parts of the body, usually in the later stages of cancer. Oftentimes, there are no symptoms associated with early stage prostate cancer. In fact, it’s not unusual for some patients to have the disease for many months or years and not be aware of it.

Exact cause of prostate cancer is unclear

Cancer may spread to other parts of the body

Early-stage disease may have no symptoms

Possible Symptoms

Symptoms may affect urinary function or cause discomfort in nearby areas. When symptoms are noticeable, patients may experience:

Frequent urination, especially at night

Weak urine flows

Painful erections

Discomfort in the rectum

Blood appearing in semen or urine

Stiffness or pain felt in the lower back, pelvis, or parts of legs

Making a Prostate Cancer Diagnosis

A DRE uses a gloved finger to examine the prostate.

Abnormal findings may require additional testing.

PSA testing measures prostate-specific antigen levels.

Blood samples are used to evaluate PSA levels.

The most effective way to diagnose prostate cancer is with regular screenings since most patients have no tell-tale symptoms. Screening usually involves a digital rectal exam (DRE) and a prostate-specific antigen (PSA) test.

Additional Diagnostic Testing

Ultrasound imaging may be used for evaluation.

Prostate tissue samples may be collected.

MRI fusion imaging may also be performed.

Additional tests help confirm the diagnosis.

With a DRE, a gloved finger is inserted into the rectum to evaluate the prostate. If a urologist finds anything abnormal, additional testing may be done. With a PSA test, a blood sample is taken from an arm vein and tested for a substance referred to as a prostate-specific antigen, which is produced by the prostate. Results showing higher levels of PSA suggest the prostate is likely infected, enlarged, or inflamed. Further evaluation may involve an ultrasound, collection of a prostate tissue sample, or an MRI fusion.

Non-Surgical and Surgical Treatment

Monitoring and Active Surveillance

If a positive diagnosis is made, additional testing may be done to determine how fast the cancer is growing and whether or not it has spread. With low-risk prostate cancer, initial treatment may be limited to periodic observation and testing (active surveillance).

Non-Surgical Treatment Options

Radiation therapy to kill cancer cells in and around the prostate can be delivered internally with radioactive seeds placed in tissues or externally with high-powered energy beams. Some patients also see positive results with chemotherapy, immunotherapy, hormone therapy, or the freezing of tissue to kill cancer cells (cryosurgery).

Surgical Treatment and Risk Factors

Should surgery be necessary, options include robot-assisted removal of the prostate, referred to as a radical prostatectomy. Nearby tissues and lymph nodes may also be removed. Other than age, risk factors associated with prostate cancer include a family history that includes both prostate and breast cancer and obesity. Regular rectal exams and blood tests increase the odds of early detection, and patients are often referred to a urologist for further evaluation if screening results suggest a prostate problem.