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Disease & Conditions >>> Prostate Cancer Articles & News

What Is Prostate Cancer

By: Joshua Levine-Health Correspondent

Prostate cancer is the third most common cause of cancer-related death in men. Most men do not realize the severity of this hazardous disease and think they are too busy to get checked out.

In a way, prostate cancer is the male equivalent of breast cancer, which plagues millions of women, but, unlike women, men pay little attention to the detecting its early signs. A little precaution today can go a long way tomorrow, and may even save your life. If you have a minute or two, take the time to learn more about this potential adversary. It is crucial for men to pay attention to their health.

Meet the enemy
Prostate cancer begins with the growth of a malignant tumor within the prostate gland and spreads by extending into the seminal vesicles, bladder and peritoneal cavity. It eventually metastasizes to the lymph nodes, bones, lungs, liver, and kidneys. The cause is unknown, although studies illustrate a small relation between high dietary fat intake and increased testosterone levels.

Prostate cancer is rarely found in men younger than 40 years of age. The frequency of occurrence is greatest in African-American men over 60 years old. Increased occurrence is also associated with farmers, tire workers, painters, and men exposed to the cadmium, a metallic element. The lowest incidence occurs in vegetarians.

The cancer is classified based on the tumor's aggressiveness and the degree of its difference from the surrounding tissue. Most prostate cancers are staged using the Whitmore-Jewett system (A B C D system). The system categorizes the tumors using the following scale:

A: Tumor that cannot be detected by touch but only through microscopic biopsy (tissue sampling).

B: Tumor that can be detected through touch and is still confined to the prostate.

C: Spreading of the tumor beyond the prostate.

D: The cancer has spread to regional lymph nodes.

Risk factors
The risk factors are well documented but inadequately understood. Some studies show positive associations with:

Age: Prostate cancer is particularly common among elderly men. Its prevalence has been reported in over 40% of men aged 70 years or older.

Race/Ethnicity: Large variations in the number of cases and mortality rate of prostate cancer have been observed among countries and racial/ethnic groups. African-Americans have the highest mortality rate for prostate cancer in the world, followed by Caucasians in Scandinavian countries. Asian men have the lowest mortality rate.

Family History: Epidemiological studies report that men who have family histories of prostate cancer are two or three times more likely to develop the disease.

Diet: The main component associated with prostate cancer is fat. One can actually reduce his chances of developing the cancer by modifying their diet.

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Delayed or slow start of urinary stream (urinary hesitancy)
Pain with urination
Urinary dribbling
Urinary retention
Lower back pain
Pain with ejaculation
Pain with bowel movement
Excessive urination during the night
Excessive sweating
Frequent and urgent urination
Abnormal urine color
Weight loss
Bone pain
Abdominal pain

Treatment options
Once a positive diagnosis is identified, the patient and doctor mutually decide on treatment. Patients should be well informed of the different treatments available because the final decision will have an effect on their quality of life. The decision should be considered very carefully and should include their partners' input, because they will ultimately be affected by the chosen course of action as well. The following list comprises a summary of different treatment possibilities:

1. Watchful Waiting: This is not actually a medical treatment. This option is best suited for older men with a ten-year life expectancy or less and whose tumor has not spread beyond the prostate. The reason for waiting is that the cancer is growing slowly and the men will probably die from natural causes before the tumor spreads. Other radical treatments, such as surgery, might be more dangerous than simply waiting.

2. Radical Prostatectomy (RP): A treatment where the prostate is completely removed. If performed when cancer is confined to the gland, the patient should be cured since, in theory, it removes all the cancer. RP is a serious operation that requires weeks of recuperation. This treatment can have lasting side effects, including impotence and incontinence. The FDA, however, recently approved a device called the CaverMap, which aids surgeons in locating nerve bundles, to help avoid severing nerves related to continence and erections when removing the prostate.

There are two major surgical methods used for removing the prostate gland. The first one -- the "perineal" method -- is used primarily when the prostate cancer is limited to the prostate gland and has not spread. An incision is made in the perineum. The second surgical method involves making an incision in the abdomen, just below the umbilicus, which extends downward to the pubic bone. This method is generally used for a more advanced cancer that has spread to the lymph nodes of the pelvis.

3. Radiation: An option that is less traumatic than RP and appears to have similar results when used in the early stages. Radiation treatment, however, also has side effects. Half the patients treated have reported various types of impotence. The treatment is applied through an external beam that directs the radiation dose directly within the prostate to kill cancer cells.

4. Cryotherapy: An experimental treatment with unknown long-term effectiveness due to inadequate data. The treatment involves killing the tumor's cells by freezing them. Early results are very encouraging.

5. Hormonal therapy: Used in all phases of prostate cancer treatment. It helps block production or action of male hormones that have been shown to fuel prostate cancer. The most widely used and approved hormone blockers are Lupron, Casodex, Eulexin, Nilandron, and Zoladex. In some situations, the testicles are removed because they produce male hormones.

It is recommended that patients commit to further research before making their final decision. The treatments mentioned above are in a summarized format. More information is available at your family doctor's office.

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