Important Facts about Prostate Cancer:

• The prostate is a gland found only in men. It is about the size of a walnut and sits below the bladder.
• Prostate cancer is the second most common cancer among men. About one in seven men in the U.S. will be diagnosed with the disease during his lifetime.
• More than 90 percent of all prostate cancers are discovered when they are confined to the prostate and nearby organs. The five-year survival rate for men diagnosed with prostate tumors discovered at these stages is nearly 100 percent.
• Compared with other men, African-American men and men with a family history of the disease are at higher risk of developing prostate cancer. A man with a father or brother who had prostate cancer is twice as likely to develop the disease.

Overview

Prostate cancer is the second most common diagnosed cancer in American men. According to the American Cancer Society, one in seven men will be diagnosed with prostate cancer during his lifetime. About 80 percent of prostate cancers are diagnosed at a localized stage, which means that the cancer hasn’t spread outside of the prostate. The average age at the time of prostate cancer diagnosis is about 66.

Less than 10 percent of men diagnosed with prostate cancer have advanced disease that has spread beyond the prostate gland. The American Cancer Society reports that the five-year survival rate for distant stage disease is about 28 percent.

The National Institute on Aging reveals that prostate problems are common after age 50. However, learning all you can about prostate cancer and prostate-related health issues can help you optimize your health, especially as you age.

Symptoms of Prostate Cancer

Though early warning signs of prostate cancer are rare, sometimes men experience symptoms before they are diagnose. The severity of symptoms may depend on where the cancer is located in the prostate and how advanced it has become. However, having any of these symptoms does not necessarily mean that you have prostate cancer or that the disease has progressed beyond its early stages.

Urinary Symptoms

• A need to urinate frequently, especially at night
• Difficulty starting urination or holding back urine
• A weak or interrupted flow of urine
• Painful or burning urination
• Hematuria

Erectile and Ejaculatory Symptoms

• Difficulty achieving or maintaining an erection
• Painful ejaculation
• Blood in the semen
• Decreased volume of ejaculation (though hydration, diet and frequency of ejaculation are more likely than prostate cancer to impact the volume of fluid)

Lower Extremity Symptoms

• Frequent pain or stiffness in the lower back, hips or upper thighs
• Swelling in the lower extremities

If a patient experiences bone pain and swelling in the lower extremities—especially when accompanied by urinary, erectile or ejaculation dysfunction—these could be symptoms of advanced prostate cancer.

Prostate Cancer Diagnosis

Prostate cancer is diagnosed with a prostate biopsy, which removes tissue from the prostate to examine it for cancer cells. This removal is guided by transrectal ultrasound, which uses a rectal probe to deliver ultrasound waves to the prostate and surrounding tissues.

A typical biopsy collects about 12 core samples from different areas of the prostate. Once the biopsy tissue is obtained, the pathologist examines it under the microscope. To diagnose prostate cancer, pathologists first examine the biopsy for abnormal, cancerous cells. If the pathologist sees cancer, the next step is to determine the grade of the cancer (how aggressive each cell looks under the microscope). The pathology report often includes information on how many biopsy core samples contain cancer as well as the percentage of cancer in each of the cores.

Some urologists use MRI combined with ultrasound technology to achieve a clearer biopsy target. Your physician may use an MRI-targeted prostate biopsy if you have had previous negative biopsies, worrisome features (e.g., an elevated PSA) and lesions visible on an MRI.

Potential complications from a prostate biopsy include:

• Blood in the urine
• Blood in the semen
• Infection in the prostate or urinary tract
• Rectal bleeding

Antibiotics are typically prescribed prior to a prostate biopsy in order to reduce the risk of an infectious complication.

Prostate Cancer Treatment

Prostate Cancer Treatment: What You Need to Know

• Your doctors may use a combination of several treatments, including surgery, radiation therapy or hormone therapy, to treat prostate cancer. Some treatments help enhance the effect of other treatments.
• Learning about side effects ahead of time is key to managing them. Although side effects are common for many prostate cancer treatments, sometimes you can take action to minimize them.
• When it comes to prostate cancer treatment, timing is often just as important as the type of treatment chosen. Some patients select active surveillance or watchful waiting to delay treatment and avoid its associated risks and side effects.

It is important to understand the various prostate cancer treatment options before making a decision. Your physician team will provide a comprehensive assessment of available treatments as well as expected outcomes.

Your treatment decision will be based on a number of clinical and psychological factors, including your:

• Cancer stage
• Need for therapy
• Level of risk
• Anticipated life expectancy
• Overall health
• Personal preference

Medical researchers and doctors still have much to learn about prostate cancer therapy. Even when considering each patient’s unique clinical and psychological factors, there still may be some uncertainty about therapy selection and the need for immediate treatment.

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