Prostate Cancer
Approximately 41,000 men die annually due to prostate cancer making it the second most fatal cancer in men. Advances in the early detection and treatment of this disease are believed to have sharply increased survival. Use of the blood enzyme marker, prostate specific antigen, or PSA for short, and new methods for accurate biopsies of the prostate gland (Trans Rectal UltraSound or TRUS) have allowed earlier and more accurate detection. New advances in treatment range from short stay surgery (2-3days), with continence rates >90%, for surgery; to new radioactive non-surgical "seed" implants accurately placed by TRUS; and hormone therapies of greater ease, and choice of costs.
Ten-year disease specific survival rates of patients with radical prostatectomies are greater than 90% for low grade adenocarcinomas, greater than 85% for medium grade adenocarcinomas. Early detection of prostate cancer is strongly believed to significantly increase long term survival rates.
Who Should Be Screened?
It is recommended that men greater than 50 years old have an annual Digital Rectal Exam (DRE), and a PSA blood test. Please consult your family physician to see if you are due. Prostate cancer is rare in men under the age of 40 years old. Several groups have been found to be at a higher risk for prostate cancer. Brothers, or sons of men with prostate cancer carry a 2 to 9 times higher risk of disease. Also African-Americans also carry a higher risk than the average population of 2 to 5 fold. Both these two groups should begin annual exams and PSA at age 45. Patients who do not have family physicians, and are concerned about prostate cancer, should note that in late September is Prostate Cancer Awareness Week. The UCI Medical Center as well as other hospitals participate in a national week of prostate cancer screening, by offering DRE exams and PSA testing.
What Is The Prostate Gland And What Does It Do?
The prostate gland is normally the size of a walnut in the average adult and will increase in size in the senior years. The urethra is the tube, which delivers urine from the bladder through the prostate to the outside. At the base of the bladder, the prostate gland surrounds the urethra. The prostate is accessory part of the male ejaculatory system. Sperm are made and stored in the seminal vesicles until ejaculation occurs. The prostate gland provides 10-20% of the ejaculatory fluid. The precise function of the prostate is poorly understood. It is thought that its secretions may produce anti-bacterial substances to prevent urinary infection and possibly other secretions may play a role in fertilization. Nerves that control erection run alongside the gland, and may be carefully preserved in surgery to prevent impotency. This is called a nerve-sparing prostatectomy and is usually more successful in younger patients.
Common Questions
1. I have urinary symptoms, should I be worried about prostate cancer?
Symptoms of frequency, especially at night, urgency, stuttering of urine stream, waiting for urination increase with age. One cause is Benign Prostatic Hypertrophy or BPH. This involves the benign enlargement of the prostate and is not associated with cancer. Treatment generally starts with oral medications to relax or shrink the prostate to improve the symptomology. Inflammation and infection of the prostate gland can also occur causing Prostatitis, which will also cause urinary symptoms. Treatment is usually with a prolonged course of antibiotics. One should consult with their family physician to determine what the cause of symptoms may be.
Prostate cancer usually occurs in men without urinary symptoms. The only means to identify prostate cancer early is a digital rectal exam and PSA. When symptoms are present in prostate cancer the disease is almost always advanced.
More information can be found at:
Medline Prostate Cancer Site
National Cancer Institute
Prostate Cancer at Yahoo! Health
Prostate.com
Prostate Cancer Foundation
Cancer Information Network