Prostate Cancer

prostate cancerProstate cancer is cancer of the prostate gland. It is the second-leading cause of cancer death for men in the United States. About 1 in 7 men will be diagnosed with it in their lifetime. About 1 in 35 men will die from it. Growths in the prostate can be benign (not cancer) or malignant (cancer).

Benign growths (such as benign prostatic hypertrophy):

Are rarely a threat to life
Don’t invade the tissues around them
Don’t spread to other parts of the body
Can be removed and can grow back very slowly (however, it doesn’t usually grow back)

Malignant growths (prostate cancer):

May sometimes be a threat to life
Can invade nearby organs and tissues (such as the bladder or rectum)
Can spread to other parts of the body
Often can be removed but sometimes grow back

Prostate cancer cells can spread by breaking away from a prostate tumor. They can travel through blood vessels or lymph vessels to reach other parts of the body. After spreading, cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues. When prostate cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if prostate cancer spreads to the bones, the cancer cells in the bones are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer. For that reason, it’s treated as prostate cancer, not bone cancer.

Symptoms

In its early stages, prostate cancer often has no symptoms. When symptoms do occur, they can be like those of an enlarged prostate or BPH. Thus, it is vital to talk to your health care provider when you have urinary symptoms. Later symptoms include:

Dull pain in the lower pelvic area
Frequent urinating
Trouble urinating, pain, burning, or weak urine flow
Blood in the urine or semen
Painful ejaculation
Pain in the lower back, hips or upper thighs
Loss of appetite
Loss of weight
Bone pain

Diagnosis

Screening
Screening is when you test for a disease even if you have no symptoms. Health care providers use the prostate specific antigen (PSA) test and digital rectal examination (DRE), to screen for prostate cancer. They advise both for early detection. There is debate on how often men should have a PSA test. Abnormality in either test is usually not due to cancer, but to other common conditions.

The American Urological Association (AUA) recommends talking with your health care provider about if you should be screened and when. To find out if prostate cancer screening is right for you, take our Risk Assessment Test. Take your results to your next appointment and talk with your health care provider about the benefits and risks of screening. There are two types of screenings, they are:

PSA Test
The prostate-specific antigen (PSA) blood test is the main method for screening for prostate cancer. This blood test measures the level of prostate-specific antigen (PSA) in the blood. PSA is a protein made only by the prostate gland. The PSA test can be done in a lab, hospital or health care provider’s office. There is no special preparation. The PSA test should come before the health care provider does a DRE. Ejaculation can raise the PSA level for 24 to 48 hours. So the patient should not ejaculate for two days before a PSA test.

Very little PSA is found in the blood of a man with a healthy prostate. A low PSA is better for prostate health. A rapid rise in PSA may be a sign that something is wrong. One possible cause of a high PSA level is benign (non-cancer) enlargement of the prostate. Inflammation of the prostate, called prostatitis is one more common cause of high PSA levels. Prostate cancer is the most serious cause of a high PSA result. Talk with your health care provider about whether the PSA test is right for you. If you decide to get tested, be sure to talk about changes in your PSA score with your provider.
DRE

Digital Rectal Exam (DRE)
The digital rectal examination (DRE) is done with the man bending over or lying curled on his side. The health care provider puts a lubricated gloved finger into the rectum. The health care provider will feel the prostate. They will be looking for abnormal shape or thickness in the prostate. The DRE can help your health care provider find prostate problems.
Who Should Get Screened?

Talk to your healthcare provider about prostate cancer screening if you are a man:

Between 55–69 years old
African–American
Have a family history of prostate cancer

 

Treatment

Deciding what treatment you should get can be complex. It depends on the stage and grade of the cancer. It also depends on your age and health. When thinking about which treatment to choose, you should consider side effects, long–term effects and outcomes of each. No one treatment is perfect for every man.

Some cancers grow so slowly that treatment may not be needed. But some grow fast and are life–threatening. Your health care provider will review your PSA level, T stage, Gleason score, and biopsy results. The results from these test will help your health care provider predict the likelihood of your cancer progressing or coming back. With all of this information you and your health care provider should decide the best treatment option for you. To help you make the best decision visit Michigan Cancer Consortium to review their materials on how to choose the best treatment for you.

The treatment choices for prostate cancer are:

Active Surveillance
Watchful Waiting
Radiation Therapy
Surgery
Cryotherapy
Hormonal Therapy
Chemotherapy

Dr. Lawrence Newman, the Las Vegas valley’s leading urologist, specializes in treating prostate cancer. Contact his office today for an appointment.