Prostate cancer is cancer that starts in the prostate gland. The prostate is a small, walnut-sized structure that makes up part of a man’s reproductive system. It wraps around the urethra, the tube that carries urine out of the body.
Most of the symptoms listed below can occur with prostate cancer, they are more likely to be associated with noncancerous conditions.
- Urinary hesitancy (delayed or slowed start of urinary stream)
- Urinary dribbling, especially immediately after urinating
- Urinary retention
- Pain with urination
- Pain with ejaculation
- Lower back pain
- Pain with bowel movement
Other symptoms that may occur with this disease:
- Excessive urination at night
- Urinary leakage (incontinence)
- Bone pain or tenderness
- Blood in the urine (hematuria)
- Abdominal pain
- Low red blood cell count (anemia)
- Unintentional weight loss
Causes & Risk Factors
The cause of prostate cancer is unknown. Some studies have shown a relationship between high dietary fat intake and increased testosterone levels.
There is no known association with an enlarged prostate or benign prostatic hyperplasia (BPH).
Prostate cancer is the third most common cause of death from cancer in men of all ages and is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40.
The lowest number of cases occurs in Japanese men and those who do not eat meat (vegetarians).
Tests & Diagnostics
A number of tests may be done to diagnose prostate cancer:
- PSA test (may be high, although noncancerous enlargement of the prostate can also increase PSA levels)
- Free PSA (may help tell the difference between BPH and prostate cancer)
- AMACR (a newer test that is more sensitive than the PSA test for determining prostate cancer)
- Urinalysis (may show blood in the urine)
- Urine or prostatic fluid testing (may reveal unusual cells)
Prostate biopsy is the only test that can confirm the diagnosis.
The following tests may be done to determine whether the cancer has spread:
- CT scan
- Bone scan
- Chest x-ray
Health care providers use a system called staging to describe how far the cancer has grown. Tumor size, and how far the cancer has spread outside of the prostate determine the stage. Identifying the correct stage may help the doctor recommend the best treatment.
There are several different ways to stage tumors, including:
- The TNM staging system (most common)
- The A-B-C-D staging system, also known as the Whitmore-Jewett system
The grade of a tumor describes how aggressive a cancer might be. The more tumor cells differ from normal tissue, the faster these cells are likely to grow. The grading system for prostate cancer is called the Gleason grade or score. Higher scores are usually faster growing cancers.
Treatment options vary based on the stage of the tumor. In the early stages, talk to your doctor about several options including surgery, radiation therapy, or, in older patients, monitoring the cancer without active treatment.
Prostate cancer that has spread may be treated with drugs to reduce testosterone levels, surgery to remove the testes, or chemotherapy.
Surgery, radiation therapy, and hormonal therapy can interfere with sexual desire or performance on either a temporary or permanent basis. Discuss your concerns with your health care provider.