Prostate Cancer

An Overview of Prostate Cancer: A Guide for Men’s Health

Prostate cancer can become a cause for concern in men over 40, learn about prostate cancer symptoms and the latest prostate cancer treatment.

Prostate Cancer

The prostate is a small walnut-shaped gland which functions with the purpose of producing the seminal fluid that nourishes and transports sperm. As men age, the prostate can enlarge to a much bigger size.

Following skin cancer, prostate cancer is one of the most common cancers found in American men. It is estimated that approximately 1 out of every 7 men will be diagnosed with prostate cancer in his lifetime. Occurring mostly in older men, about 60 percent of cases are diagnosed in men age 65 and older, with the average prostate cancer age at time of diagnosis being 66.

It is recommended that men should speak with their physician about the benefits and risks of prostate cancer screening, including a prostate exam, before deciding to be tested as this can help detect prostate cancer in its early stages.

Prostate Cancer Symptoms

Prostate cancer is a slow-growing cancer. In the early stages there are typically no warning signs. The following symptoms can occur after a tumor has caused the prostate gland to swell or the cancer has spread beyond the prostate:

  • Difficulty starting or stopping urination;
  • Frequent urge to urinate, especially at night;
  • Weak or interrupted stream of urine;
  • Inability to urinate when standing;
  • Leakage of urine when coughing or laughing;
  • Pain or a burning sensation during urination or ejaculation; and
  • Blood noted in the urine or semen.

These symptoms are similar to those seen in men who have been diagnosed with an enlarged, noncancerous prostate or a urinary tract infection. These symptoms are not directly related to the cancer as they are caused by the blockage resulting from cancer growth in the prostate. Advanced prostate cancer may present with the following symptoms:

  • Weight loss and loss of appetite;
  • Fatigue;
  • Nausea and/or vomiting;
  • A dull and deep pain or stiffness in the lower back, ribs, pelvis or upper thighs;
  • Lower extremity swelling; and
  • Weakness or paralysis in the legs, often accompanied by constipation.

Prostate Cancer Stages

After a diagnosis of prostate cancer is made, the next step is to determine the stage so proper treatment is initiated. There are specific tests that can be performed to detect if the cancer has spread outside of the prostate and to what extent. These tests can include a digital rectal exam, blood tests, ultrasound, MRI, CT scan, and even surgery to examine lymph nodes in the pelvis for signs that the prostate cancer has spread. There are four prostate cancer stages, each described below:

Stage I

The cancer is contained within the prostate with a prostate-specific antigen blood test less than 10. Cancer in this stage is microscopic and cannot be felt during a prostate exam or seen when imaging of the prostate is performed.

Stage II

The tumor remains within the prostate, but has grown in size. Stage II-a means the tumor involves more than one-half of only one lobe of the prostate. Stage II-b means the tumor involves both lobes of the prostate.

Stage III

At this prostate cancer stage, the cancer has spread beyond the prostate, but minimally. Nearby tissues such as the seminal vesicles may be affected only, leaving the lymph nodes and distant tissues cancer-free.

Stage IV

In this stage, the cancer has spread to distant areas including the lymph nodes, liver, lungs or bones.

It is greatly important to undergo the testing to determine the prostate cancer stage as this aids in determining optimal treatments and can provide insight related to prognosis.

Prostate Cancer Treatment

There are several forms of treatment available. When men are diagnosed in very early stages treatment may not be necessary, rather, active surveillance may be recommended when no symptoms are experienced. When appropriate, the following treatments may be utilized.

Chemotherapy

Chemotherapy involves the use of specific drugs to kill cancer cells and can be administer in a pill form or given intravenously (through a vein).

Radiation Therapy

During radiation, high-powered energy is used to kill cancer cells. Radiation therapy can be delivered externally or internally. When administered externally, a machine directs high-powered energy beams such as x-rays directly to the prostate. Internal administration involves the placing of several rice-sized radioactive seeds within the prostate tissue. These seeds deliver low doses of radiation over a longer period of time. The implantation of the seeds is done using an ultrasound-guided needle and there is no need for removal.

Hormone Therapy

This prostate cancer treatment is performed to stop the body from producing testosterone, a male hormone that can aid in the growth of cancer cells. Interrupting the supply of this hormone can result in the death of cancer cells or prevent their growth.

Biological Therapy

This therapy involves the use of your own immune system to fight cancer cells. During therapy, a patient’s own immune cells are collected, genetically engineered to fight prostate cancer and re-injected back into the patient’s body via a vein.

Freezing of Prostate Tissue

This form of treatment may include cryosurgery or cryoablation, which involves the freezing of tissues to kill cancer cells. During treatment, small needles are inserted into the prostate by ultrasound guidance. Initially, a very cold gas is place in the needles to freeze the surrounding tissue. Then, a second gas is used to reheat the tissue. Cycles of freezing and thawing of the tissue kills cancer cells, as well as some surrounding tissue that is healthy.

Surgery

There are many ways surgery can be performed. Whether laparoscopically, via a perineal incision, or an abdominal incision, the goal is to remove the prostate gland along with some surrounding tissue and lymph nodes.

Treatment is individualized for each patient and is dependent upon their overall health, age, symptoms and cancer stage.