Ask the Expert: Prostate Cancer

What is the prostate?

The prostate is a small gland about the size of a walnut that sits under the bladder and in front of the rectum. The urethra, which carries urine and semen out of the body, runs directly through the prostate. The prostate produces fluid that nourishes the sperm and also is involved in bladder control. Running along, and attached to, the sides of the prostate are the nerves that control erectile function.

How common is prostate cancer?

Prostate cancer is the most common non-skin cancer in America, affecting 1 in 6 men. It is the second leading cause of cancer deaths among American men. In 2008, more than 186,000 men will be diagnosed with prostate cancer, and more than 28,000 men will die from the disease. One new case occurs every 2.5 minutes and a man dies from prostate cancer every 19 minutes. It is estimated that there are more than 2 million American men currently living with prostate cancer.

How does prostate cancer compare with other cancers?

A non-smoking man is more likely to develop prostate cancer than he is to develop colon, bladder, melanoma, lymphoma and kidney cancers combined. In fact, a man is 35% more likely to be diagnosed with prostate cancer than a woman is to be diagnosed with breast cancer.

Who is at risk for developing prostate cancer?

Age, family history and African American race can all increase the risk of being diagnosed with the disease. More than 65% of all prostate cancers are diagnosed in men over the age of 65.

• 1 in 10,000 under age 40 will be diagnosed;
• 1 in 39 for ages 40 to 59, and;
• 1 in 14 for ages 60 to 69.

African American men are 56% more likely to develop prostate cancer compared with Caucasian men and nearly 2.5 times as likely to die from the disease.

Men with a father, brother or son who have had prostate cancer are twice as likely to develop the disease. Those with two or more relatives are nearly four times as likely to be diagnosed. The risk is highest in men whose family members were diagnosed before age 65.

Can prostate cancer be prevented?

There are anecdotal claims by the supplement industry and some medical experts that certain compounds provide preventative benefits without adequate clinical research. Recently, however, a few large-scale, well-designed clinical trials have been published and several more remain underway. Despite this progress, information and recommendations regarding the prevention of prostate cancer remains unreliable and at times controversial. Your urologist is the best source of current information on prevention research.

What are the symptoms of prostate cancer?

If the cancer is caught at its earliest stages, most men will not experience any symptoms. Some men, however, will experience symptoms such as frequent, hesitant, or burning urination, difficulty in having an erection, or pain or stiffness in the lower back, hips or upper thighs.

Because these symptoms can also indicate the presence of other diseases or disorders, men who experience any of these symptoms will undergo a thorough work-up to determine the underlying cause of the symptoms.

How is prostate cancer detected?

Screening for prostate cancer can be performed in a urologist’s office using two tests:

• A PSA (prostate-specific antigen) blood test; and
• A digital rectal exam (DRE).

The American Cancer Society recommends that both the PSA and DRE be performed annually, beginning at age 50, for men who have at least a 10-year life expectancy. Men at high risk, such as African American men and men with a strong family history should begin testing at age 40.

As with all cancers, early detection is the key to effective treatment.

How curable is prostate cancer?

"Cure" rates for prostate cancer are defined by the percentage of patients likely to remain disease-free for a specific time. 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 early with local or regional disease, the cure rate for prostate cancer is very high.

How is prostate cancer treated?

There are a wide variety of treatment options available for men with prostate cancer, any or all of which might be used at different times depending on the stage of disease and the need for treatment. Your urologist can provide the most comprehensive assessment of the available treatments and expected outcomes.

This information is provided by Urology of Indiana. For more information on prostate cancer, please visit www.urologyin.com and search “prostate cancer.”

Great Prostate Cancer Challenge Presented by UOI and Clarian North
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