Prostate Cancer

It is the second-leading cause of cancer death for men in the United States.

Prostate cancer cells can spread by breaking away from a prostate tumor. They can travel through blood vessels or lymph vessels to reach other parts of the body.

The Prostate

The prostate the size of a walnut and goes all the way around a tube called the urethra.
The main job of the prostate is to make fluid for semen.

What are the Symptoms of Prostate Cancer?

In its early stages, prostate cancer often has no symptoms. When symptoms do occur, they can be like those of an enlarged prostate or BPH.

What are Risk Factors for Prostate Cancer?

These associations may increase the risk of developing prostate cancer:

• Age: Most prevelant in men aged 55-79 years
• Ethnicity: African–Americans are in the highest risk group.
• Family history: 2 to 11 times more at–risk
• Smoking: risk may double for heavy smokers
• World area: higher in North America and Northern Europe
• Diet

How is Prostate Cancer Diagnosed?

PSA Test

The prostate-specific antigen (PSA) blood test is the main method for screening for prostate cancer. This blood test measures the level of prostate-specific antigen (PSA) in the blood. PSA is a protein made only by the prostate gland.

A rapid rise in PSA may be a sign that something is wrong. While many conditions can cause an elevated PSA, prostate cancer is the most serious cause of a high PSA result.

DRE

The digital rectal examination (DRE) is done to examine the prostate via the rectum.

Who Should Get Screened?

• Between 55–69 years old
• African–American
• Have a family history of prostate cancer

Biopsy

Prostate biopsy is done with an ultrasound to determine if you have prostate cancer. You are instructed to take an enema and antibiotics before the biopsy. You receive local anesthesia followed by 12-14 biopsies being taken.
After a biopsy, you may have blood in the ejaculate, urine and stool. This stops within a few days for urine and a few weeks for semen.

What Are The Stages of Prostate Cancer?

Grading

The most common grading system is called the Gleason score. The lowest score usually found is 5 (less aggressive) and the highest is 10 (most aggressive).

Staging

Tumor stage shows the size and spread of the cancer.

Imaging

Prostate cancer may spread into nearby tissues. You may need to have a CT scan, an MRI scan, or a bone scan to fully evaluate your prostate cancer.

What is the Survival Rate for Prostate Cancer?

Today, 99% of men with prostate cancer live at least 5 years. But only 33% survive 5 years if their cancer is diagnosed after it has spread to other parts of the body.

How is Prostate Cancer Treated?

(1) Active Surveillance

• Monitoring your PSA, DRE, and biopsies every 6 months to 1 year
• Used for men who are very low risk or low risk
• May require additional curative treatment if disease noted to progress

(2) Watchful Waiting

• Often confused with active surveillance
• Monitoring cancer and ONLY treating if symptoms develop
• Not curative

(5) Cryotherapy

• Freezing of the prostate gland to kill cancer cells

(6) Hormone therapy

• Block/lower testosterone levels the fuel prostate cancer
• May be used with radiation or if cancer has spread outside the prostate

(7) Chemotherapy

• Used for cancer that has spread outside the prostate

What Happens After Treatment?

Erectile Dysfunction (ED) Issues after Prostate Cancer Treatment

After prostate cancer, men can experience various side effects including erectile dysfunction and depends on:

• Age 
• Health
• Sexual function before treatment
• Stage of the cancer
• Whether the nerves that control erection were saved

Incontinence Issues after Prostate Cancer Treatment

Incontinence is the inability to control your urine and may sometimes occur after treatment for prostate cancer. You may need to wear a pad for a few weeks to months. Usually incontinence does not last long. But it can last as long as six to twelve months. Most men will recover urinary control.