Frequently asked questions about prostate cancer
What is prostate cancer?
Prostate cancer is the presence of cancerous cells in the prostate. Cancerous
cells, wherever they’re found in the body, are the result of a genetic mutation,
or change. This
mutation causes cells to reproduce more rapidly than usual, and the mutated
cells do not die off in a normal period of time.
In many cases, these cancerous cells form solid growths or tumors
that can spread from the prostate to other parts of the body. As cancerous cells
grow and spread, they can damage or interfere with the function of organs in the
body, causing a variety of symptoms.
Who gets prostate cancer?
Aside from non-melanoma skin cancer, prostate cancer is by far the most common cancer
among men. In fact, 1 in every 6 men will be diagnosed with prostate cancer at some
point in their lives. And the risk of prostate cancer goes up with age.
More than 65% of all prostate cancers are diagnosed in men over the age of 65.
The American Cancer Society estimated that there would be more than 192,280 new
cases of prostate cancer diagnosed in the United States, and that about 27,360 men
would die of prostate cancer in 2009.
What is the prostate?
The
prostate is a walnut-shaped organ that surrounds the base of the
urethra. A type of organ known as a gland, the prostate produces a milky fluid that provides
nutrients to a man’s sperm and is discharged into the urethra at the time of semen
emission. Though other types of cells are found in the prostate, it’s
the gland cells that give rise to 99% of prostate cancers.
What are some of the symptoms of prostate cancer?
Prostate cancer is, to a large extent, a silent disease. When prostate cancer does
cause symptoms, they are frequently confused with those of
BPH (benign prostatic hyperplasia) or enlarged prostate, a very common condition
in men over the age of 60.
Men may associate urinary problems—incomplete urination, frequent urination, interrupted
urine flow, urgency, weak urine stream, straining to begin urination—with “simply
getting older.” But these may be symptoms of prostate disease.
Advanced prostate cancer—cancer which has spread to other parts of the body—often
demonstrates more symptoms such as blood in the seminal fluid, impotence, back pain,
and fatigue. However, the lack of these specific symptoms does not mean that advanced
prostate cancer is not present.
How is prostate cancer staged?
Prostate cancer is both staged and
graded. The grade describes how aggressive the cancer is and how fast it
is likely to grow. Most pathologists use the Gleason scale to grade
prostate cancer. They look for the most common type of cancer cell in the sample
and assign it a number between 1 and 5—the higher the number, the more abnormal
the cells are. Another number is assigned to the second-most common type of cancer
cell in the sample. The Gleason score is the sum of these two numbers, which will
be between 2 and 10.
The Gleason Score and other information is combined to determine the cancer’s stage:
- Stage I prostate cancer: The prostate cancer may not have been
detected through a digital rectal exam (DRE) or an imaging machine (MRI, CT scan,
etc). Most likely, it was found during a surgical procedure. It has a very low Gleason
score and has not spread to the lymph nodes
- Stage II prostate cancer: The prostate cancer has not spread to
the lymph nodes or other parts of the body. It was found during a DRE, PSA test,
needle biopsy, or transrectal ultrasound
- Stage III prostate cancer: The prostate cancer has begun to spread
beyond the prostate. It may have spread to the seminal vesicles, but it has not
spread to the lymph nodes, bladder, rectum or distant organs
- Stage IV prostate cancer: The prostate cancer has spread to tissues
next to the prostate (other than the seminal vesicles), to lymph nodes, or to other,
more distant sites in the body such as the bones. These cancers are not considered
curable
Staging is complex, so be sure to ask your doctors and nurses any questions you
have about it.
How is prostate cancer screened?
The most common tests are the
digital rectal exam, or DRE, which looks for any unusual features on the
prostate itself, and the
prostate-specific antigen (PSA) test, which measures a protein produced
in the prostate. According to the American Cancer Society, not all
men need to be screened for prostate cancer. But men over the age of 50 who choose
to be tested should include a DRE and PSA test.
During this exam, the doctor inserts a gloved and lubricated finger (digit) into
the rectum to feel for any unusual features of the prostate, including hardness,
bumps, or swelling. Although uncomfortable, the procedure is not usually painful.
This blood test looks at the body’s level of something called prostate-specific
antigen (PSA), a protein produced in the prostate. PSA levels may be high in men
who have prostate cancer. A rise in PSA scores from year to year may also suggest
that the prostate is growing larger.
How is prostate cancer diagnosed?
To diagnose prostate cancer, a
biopsy may be needed. During a biopsy, samples of prostate tissue are taken
through a small needle that may be inserted into the rectum or through the perineum
into the prostate. An ultrasound probe inserted into the anus guides the needle.
The procedure is uncomfortable but is usually not very painful.
The biopsy is then examined by a
pathologist, or a doctor who specializes in diagnosing diseases based on
tissue samples.
Besides the PSA and DRE, your doctor may recommend further tests to help learn more
about an abnormality, or to stage and grade a cancer. Other tests may include:
- Radionuclide bone scan: In this test, the patient is injected with
a small amount of slightly radioactive material. This material settles into damaged
bone tissue throughout the body over a few hours. A special camera then detects
the radiation and creates an image of the skeleton
- Computed tomography (CT or CAT scan): The CT scan is a special
X-ray that makes detailed images of the body. Instead of taking a single picture,
a CT scan takes many pictures as it rotates around the body
- Magnetic resonance imaging (MRI): MRI scans use radio waves and
strong magnets to create very detailed images of parts of the body
- ProstaScint™ scan: Using an injection of slightly radioactive
material, ProstaScint scans find cancer that has spread beyond the prostate
- Lymph node biopsy: In a lymph node biopsy, one or more lymph nodes
is removed. Sometimes called a lymph node dissection or a lymphadenectomy, this
procedure is performed to find out if a cancer has spread from the prostate to nearby
lymph nodes. There are different ways to biopsy
lymph nodes, including surgical, laparoscopic, and fine-needle biopsies
How is prostate cancer treated?
The common treatment options for prostate cancer include:
What are some of the possible side effects of surgery?
Possible side effects include:
- Surgery-related complications, such as bleeding, infection, or cardiovascular problems
- Loss of urinary control (incontinence)
- Loss of the ability to achieve or maintain an erection (impotence)
Side effects may be temporary or permanent, depending upon the patient’s age, the
extent of the cancer, and the type of surgery performed.
What are some of the possible side effects of chemotherapy?
Anti-cancer drugs harm cells that grow quickly, including the blood cells that fight
infections, the cells that line the mouth and digestive tract, and the hair follicles.
Chemo can cause:
- Anemia
- A low white blood cell count (neutropenia)
- Infection
- Fatigue
- Nausea
- Vomiting
- Hair loss
- Loss of appetite
- Mouth sores
- Numbness or tingling of the skin (paresthesia)
People being treated with chemotherapy should talk with their doctors and nurses
about the side effects they are experiencing, and how best to manage them.
Watch videos about cancer and its treatment
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