Prostate Cancer

The prostate gland is part of the male reproductive system. Located directly below the bladder and in front of the rectum, the gland produces a thick fluid that becomes part of the semen and carries sperm. The prostate gland is normally about the size of a walnut.

Prostate cancer is usually a slow-growing tumor. Most types do not cause symptoms or shorten life expectancy. It can occur when men are in their 40s, but becomes much more common as they age.

CAUSES AND RISKS
Prostate cancer is the most common type of cancer found in American men, other than skin cancer. No definitive causes of prostate cancer have been established by researchers. Men over the age of 50, African American men, and men with a family history of prostate cancer are at increased risk. Men at any age can get prostate cancer but 8 of 10 men with prostate cancer are over the age of 65. Men who are over weight and eat a diet high in fat are at more of a risk of getting prostate cancer.

SYMPTOMS
The following symptoms commonly occur in men with prostate cancer.

• frequent urination, especially at night
• trouble starting and stopping urination
• inability to urinate
• less force to the stream of urine
• pain or a burning sensation while urinating
• blood in the urine or ejaculation
• a feeling of not fully emptying the bladder after urination

Many times, however, early prostate cancer does not produce symptoms.

PREVENTION
Prostate cancer often progresses slowly and is most treatable when detected early. Currently, early detection and treatment are the only effective measures for decreasing the mortality rate for prostate cancer.

Two tests are used to screen for prostate cancer, the digital rectal exam and a prostate-specific antigen (PSA) blood test. The digital rectal exam is a procedure in which the physician feels the prostate through the rectal wall to detect tumors. It is often difficult to detect small tumors and difficult to distinguish cancerous from non-cancerous abnormalities.

The PSA blood test measures the level of a prostate specific antigen and is used specifically to detect prostate cancer. If prostate cancer is suspected, the doctor will then do a biopsy to verify or disprove a cancer diagnosis.

The decision to screen for prostate cancer depends on each person’s situation and should be based on age, health status, family history, risk factors and the man’s educated opinion about the test.

It is strongly recommended that African American men and men with a family history of prostate cancer have regular screenings, beginning at age 40. Some recent evidence does indicate that aggressive diagnosis and treatment are having some effect on decreasing mortality due to prostate cancer.

The American Academy of Family Physicians and the U.S. Preventive Services Task Force, feel that the high false-positive rate (66% of positive tests are wrong) and the subsequent inconvenience and cost of more confirmatory testing make the PSA a poor general screening test. They do not recommend routine screening. On the other hand, because early detection may save lives, the American Cancer Society and the American Urological Association feel annual testing should begin at age 50 for all men.

TREATMENT
Each year more than 40,000 American men die of prostate cancer. When the tumor is detected early a number of treatment options are available, such as surgery and radiation therapy.

Success of a treatment is influenced by the one’s age, existing health conditions and aggressiveness of the tumor. Once prostate cancer has spread beyond the gland there is no cure. It is important to note that prostate cancer is rarely the primary cause of a person’s death. Often, men with prostate cancer die from other diseases before the cancer becomes a problem. The most effective way for our male population to live healthier and longer is to practice positive health behaviors, like regular exercise, eating low-fat diets, and quitting smoking. This will often do more to prolong life than treating prostate cancer.

References
Centers for Disease Control Web site, search for prostate cancer
American Academy of Family Physicians Web site, search for prostate cancer
American Urological Association Web site, search for prostate cancer
American Cancer Society Web site, search for prostate cancer

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