Prostate cancer happens when normal cells in the prostate gland change into abnormal cells and grow out of control. The prostate gland makes fluid that is part of semen. This gland sits below the bladder and in front of the rectum, and forms a ring around the urethra, the tube that carries urine out of the body.
Prostate cancer occurs most often in men older than 50. Although prostate cancer is very common, most men do not die from it. This is because prostate cancer usually grows very slowly.
Risk factors for prostate cancer
Prostate cancer is the second most common cancer in men worldwide, with over 1.2 million cases and 358,000 deaths annually. Of the several known prostate cancer risk factors, the most important are age, ethnicity, genetic factors, and dietary factors.
AGE: Age is the strongest risk factor for prostate cancer – 99% of prostate cancers occur in men aged 50 and over. The majority of cases are diagnosed in men over 65.
ETHNICITY: Men of African or Caribbean ancestry have a higher probability of developing prostate cancer.
GENETICS: There are genetic mutations that predispose individuals to a greater risk for prostate cancer. These cancers seem to run in families. Your risk is higher if a first-degree relative (father or brother) has had prostate cancer. Your risk increases with each additional first-degree relative who has or had the disease.
DIET: A diet high in animal fat and low in fruits and vegetables may increase the risk of prostate cancer. Some studies have found a very high calcium intake is associated with increased risk. Preliminary research also indicates that being overweight increases the risk for prostate cancer.
Signs and symptoms
Prostate cancer often causes no symptoms at first. But if symptoms do occur, they can include:
- Needing to urinate more often than usual;
- A urine stream that is slower than usual;
- Hematuria (blood in urine).
These symptoms can also be caused by conditions that are not prostate cancer. But if you have these symptoms, you should let your doctor or nurse know.
Diagnosing prostate cancer
Diagnosing prostate cancer usually begins with a visit to your health care provider who will ask about symptoms and complete a physical exam. Based on this information, if there is a suspicion of prostate cancer follow up testing can include:
- The prostate-specific antigen (PSA) test – often the first diagnostic used to detect prostate cancer. PSA is a protein produced by the prostate and the PSA test measures the amount of PSA in your blood.
- Digital rectal exam (DRE) – your doctor or nurse puts a finger in your anus and up into your rectum. He or she presses on the rectum wall to feel for abnormal areas on the prostate.
- Biopsy – A doctor will take a small sample of tissue from the prostate. Then another doctor will look at the sample under a microscope to see if it has cancer.
- Ultrasound, MRI scan, or other imaging tests – These tests create images of the inside of the body and can show abnormal growths.
Treating prostate cancer
Men with prostate cancer often have a choice of treatment. The main treatments for prostate cancer are:
Active surveillance – Men who choose this option do not have treatment right away. But they do have routine tests to check whether the cancer starts to grow more quickly. If so, they can start active treatment then.
Surgery – Prostate cancer can sometimes be treated with surgery to remove the prostate gland.
Radiation therapy – Radiation kills cancer cells. Radiation can be given from a machine that moves around your body. Or a doctor might put a source of radiation directly into the prostate gland.
Hormone therapy – Male hormones in the body make prostate cancer grow. Hormone therapy reduces the levels of these hormones, which can shrink the cancer. For hormone therapy, men might take medicines. Or they might have surgery to remove the testicles. (Male hormones are made in the testicles.) This treatment is usually only for men with advanced cancer. But some men with early stage cancer get it along with radiation or surgery.
Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing. Men with advanced prostate cancer might get chemotherapy if hormone therapy stops working. In some cases, chemotherapy and hormone therapy are given at the same time.
Watchful waiting – Some men, especially older men with other serious medical conditions, might choose not to do any of the above. Instead, they might choose “watchful waiting.” Watchful waiting is not exactly the same as active surveillance. It does not require regular testing, but involves treating symptoms when they happen.
Trends in prostate cancer
There are many treatments available for prostate cancer and it often responds well to treatment. The death rate has been declining significantly by an average of 3.3% per year since 2001 from improved testing for prostate cancer and better treatment options. Early detection is the key! Speak to your health care provider about your risk for prostate cancer and the steps you can take.