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What is Prostate Cancer?

The prostate is a small walnut-shaped gland in males that uses male hormones called androgens, such as testosterone and dihydrotestosterone (DHT), to trigger and maintain male sex characteristics and reproduction.  Prostate cancer begins when cells in the prostate gland start to grow out of control.

Other than skin cancer, prostate cancer is the most common cancer in American men.  According to the American Cancer Society (ACS), about one man in nine will be diagnosed with prostate cancer during his lifetime.

In many cases, prostate cancer is a slow-growing cancer that does not spread beyond the prostate gland before the time of diagnosis.  However, some cases are more aggressive and need more urgent treatment.  Prostate cancer that is detected early, when it is still confined to the prostate gland, has the best chance for successful treatment.

RISK FACTORS

Researchers have found several factors that might affect a man’s risk of getting prostate cancer, including:

  • Age – Prostate cancer is rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50.  About six in ten cases of prostate cancer are found in men older than 65.
  • Race/ethnicity – Prostate cancer occurs more often in African-American men and Caribbean men of African ancestry than in men of other races.  African-American men are also more than twice as likely to die of prostate cancer as white men.
  • Family history – Prostate cancer seems to run in some families, which suggests that in some cases there may be an inherited or genetic factor.  Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. 

While there are a lot of risk factors for prostate cancer, there are also good survival statistics associated with the disease.  It can be a serious condition, but most men diagnosed with prostate cancer do not die from it.  Survival rates for prostate cancer are very high.  The ACS estimates that more than 3.1 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.

SYMPTOMS 

Early prostate cancer usually causes no symptoms.  More advanced prostate cancer can sometimes cause symptoms such as:

  • Trouble urinating
  • Decreased force in the stream of urine
  • Blood in the urine
  • Blood in the semen
  • Pain in the hips or back
  • Erectile dysfunction
  • Weight loss

Because these symptoms may overlap with those of other conditions, it is important to get the correct diagnosis to find the right treatment.  Make an appointment with your primary care physician or urologist if you are experiencing persistent signs and symptoms that concern you. 

SCREENING

As with all cancers, the most important component in the fight against prostate cancer is detecting it as early as possible. The ACS recommends prostate cancer screening times at:

  • Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years
  • Age 45 for men at high risk of developing prostate cancer.  This includes African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65)
  • Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age)

The first step in screening for prostate cancer is usually a prostate-specific antigen (PSA) test, in which a small amount of blood is drawn from the arm and the level of PSA, a protein made by the prostate, is measured. 

If the initial PSA result is abnormal, another option might be to get another type of test(s) to help you and your doctor get a better idea if you might have prostate cancer (and therefore need a biopsy). Some of the tests that might be done include:

  • A digital rectal exam (DRE), if it hasn’t been done already
  • One or more of the other special types of PSA tests, such as the Prostate Health Index (PHI), 4Kscore test, or percent-free PSA, or other lab tests, such as the ExoDx Prostate (IntelliScore)
  • An imaging test of the prostate gland, such as MRI or transrectal ultrasound (TRUS)

If the initial abnormal test was a DRE, the next step is typically to get a PSA blood test (and possibly other tests, such as a TRUS).

For some men, getting a prostate biopsy might be the best option, especially if the initial PSA level is high. A biopsy is a procedure in which small samples of the prostate are removed and then looked at under a microscope.  This test is the only way to know for sure if a man has prostate cancer.  If prostate cancer is found on a biopsy, this test can also help tell how likely it is that the cancer will grow and spread quickly.

There are numerous benefits of prostate cancer screening. Finding and treating prostate cancer early offers men more treatment options with potentially fewer side effects and the disease is often curable with early detection. Alliance Cancer Care advocates screening for prostate cancer and encourages patients to discuss PSA testing with their physician to better understand the benefits and risks associated with the screening.

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