Prostate cancer is the #1 most common cancer among men aside from non-melanoma skin cancer. Every year more than 248,900 American men are diagnosed with prostate cancer, and 33,720 die from the disease, according to the National Cancer Institute. In general, the earlier the cancer is caught, the more likely it is for the patient to remain disease-free. Because approximately 90% of all prostate cancers are detected in the early stages, the cure rate for prostate cancer is very high-nearly 100% of men diagnosed at this stage will be disease-free after five years. It’s important to know the facts about prostate cancer so you and your family can make informed choices about screening and treatment.
Scientists are still trying to determine what causes prostate cancer. What they do know is that there are probably many reasons the disease occurs-and that by examining common risk factors, they can better determine who is likeliest to develop it. These risk factors include:
- Age: The diagnosis of prostate cancer is rare in men younger than 40. As men age, they are increasingly more likely to develop it. 1 in 6 men will be diagnosed in their lifetimes.
- Family history: If your father, grandfather, brother, son or other closely related family member has had prostate cancer, you are at an increased risk yourself.
- Race: African-American men are 60% more likely to develop prostate cancer than Caucasian or Hispanic men. The disease is rarer among Asian-American and American Indian men.
- Diet: Some studies suggest that men with diets high in fat may be at higher risk. Other research suggests that nutritional factors, like greater intake of vitamin D, lycopene and selenium, may lower a man’s risk of developing prostate cancer.
What are the symptoms of prostate cancer?
It’s important to understand that by the time prostate cancer symptoms usually appear, the cancer is likely in a later stage and is generally not curable. The disease needs to be found and cured before symptoms develop, which is why prostate cancer screenings are recommended starting at age 40.
Men with early-stage prostate cancer may not have symptoms at all. In fact, it could be 10 years before symptoms become noticeable. Some older men may never even know that they have prostate cancer since it may have not progressed or caused symptoms in their lifetime. And other forms of the disease may be small and grow so slowly that they don’t require treatment at all.
Some symptoms of prostate cancer may include:
- Difficulty urinating and/or difficulty starting and stopping urine flow
- Needing to urinate frequently, especially at night
- Pain or burning during urination
- Dull lower pelvic pain
- Blood in the urine or semen
- Painful ejaculation
- Pain in the lower back, hips or thighs
Prostate Cancer Treatments:
Prostate cancer treatment depends on the age and health of the patient, the aggressiveness of the cancer and the extent of the cancer at the time of diagnosis. There is no data that shows one treatment is better than the others. However, all treatments for prostate cancer except observation may have an effect on the quality of life with urinary control, erectile function and bowel function being the primary concerns. For this reason, it is important to have a thorough discussion with your urologist to weigh the risks and benefits of each option.
Active Surveillance: This is also known as watchful waiting. The timing of check-ups will vary for each man. It may be a personal choice or a choice because a man has a shorter life expectancy and wants to avoid possible problems with treatment. This may also be a good choice for a man with a longer life expectancy and a low-risk tumor. Other treatments can be initiated if the cancer shows signs of growth or of becoming more aggressive.
Radiation therapy: There are two types: interstitial prostate brachytherapy and external beam radiation therapy. If the cancer is very aggressive or more extensive, a combination of surgery followed by radiation therapy may be the best chance for a cure. With interstitial prostate brachytherapy, small radioactive “seeds” are planted in the prostate. Before treatment, the size of the prostate is checked to determine the dosage of seeds. These seeds are then placed into the prostate using needles that go through the skin between the scrotum and anus. With external beam radiation therapy, the prostate and other important tissues are treated with a carefully targeted beam of radiation. The advantage of radiation therapy is that it is less invasive than surgery. Urinary incontinence and erectile dysfunction may happen less often with radiation than with radical prostatectomy. However, one disadvantage of radiation therapy is that it leaves the prostate in the body. It is possible for some cancer to remain and worsen in the future.
Surgery: A radical prostatectomy is performed to remove the entire prostate. We have fellowship trained robotic surgeons who can expertly remove the prostate robotically. This newer technology reduces the side effects and offers excellent cancer control. Radical prostatectomy offers the man with cancer that has not spread outside the prostate the possibility of freedom from the disease for the rest of his life. The problems reported most often are erectile dysfunction and urinary incontinence. The chance of having erectile dysfunction depends on a man’s age and health, his sexual function before treatment, the stage of the cancer, and the ability to save the nerves that control erection during the surgery. Younger men (those under 60 years of age) are less likely to have problems with their erections than are older men. Even if erectile dysfunction does occur after surgery, erections may return to normal over time. Refer to Penile Rehabilitation under Erectile Dysfunction on our website for more information. While many men experience some form of urinary incontinence following prostate cancer treatment, the good news is, 90 to 95% of men do regain their continence with time without the need for additional surgery.
Hormone therapy: This involves stopping your body from producing the male sex hormone testosterone which stimulates the growth of prostate cancer cells. Another type of this therapy can block testosterone from getting into the cancer cells. Sometimes a combination of two drugs is used to achieve both effects. While hormonal therapy may lessen the cancer symptoms in men who choose not to or who cannot be treated with other therapies, it makes heart disease and diabetes worse in those who have these diseases. It can be a useful treatment, but does have some undesirable side effects. These include breast enlargement, reduced sex drive, erectile dysfunction, hot flashes, weight gain, and reduction in muscle mass.