Prostate Cancer

Research has found risk factors that increase your chances of getting prostate cancer. These risk factors include—

• Age: The older a man is, the greater his risk for getting prostate cancer.
• Family history: Certain genes (passed from parent to child) that you inherited from your parents may affect your prostate cancer risk. Currently, no single gene is sure to raise or lower your risk of getting prostate cancer. However, a man with a father, brother, or son who has had prostate cancer is two to three times more likely to develop the disease himself.
• Race: Prostate cancer is more common in African-American men. It tends to start at younger ages and grow faster than in other racial or ethnic groups, but medical experts do not know why.

Researchers are trying to determine the causes of prostate cancer and whether it can be prevented. They do not yet agree on the factors that can influence a man’s risk of developing the disease, either positively or negatively.

There are usually no symptoms in the early stages. Some men do not have symptoms at all.

Some symptoms of prostate cancer include—

• Difficulty starting urination.
• Weak or interrupted flow of urine.
• Frequent urination, especially at night.
• Difficulty emptying the bladder completely.
• Pain or burning during urination.
• Blood in the urine or semen.
• Pain in the back, hips, or pelvis that doesn’t go away.
• Painful ejaculation.

If you have any symptoms that worry you, be sure to see your doctor right away. Keep in mind that these symptoms may be caused by conditions other than prostate cancer.

Two tests are commonly used to screen for prostate cancer—

• Digital rectal exam (DRE): A doctor or nurse inserts a gloved, lubricated finger into the rectum to estimate the size of the prostate and feel for lumps or other abnormalities.
• Prostate specific antigen (PSA) test: Measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others. PSA levels also can be affected by—

• Certain medical procedures.
• Certain medications.
• An enlarged prostate.
• A prostate infection.

Because many factors can affect PSA levels, your doctor is the best person to interpret your PSA test results. Only a biopsy can diagnose prostate cancer for sure.

Different types of treatment are available for prostate cancer. You and your doctor will decide which treatment is right for you. Some common treatments are—

• Active surveillance. Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms.
• Surgery. A prostatectomy is an operation where doctors remove the prostate. Radical prostatectomy removes the prostate as well as the surrounding tissue.
• Radiation therapy. Using high-energy rays (similar to X-rays) to kill the cancer. There are two types of radiation therapy—
  • External radiation therapy. A machine outside the body directs radiation at the cancer cells.
  • Internal radiation therapy (brachytherapy). Radioactive seeds or pellets are surgically placed into or near the cancer to destroy the cancer cells.
• Hormone therapy. Blocks cancer cells from getting the hormones they need to grow.

Other therapies used in the treatment of prostate cancer that are still under investigation include—

• Cryotherapy. Placing a special probe inside or near the prostate cancer to freeze and kill the cancer cells.
• Chemotherapy. Using special drugs to shrink or kill the cancer. The drugs can be pills you take or medicines given through your veins, or, sometimes, both.
• Biological therapy. Works with your body’s immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments.
• High-intensity focused ultrasound. This therapy directs high-energy sound waves (ultrasound) at the cancer to kill cancer cells.

For more information, visit the National Cancer Institute’s (NCI’s) Prostate Cancer Treatment PDQ^®. This site can also help you find a doctor or treatment facility that works in cancer care. Visit Facing Forward: Life After Cancer Treatment for more information about treatment and links that can help with treatment choices.