Summary for HealthiNation’s Prostate Cancer

Hosted by Dr. Paul Knoepflmacher, Internal Medicine

What Is Prostate Cancer?

The prostate is a walnut-sized gland found only in men that aides in reproductive function. It produces a fluid that helps sperm cells exit the body. It is located just under the bladder, and surrounds the urethra, the tube that carries the urine to the outside. When cancer affects the prostate, it can cause serious urinary and sexual complications.

How Does Prostate Cancer Happen?

Prostate cancer develops when normal cells in the prostate gland mutate, or divide abnormally, and become cancerous. The hard cluster of cancer cells in the prostate usually grow slowly and often remain in the prostate for many years before spreading to other parts of the body. In some rare cases, prostate cancer can grow and spread quickly. When that happens, the cancer often travels to the lymph nodes and bones.

Signs & Symptoms of Prostate Cancer

Typically, there are no signs or symptoms of early stage prostate cancer. If you experience these symptoms, you should call your doctor immediately to discuss the possibility of prostate cancer, or other serious prostate or urinary tract problems:

• Weak Urination
• Blood in the urine or semen
• Difficult or painful urination
• Frequent urges to urinate
• Dull pain in the back or spine, pelvis or hips
• Unexplained weight loss

Screening for Prostate Cancer

A simple blood test performed by your doctor can help you determine if you have prostate cancer. The blood test looks for excessive amounts of PSA, or Prostate Specific Antigen. An elevated PSA may indicate the presence of cancer, or another problem in the prostate, such as an enlarged prostate (also called BPH), an infection, or inflammation in the prostate gland.

Risks Factors for Prostate Cancer

Since all men have the prostate gland, all men are at risk of developing this form of cancer. However, there are certain risk factors that increase a man’s chances of developing it. These include:

• Age. Men over age 60 are at a higher risk of the disease. In fact, three out of four cases of prostate cancer are in men over the age of 65.
• Race: African American men are more likely to develop prostate cancer.
• Family History: Your chances of developing prostate cancer are higher if your father or brother has been diagnosed.
• Lifestyle Choices: Research has shown that high fat diets can increase the risk of prostate cancer.

Prostate Cancer Screening Guidelines

All men need to get regular checkups, and should be screened for prostate cancer beginning at age 40. If you are at a higher risk due to age, race and family history, you should talk to your doctor about starting screening earlier.

• Age 40 and up. The American Urological Association recommends that men 40 and older get an annual digital rectal exam. For this test, your doctor will use his or her finger to feel your prostate through the rectal wall. They are looking for hard spots or clusters that may be densely packed cancer cells.
• Age 50 and up. According to the American Cancer Society, men older than 50 should be screened for elevated levels of PSA every year.

Depending on the results of these two tests, your doctor may recommend a prostate biopsy. With a biopsy, your doctor will take tissue samples of your prostate and send them to a lab to be examined for the presence of cancer. The biopsy result will yield what is called the Gleason score, which will tell your doctor how aggressive the cancer is.

Preventing Prostate Cancer

While there is no foolproof way to prevent prostate cancer, research suggests that a healthy lifestyle can lower your chances of developing it.

Exercise helps boost the immune system, improves circulation and helps digestion. It also helps prevent obesity, which is a risk factor for prostate cancer.

A diet low in fat may also help. High fat diets have been linked to prostate cancer.

Food high in the antioxidant lycopene, like tomatoes, grapefruit and watermelon, may help lower your risk as well.

Soy products that contain isoflavones can also help by keeping testosterone in check.

Treating Prostate Cancer

Based on the severity of your cancer, your doctor may refer you to a urologist or oncologist, who will work with you to create a cancer treatment plan. A typical prostate cancer treatment plan includes the following:

• Watchful Waiting. This means you and your doctor will watch the progress of the cancer, testing often, to make sure it isn’t growing and spreading. This option is usually used for early stage cancers or for patients who are elderly or too sick to undergo other forms of treatments.
• Radiation Therapy. If the cancer starts to grow, one of two types of radiation may be prescribed:
  • External Beam Radiation. This type of radiation entails using a machine to direct X-rays into the prostate to kill the cancer cells.
  • Seed Implants. The doctor will place several small radioactive “seeds” in your prostate. These seeds generate higher doses of radiation than the external beam method and over a longer period of time. The radiation usually “runs out” in about a year and there is no need to remove them. This type of radiation therapy is used for low-grade prostate cancer.
• Hormone Therapy. Since testosterone spurs the growth of cancer cells in the prostate, this type of treatment works by regulating the amount of testosterone in the body. It is generally used for people with advanced prostate cancer; or, it can be used to shrink a cancer cluster before radiation or surgery.
• Surgery. This can be performed to remove the prostate gland entirely. Your surgeon will make every attempt to spare the nerves and muscles involved in urination and sexual functioning, while clearing all the cancer from the body.

Side effects of these treatments include bladder and rectal problems, sexual problems—including erectile dysfunction--and reduced muscle and bone mass. Many of these side effects can be treated successfully, so be sure to tell your doctor about any side effects you think you may be experiencing.

While prostate cancer can be intimidating, more men are beating the disease every year thanks to better screening and treatment options.

HealthiNation offers health information for educational purposes only; this information is not meant as medical advice. Always consult your doctor about your specific health condition.