Prostate Cancer

Prostate cancer originates in the male prostate gland, which is a small, walnut-shaped gland that is located anterior to the rectum and posterior to the urethra. In actuality, the urethra passes through the prostate gland so that parts of semen can be added to the sperm to make complete semen in ejaculation.

Prostate cancer is the 3rd most common cause of death from cancer in men at all ages and the most common cause of cancer death in men who are over the age of 75 years. It is common in men older than aged forty but not common below that age. Higher risk people include African American men, men older than the age of 60 years and men with a strong family history of prostate cancer. Men who are alcoholics, farmers, men who eat a lot of animal fat, men who have been exposed to agent orange, painters, those who work in tire plants and men who have been exposed to cadmium are at higher risk of getting prostate cancer. Men living in Japan who are also Japanese have a very low risk of developing prostate cancer.

Symptoms of prostate cancer include having a high PSA (prostate specific antigen) test are at risk for having prostate cancer, even without symptoms. Symptoms include dribbling or leakage of urination after urinating, slow stream, delayed start of urinary stream, blood in the urine or semen, straining when urinating and being unable to empty the bladder, and pain in the bones.

There are many tests for cancer of the prostate including a prostate biopsy. Tissue is taken from a needle biopsy of the prostate taken through the rectum is examined under the microscope. There is a Gleason grade that determines the grade of the tumor. It looks at the aggressiveness of the tumor. Scores of two to ten are possible with scores of 2-4 mean a low grade cancer, scores of 5-7 mean an intermediate grade cancer (this is the most common score received) and scores of 8-10 are high grade cancers or poorly differentiated cancer cells.

A biopsy is performed whenever the PSA is high for no obvious reason. A prostate examination can show an irregular surface or lump in the prostate and this requires a biopsy as well. The PSA test can monitor the effectiveness of the tumor, especially if it is high to begin with.

Tests can be done to see if the cancer has spread beyond the borders of the prostate. A CT scan of the abdomen can show if the cancer has spread or metastasized to other body areas. A bone scan can show if the tumor has metastasized to bone, which is fairly common.

The treatment for prostate cancer depends on its grade and stage. In some cases, nothing is done because the cancer is slow growing and isn't likely to progress faster than the lifespan of the patient. The more aggressive tumors are treated with surgery, radiation and chemotherapy, especially if the cancer has spread outside of the prostate and outside of the pelvis. The urinary problems will control themselves over time.

Surgery is not done all the time. Instead, radiation is done and medications to reduce the level of testosterone in the bloodstream are given. Surgery is done only if the cancer hasn't spread to other areas of the prostate and is located within the prostate tissue. Erection problems and urinary problems can result from surgery.

Radiation can be done via external beam radiation or using radioactive seeds inserted into the cancer. There are fewer side effects if the seeds are used and both types of radiation work best when the cancer has not spread much beyond the prostate area. Another type of radiation therapy is proton therapy, which causes less damage to the nearby tissues.

Hormonal therapy is the main male hormone of the body. You cannot have growth of the hormone-sensitive prostate tissue if there is no testosterone around. The major treatments include LH-RH agonists, which block the body from making testosterone. These are injectable drugs given every three to six months. Side effects of the medications for this type of treatment include hot flashes, vomiting, nausea, anemia, reduced sexual desire, osteoporosis, low muscle mass, impotence and weight gain.

Androgen blocking agents are also used, such as flutamide and nilutamide. Side effects include loss of sexual desire, erectile dysfunction, diarrhea, liver problems and enlarged breast size. An orchiectomy can be done to reduce the amount of testosterone produced by the body.