What is the prostate?

The prostate is a small but important gland found only in men. It sits below the bladder and actually encircles the urethra, the tube that carries urine out of the bladder. In younger men it is generally about the size of a walnut. The prostate helps produce semen, so it plays an important role in the male reproductive system.

What problems are associated with the prostate?

For most men, the prostate is rarely an issue until later in life. There are three main problems associated with the prostate: BPH (benign prostatic hyperplasia), prostatitis, and prostate cancer. BPH, also known as enlarged prostate, is a common aging problem that results in the enlarged prostate compressing the urethra and causing complications with urination. If needed, BPH may be treated with medications, supplements, surgery, or other options, but it is not life-threatening.

Prostatitis is an inflammation of the prostate, usually as a result of a bacterial infection. It occurs in a wider age range of men, but it is not all that common and is rarely serious. Prostatitis is usually treated with antibiotics.  And the final problem is prostate cancer.

The facts about prostate cancer

Prostate cancer is the second most common cancer in men (following non-melanoma skin cancer). It is also the second leading cause of cancer-related death in men (following lung cancer).
According to current statistics, around 1 in 6 men (about 16%) will be diagnosed with prostate cancer. However, it should be noted that only about 1 in 36 men will die from it. In other words, the vast majority of men who have prostate cancer won’t die from it.

An important thing to know about prostate cancer is that, unlike many other cancers, prostate cancer is usually remarkably slow growing and in many cases may never become a serious problem. Many men may have prostate cancer for years with no significant consequences, and eventually die from unrelated causes.

What are the biggest risk factors for prostate cancer?

Age: The #1 risk factor is age. Prostate cancer is rare in men under the age of 40, while nearly two-thirds of prostate cancers are found in men over age 65.
Race: Prostate cancer occurs more often in African-American men than other races, followed by Caucasians.
Family History: Prostate cancer sometimes runs in families. Having a father or brother diagnosed with prostate cancer makes a person about twice as likely to develop it himself.

How do I know if I have prostate cancer?

In the early stages of prostate cancer, there are usually no detectable symptoms. This is why early screening is often encouraged. In more advanced forms, possible symptoms may include complications with urination or ejaculation (but symptoms may be similar to BPH and prostatitis). Symptoms should be discussed with a doctor to help determine a course of action.

Should I be tested for prostate cancer?

Experts generally recommend that men of average risk consider testing at about age 50. For those at higher risk, age 40 to 45. But it’s important to remember that while there are tests available, some experts question the usefulness and reliability of these tests. And a positive test should never lead to a knee-jerk reaction or unnecessary treatment.
It should also be noted that in addition to the traditional tests listed below, a number of promising new tests are being studied and developed right now.
PSA blood test: This blood test detects prostate-specific antigen (PSA), a protein produced by the prostate that is usually higher when prostate cancer is present. However, other factors can skew the results. So while the PSA test may be a good early warning sign, some doctors caution that its overuse may lead to unnecessary testing, treatment, and fear.
DRE (Digital Rectal Exam): Another common way to test for prostate cancer is DRE, in which the doctor actually feels the prostate for signs of abnormality. Like the PSA test, this test is also helpful but often inconclusive.
Biopsy: If you and your doctor feel there is good enough reason to be tested beyond a PSA or DRE test, the next likely step is a biopsy. This involves taking various tissue samples from the prostate to test them for cancer. A biopsy also helps grade the severity of the cancer.

What are the treatment options?

If you are diagnosed with prostate cancer, it’s important to remember your #1 tool: education! Do your research and talk with your doctor. Every case is unique, and not every case requires immediate action.

While there are many treatments being studied, some of the main treatment options include: surgery, radiation therapy, hormone therapy, and chemotherapy. These traditional treatments are sometimes necessary to eliminate or at least slow down the cancer. However, they all present possible risks to a man’s urinary and sexual health.

Depending on a man’s age and the aggressiveness of the cancer, many men are choosing an option termed watchful waiting, or active surveillance. Basically, this involves monitoring the cancer over time for signs of progression before turning to more drastic treatments.

While the prostate is a subject that most men don’t often think about, it is an important subject for every man to learn about. Get educated! And when it’s time, talk with your doctor.

Sources:
Prostate Cancer Detailed Guide, American Cancer Society,
http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/index, 2011.
Invasion of the Prostate Snatchers, Ralph H. Blum & Mark Scholz, 2010.
A Snapshot of Prostate Cancer, National Cancer Institute, 2010.
Understanding Prostate Cancer, Prostate Cancer Foundation,
http://www.pcf.org, 2011.
Prostate Problems, WebMD, http://men.webmd.com/prostate-problems, 2011.