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Facts About Prostate Cancer
- Approximately 1 in 9 men will receive a prostate cancer diagnosis in their lifetime.
- Every year, there are roughly 175,000 new cases diagnosed.
- Approximately 1 in 41 men will die of prostate cancer.
- Every year, there are roughly 32,000 deaths from prostate cancer.
Of course, these numbers mask the human toll that prostate or any other cancer takes on not just the patient, but also those closest to them.
Let’s explore what exactly prostate cancer is, its symptoms and treatments, and if the disease is treatable with the potential for positive outcomes.
What is Prostate Cancer?
Above all, to understand prostate cancer, we must first explore what the prostate is and what it does.
The prostate is a small gland in the pelvic region that is part of the male reproductive system. The gland rests just below the bladder, in front of the rectum. Its primary purpose is to produce fluid for semen.
Prostate cancer develops with malignant cells forming within tissue in the prostate. In fact, the development, however, is most often slow-moving. In some instances, autopsies revealed cancer developing at such a slow pace that older patients died of other causes without knowing or being affected by undiagnosed prostate cancer.
The vast majority of cases are considered adenocarcinomas or formed within the gland cells. Other types include neuroendocrine tumors, sarcomas, small cell carcinomas, or transitional cell carcinomas, although each one is scarce.
Even with its prevalence, doctors do not fully understand what causes prostate cancer. They do know that as a man ages, their chances of developing prostate cancer also increases. The majority of cases occur in males over the age of 50.
African-American men are at higher risk for developing prostate cancer, as are those who’ve had a family history with either a father or brother receiving a diagnosis. Lifestyle and environment are also considered potential contributing factors.
Some studies even suggest a link between obesity and a recurrence of prostate cancer or increased risk of death.
Prostate Cancer Symptoms and Diagnosis
As evidenced by the slow-moving nature of the disease, symptoms and warning signs can be few and far between. Tumors that develop don’t necessarily have anything against which to put pressure, resulting in no pain.
There are instances where certain symptoms may be cause for alarm and should prompt a visit to the doctor, including:
- Frequent or urgent need to urinate
- Problems with the flow of urine (unable to start or stop)
- Weak or inconsistent or painful urination, or urination accompanied with a burning sensation
- Problem with having or sustaining an erection
- Reduction in the amount of ejaculate produced or painful ejaculation
- Blood within urine or semen
- Pressure or pain in the rectum
- Stiffness or any measure of pain in the pelvic region, lower back, or hips or thighs
Due to the rarity of symptoms or any outward warning signs, symptoms may have nothing to do with prostate cancer. They could be an indicator of benign prostatic hyperplasia or BPH, which is a non-cancerous enlargement of the prostate that may increase your risk of cancer.
Additionally, the symptoms could mean the potential for prostatitis, a painful diagnosis that most often leads to urinary tract infection.
As such, any abnormalities in urination or unexplained pain should remain a cause for concern. Seek the advice of a physician if any symptoms occur.
With prostate cancer being something akin to an introverted disease, the best form of detection is through regular screening. Starting at age 50 – earlier for those with an established family history or in a high-risk group – men should seek out routine screening for prostate cancer.
There are two types of test used for the routine screens: a digital rectal exam or DRE and the prostate-specific antigen or PSA test.
Digital Rectal Exam
The first prostate cancer test is the DRE. For this exam, a doctor inserts a lubricated, gloved finger into your rectum. With the prostate in front of the rectum, the physician can determine if the prostate is enlarged.
The test is relatively painless. If the results indicate enlargement of the prostate, then further tests would be necessary to confirm the scope and severity of the increased size.
Prostate-Specific Antigen (PSA)
For the PSA, this test requires blood to be drawn and tested at a lab. The prostate produces an antigen that when abnormally high may indicate the presence of cancer.
Although there is no generally accepted “normal” PSA level, the following is often used as a guide when determining test results:
- 0 to 2.5 Nanograms per milliliter (ng/mL) is considered safe
- 2.6 to 4 ng/mL is considered safe for most
- 4 to 10 ng/mL indicates a potential 25% chance of prostate cancer
- Greater than 10 ng/mL indicates a potential 50% chance or more of prostate cancer
However, in interpreting the test results, a doctor does take into account the following:
- Size of prostate
- Current or prior medical conditions, including the above mentioned BPH or prostatitis, that might increase PSA levels
- Any medications that might also increase PSA levels
An elevated PSA level doesn’t always indicate the presence of cancer. Prostate enlargement is a common sign of general aging. Regular testing, though, can help identify if a problem is present and more quickly help to determine the next steps to take.
Additional tests include transrectal ultrasound or transrectal MRI. A transrectal biopsy may also be performed to determine not only if cancer is present but if so, also the grade of cancer. The grade applied is also referred to as the Gleason score.
Prostate Cancer Treatment
Should prostate cancer be diagnosed in a patient, several critical points help determine the severity of the cancer and treatment options.
First, after a positive diagnosis, tests are conducted to determine if cancer has spread, either within the prostate itself or other parts of the body. These tests may include additional MRIs or scans, pelvic lymphadenectomy, where lymph nodes are removed from the pelvis and the tissue examined for cancer cells, or seminal vesicle biopsy.
When it comes to treatment, there exist multiple options. Treatment is determined by the size and how far its spread, the potential for cancer to grow, or a patient’s age or current level of health.
The most common treatments include:
- Watchful Waiting or Active Surveillance
- Radiation Therapy
- Hormone Therapy
- Vaccine Treatment
- Prevention or Treatment of the Cancer Spreading to Bones
There are also several alternative methods that a patient may seek.
There are, of course, risks and side effects associated with all treatments, including a reduction in sex drive, erectile dysfunction or the inability to impregnate a woman. Bowel and bladder issues are also common with prostate cancer treatments and include a leaky bladder or loss of bladder control.
Can Prostate Cancer be Prevented?
Although there is no guarantee against the prevention of prostate cancer, experts do agree that you can reduce risks and promote better outcomes with changes in your lifestyle.
First and foremost, a patient who smokes should quit. It not only raises the risk of a recurring instance of prostate cancer, but it also increases the risk of dying from it.
Exercise is also a critical factor for potentially keeping more aggressive cancer at bay. Of course, pairing a regular routine with healthy eating will further your chances of keeping your risk of prostate cancer low.
Low-fat diets, with plenty of fruits and vegetables, certainly won’t do you any harm even if research is uneven as to the impact on limiting cancer risks.
Patients often ask what they can do to combat their prostate cancers. The number one thing I talk to them about is weight loss. Among lifestyle factors, obesity is by far the strongest and clearest link to an aggressive and ultimately deadly course for this disease.
What are the Positive Outcomes for Prostate Cancer?
There’s little debate that prostate cancer is a very serious disease – one that has made a profound impact on men and their families. Even though its direct causes remain unknown, and data is inconclusive as to robust methods of prevention, prostate cancer is a disease where favorable outcomes are possible.
Through regular testing based on age and greater awareness of risk factors, prostate cancer does not have to be a death sentence. A healthy lifestyle, including diet, exercise, maintaining healthy body weight, and avoiding known risks such as smoking are positive steps towards improving your overall health.
Even if you are diagnosed with prostate cancer, you stand a far better chance of fighting it if you are otherwise healthy.
If you believe you’re at risk of prostate cancer, talk to your doctor. Even if you possess lower risk factors now, as you age those risks can increase, so it’s critical to educate yourself.