Prostate cancer is the most common male cancer in the United States. Each year, more than 200,000 men are affected by the disease. Men age 50 and older, African American men and men with a family history of the disease are at a higher risk. Fortunately, most prostate cancers are slow growing and can be detected at an early stage when most can be cured.
Factors that may increase your risk of prostate cancer include:
- Family history – having a brother, father, grandfather, son or cousin with prostate cancer
- Age – 90% of prostate cancers are diagnosed in men over the age of 50
- Race – African Americans are at greater risk
- Diet and lifestyle – obesity and/or a diet high in saturated fats, sugar, and red meat may increase risk
Symptoms and screening
- Early stage prostate cancer often has no warning signs. Making regular screening tests, such as PSA and digital rectal exams very important
- Digital rectal exam - during the DRE, your physician will insert a gloved finger into your rectum to feel the size shape and texture of your prostate.
- PSA (prostate specific antigen) blood test - determines the level of PSA in a blood sample. High levels may indicate prostate cancer, an enlarged prostate, or a prostate infection. Men with normal levels of PSA may also have prostate cancer.
These tests are recommended yearly for all men starting at age 50. African American men and anyone with a family history of prostate cancer should start yearly testing at age 40.
Diagnosis and staging
If further evaluation is needed after the screening tests, a prostate biopsy may be recommended. In this test, using a local anesthetic and ultrasound guidance, your urologist will insert a tiny needle into the prostate and withdraw small amounts of tissue to be examined in a laboratory.
If prostate cancer is found during the biopsy, additional testing such as a bone scan and a CT scan may be recommended.
In early stages, prostate cancer is usually confined to the prostate itself. As the cancer advances, it may move outside the prostate to surrounding tissues, lymph nodes, bones or other parts the body. The pathologist will assign a Gleason score to the cancer. This will help the physician to predict how the cancer may progress.
Many effective treatments for prostate cancer exist today. With early detection, many patients can be cured. The most appropriate treatment for you will depend on factors such as your age, health, lifestyle, and the characteristics of your cancer. Your treatment options may include:
- Watchful waiting (active surveillance) – men with slow growing, early stage cancers, or those with serious health problems or advanced age may be advised to monitor the cancer rather than actively treating it. Many men will “outlive” their prostate cancer.
- Surgery – a surgical procedure called radical prostatectomy removes the cancerous prostate gland. This can be done using a robotically assisted laparoscopic approach using the daVinci system, or through an open incision in the abdomen.
- Radiation therapy – Intensity modulated radiation therapy (IMRT) is used to shrink the tumor with minimal damage to surrounding tissue.
- Brachytherapy – tiny radioactive seeds are placed into the prostate to release radiation over the course of several months, providing targeted treatment to the cancer.
- Hormone therapy – medications are used to block the release of testosterone, the male hormone that fuels the growth of prostate cancer.
- Chemotherapy – chemotherapy is sometimes recommended for men who have progressive prostate cancer, or cancer that is not responding to other therapy.