(Cancer of the Prostate; Prostatic Carcinoma)
DefinitionProstate cancer is a disease in which cancer cells grow in the prostate gland. The prostate is a walnut-sized gland in men. It surrounds the urethra. The prostate makes a fluid that is part of semen.
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CausesCancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant growths. These growths can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.It is not clear exactly what causes these problems in the cells, but it is probably a combination of genetics and environment.
Risk FactorsProstate cancer is more common in men who are aged 55 years and older. It is also more common in black men than white men. Other factors that may increase your chance of prostate cancer include:
- Family history of prostate cancer, especially father or brother
- Family history of prostate cancer diagnosed at a young age
- A high-fat diet
SymptomsProstate cancer may cause:
- A need to urinate frequently, especially at night
- Difficulty starting urination or holding back urine
- Not able to urinate
- Weak or interrupted urine flow
- Painful or burning urination
- Difficulty having an erection
- Painful ejaculation
- Blood in urine or semen
- Frequent pain or stiffness in the lower back, hips, or upper thighs
DiagnosisYour doctor will ask about symptoms and medical history. A physical exam will also be done.Tests may include:
- Digital rectal exam
- Blood tests
- Urine tests
TreatmentCancer treatment varies depending on the stage of prostate cancer. You and your doctor will discuss the best treatment options for you. Treatment may include:
Watchful WaitingThis involves your doctor monitoring the cancer to see if it is growing. Watchful waiting may be appropriate if you:
- Have early stage prostate cancer that is growing slowly
- Are of an advanced age
- Have serious health problems (risks of treatment outweigh the benefits)
SurgeryTypes of surgery that may be needed include:
- Pelvic lymphadenectomy—removal of lymph nodes in the pelvis to determine if they contain cancer
- Radical retropubic prostatectomy—removal of the entire prostate and nearby lymph nodes through an incision in the abdomen
- Radical perineal prostatectomy—removal of the entire prostate through an incision between the scrotum and the anus
- Transurethral resection of the prostate (TURP)—removal of part of the prostate with an instrument inserted through the urethra (may be done to relieve symptoms)
Radiation TherapyRadiation therapy involves the use of radiation to kill cancer cells and shrink tumors. Examples include:
- Conformal radiation therapy—conformal radiation therapy uses three-dimensional radiation beams that are conformed into the shape of the diseased prostate. This treatment spares nearby tissue the damaging effects of radiation.
- Intensity-modulated radiation therapy (IMRT)— IMRT uses radiation beams of different intensities to deliver higher doses of radiation therapy to the tumor and lower doses to nearby tissues at the same time.
Hormone TherapyIf prostate cancer has spread or has returned after being treated, hormone therapy may be used. The goal of hormone therapy is to lower the levels of male hormones, called androgens. The main androgen is testosterone. Lowering androgen levels can cause prostate cancer to shrink or slow its growth.Hormone therapy may include:
- Luteinizing hormone-releasing hormone (LHRH) analogs
- Luteinizing hormone-releasing hormone (LHRH) antagonists
- Estrogen therapy—rarely used now unless other treatments are not working
- Antifungal medications
- Antineoplastic agents
Other Treatment OptionsOther options may include:
- Cryosurgery—this involves using an instrument to freeze and destroy prostate cancer cells
- Immunotherapy—a drug treatment that builds your immune system so that you can better fight cancer cells
- Targeted therapies—focus on the cancer cells, rather than attacking both the cancer cells and the healthy cells
- High-intensity focused ultrasound—an endorectal probe (a probe that is inserted into the rectum) is used to destroy cancer cells with ultrasound energy
PreventionTo help reduce your chance of prostate cancer, take the following steps:
- Eat a healthful diet. Your diet should be high in fruits, vegetables, and fish, and low in red meat.
- Ask your doctor about taking certain medications. For example, daily aspirin therapy and 5-alpha reductase inhibitors may reduce your risk of prostate cancer.
National Cancer Institute
Urology Care Foundation
Prostate Cancer Canada
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- Reviewer: Mohei Abouzied, MD
- Review Date: 08/2014
- Update Date: 09/30/2013