Slideshow: A Visual Guide to Prostate Cancer
1-What Is Prostate Cancer?
Prostate cancer develops in a man's prostate, the walnut-sized gland just below the bladder that produces some of the fluid in semen. It's the most common cancer in men after skin cancer. Prostate cancer often grows very slowly and may not cause significant harm. But some types are more aggressive and can spread quickly without treatment.
2-Symptoms of Prostate Cancer
In the early stages, men may have no symptoms. Later, symptoms can include:
• Frequent urination, especially at night
• Difficulty starting or stopping urination
• Weak or interrupted urinary stream
• Painful or burning sensation during urination or ejaculation
• Blood in urine or semen
Advanced cancer can cause deep pain in the lower back, hips, or upper thighs.
3-Enlarged Prostate or Prostate Cancer?
The prostate can grow larger as men age, sometimes pressing on the bladder or urethra and causing symptoms similar to prostate cancer. This is called benign prostatic hyperplasia (BPH). It's not cancer and can be treated if symptoms become bothersome. A third problem that can cause urinary symptoms is prostatitis. This inflammation or infection may also cause a fever and in many cases is treated with medication.
4-Risk Factors You Can't Control
Growing older is the greatest risk factor for prostate cancer, particularly after age 50. After age 70, studies suggest that anywhere from 31% to 83% of men have some form of prostate cancer, though there may be no outward symptoms. Family history increases a man's risk: having a father or brother with prostate cancer more than doubles the risk. African-American men and Caribbean men of African descent are at high risk and have the highest rate of prostate cancer in the world.
5-Risk Factors You Can Control
Diet seems to play a role in the development of prostate cancer, which is much more common in countries where meat and high-fat dairy are mainstays. The reason for this link is unclear. Dietary fat, particularly animal fat from red meat, may boost male hormone levels. And this may fuel the growth of cancerous prostate cells. A diet too low in fruits and vegetables may also play a role.
6-Myths About Prostate Cancer
Here are some things that will not cause prostate cancer: Too much sex, a vasectomy, and masturbation. If you have an enlarged prostate (BPH), that does not mean you are at greater risk of developing prostate cancer. Researchers are still studying whether alcohol use, STDs, or prostatitis play a role in the development of prostate cancer.
7-Can Prostate Cancer Be Found Early?
Screening tests are available to find prostate cancer early, but government guidelines don't call for routine testing in men at any age. The tests may find cancers that are so slow-growing that medical treatments would offer no benefit. And the treatments themselves can have serious side effects. The American Cancer Society advises men to talk with a doctor about screening tests, beginning at:
• Age 50 for average-risk men who expect to live at least 10 more years
• Age 45 for men at high risk; this includes African-Americans and those with a father, brother, or son diagnosed before age 65
• Age 40 for men with more than one first-degree relative diagnosed at an early age
The U.S.Preventive Services Task Force (USPSTF) says that testing may be appropriate for some men age 55 – 69. They recommend that men talk to their doctor to discuss the potential risks and benefits of being tested.
8-Screening: DRE and PSA
Your doctor may initially do a digital rectal exam (DRE) to feel for bumps or hard spots on the prostate. After a discussion with your doctor, a blood test can be used to measure prostate-specific antigen (PSA), a protein produced by prostate cells. An elevated level may indicate a higher chance that you have cancer, but you can have a high level and still be cancer-free. It is also possible to have a normal PSA and have prostate cancer.
9-PSA Test Results
A normal PSA level is considered to be under 4 nanograms per milliliter (ng/mL) of blood, while a PSA above 10 suggests a high risk of cancer. But there are many exceptions:
• Men can have prostate cancer with a PSA less than 4.
• A prostate that is inflamed (prostatitis) or enlarged (BPH) can boost PSA levels, yet further testing may show no evidence of cancer.
• Some BPH drugs can lower PSA levels, despite the presence of prostate cancer, called a false negative.
If either a PSA or DRE test are abnormal, your doctor will likely order other tests.
10-Prostate Cancer Biopsy
If a physical exam or PSA test suggests a problem, your doctor may recommend a biopsy. A needle is inserted either through the rectum wall or the skin between the rectum and scrotum. Multiple small tissue samples are removed and examined under a microscope. A biopsy is the best way to detect cancer and predict whether it is slow-growing or aggressive.