Prostate cancer happens when cells in the prostate grow uncontrollably and mutate. Depending on the type of prostate cancer, it may grow very slowly or quite rapidly. The prostate gland is located under the male bladder and in front of the rectum.
Women do not have prostate glands. The prostate, which becomes larger with age, generates part of the fluid that makes up the semen that transports sperm for female fertilization.
Prostate cancer most often develops in the gland cells that produce the seminal fluid. This kind of cancer is called an adenocarcinoma, which is by far the most common type of prostate cancer. Other more rare types of prostate cancer are small cell carcinomas, sarcomas, transitional cell carcinomas and neuroendocrine tumors.
Prostate cancer is the second most common cancer among American men, with non-melanoma skin cancer being the most common. Prostate cancer is the third leading cause of cancer-related deaths overall, and according to the American Cancer Society (ACS), an American man has about a 1 in 9 chance of getting prostate cancer at some time.
The majority of cases happen to men older than 50, with 6 out of 10 diagnosed cases occurring in men over age 65. Average age of diagnosis is 66, and the disease rarely occurs in men under age 40.
Even though it is the second most common form of cancer death in men, most men who get prostate cancer do not die from it, partly because most prostate cancers grow very slowly and men tend to get it late in life.
A steady increase in widespread screening for prostate cancer by men has resulted in the majority of new prostate cancers being found early when they haven’t spread beyond the prostate gland. This has led to a reduction in prostate cancer-related deaths.
Oncologists don’t know what causes prostate cancer, much like they don’t what causes most forms of cancer. But they have identified a number of risk factors for getting prostate cancer.
Having a risk factor, or several, does not mean a person will get prostate cancer. In numerous cases people with one or more risk factors never get cancer. While in other cases, those who get cancer may have had no known risk factors.
Prostate cancer can often be found early by prostate screening, which is testing to find cancer in patients before symptoms are present. Screening, such as the prostate-specific antigen (PSA) evaluation, can detect the cancer at an early stage when it is more likely to respond to treatment. A detailed explanation of screening & diagnosis of prostate cancer can be found by clicking the button below.
Usually, prostate cancer at an early stage of development does not present any symptoms. When symptoms are present, most often due to later stage cancer, they include the following:
Note that theses symptoms are also present with benign prostatic hyperplasia (BPH), also known as an enlarged prostate.
Once prostate cancer has been diagnosed (see link above), oncologists can choose from several treatment options. It’s important to think carefully about each choice and weigh the benefits of each treatment against the possible risks and side effects. Common treatment options follow.
This may be recommended if the prostate cancer grows slowly and if the man is older and/or has other serious health problems.
This is the most common treatment option if the cancer has not spread to other parts of the body (metastasized). A radical prostatectomy is the main surgical treatment, which removes the prostate gland plus the surrounding tissue. This type of surgery can be done in the following different ways.
Risks and side effects of any type of prostatectomy include blood clots in the lungs, damage to nearby organs, infections at the site of surgery and reactions to the anesthesia. Men might also experience urinary incontinence or erectile dysfunction as a side effect.
This is often used for cancer that is still just in the prostate gland. It may also be used in conjunction with other treatments on cancer that has grown outside of the prostate. The two main types of radiation therapy are external beam radiation and internal radiation (brachytherapy).
External radiation focuses the beam on the prostate gland from outside the body with a machine, whereas internal radiation uses small radioactive “seeds” placed directly into the prostate that give off certain amounts of radiation for weeks or months.
Risks and side effects of radiation therapy include tiredness, rectal irritation such as uncomfortable urination or bowel incontinence, dry skin, hair loss and urinary problems such as incontinence or frequent urination.
Oncologists often treat early-stage cancer with cryotherapy. Cryotherapy uses very cold temperatures to freeze and kill prostate cancer cells, inserting hollow needles that inject a gas that freezes the prostate cells. Cryotherapy is considered a less invasive surgery, but includes side effects such as blood in urine for a day or two, soreness and erectile dysfunction.
This is often used to reduce the level of male hormones (androgens) if the prostate cancer has spread too far to be cured by surgery or radiation. Types of hormonal therapy include surgical castration, which reduces hormone production, and several kinds of medications that act on hormone levels.
Some side effects of hormone therapy include erectile dysfunction, hot flashes, weight gain, fatigue, depression or anemia (low red blood cell count).
Chemo involves various anti-cancer drugs that are injected into a vein or taken by mouth. The drugs attack cells that are dividing quickly, which is why they work against cancer cells. This treatment is often used if hormone therapy doesn’t work and if the cancer has spread to distant organs. Because other cells in the body divide quickly, such as cells in the bone marrow, lining of the mouth and intestines, and hair follicles, these cells can also be affected by chemo. Side effects can include mouth sores, diarrhea, hair loss, nausea and fatigue.
These treatments are usually done one at a time, but in some cases can be combined. Oncologists and patients should discuss these options.
Clinical trials are research studies that help physicians find new, promising treatments and procedures for patients. They offer access to a newer, state-of-the art treatment option. But they may not be the best choice for everyone.
Patients interested in a clinical trial should discuss possible options with their doctor. California Cancer Associates for Research and Excellence have ongoing clinical trials for different types of cancers.