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Prostate Cancer

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Prostate Gland• Muscular• Walnut-sized gland• Makes seminal fluid• Muscles contract to push semen

through the urethra• Located directly beneath the

bladder and in front of the rectum

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Prostate Cancer• Most common cancer in American

men• Grows very slowly• More common in African American

men & men with family history

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Statistics• About one man in 6 will be

diagnosed

• Only one man in 34 will die

• About 80% of men who reach 80 have prostate cancer

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Outlook• Nearly 100% survive 5 years

• 93% survive at least 10 years

• 67% survive longer than 15 years

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BPH• Enlargement which is not cancer

• 50% of men between 51 and 60

• 90% of men older than 80

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Prostatitis• Inflammation of the prostate

• Can be caused by bacterial infection

• Men of all ages

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Prostate Cancer• In early stages, may not cause any

symptoms

• As it progresses, symptoms appear

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Risk Factors• Age

• Family history– Father or brother with it more than

doubles the risk– Risk even higher if multiple family

members affected

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Risk Factors• Race

– Occurs about 60% more often in African American men than in white American men

– Cancer is more likely to be advanced• Diet

– High dietary fat may contribute

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Prevention• Cannot prevent, but may be able

to lower risk• Diet

– Low-fat diet– Antioxidants especially lycopenes

• Vitamin supplements– Vitamin E– Selenium

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Screening Guidelines• Annual digital rectal exam

beginning at age 45

• PSA testing beginning at age 50

• Both of these tests beginning at age 40 for African American men & those with family history

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Digital Rectal Exam• Goal: detect cancer early when

treatment is most successful

• Done during standard physical exam

• Feels for hard, lumpy, or abnormal areas

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PSA Blood Test• PSA is produced by prostate gland

• PSA level under 4 ng/ml

• Trend is important

• Early prostate cancer found by PSA

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Elevated PSA• Prostate cancer• Prostatitis• BPH• Other factors

– Age– Medications

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Staging• Find out size and location of cancer

– And whether it has metastasized (spread)

• ABCD is simplest method• T = tumor• N = nodes (lymph nodes)• M = metastasis

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Grading• Grade refers to the cancer’s

appearance and indicates how quickly a cancer is growing

• Gleason score assigns a grade (1 to 5) based on how the cancer cells look compared to normal

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Gleason Score• The higher the number, the more

likely the cancer will grow and spread (number is between 2 & 10)

• Less than 6 indicates a less aggressive cancer

• Grade of 7 and up – more aggressive

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Specialists• Urologist• Radiation oncologist• Medical oncologist• Oncology nurses• Dietitians• Physical & occupational therapists• Psychologists or counselors

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Side Effects of Surgery• Impotence

– Unable to achieve an erection

• Incontinence– Stress incontinence: leaking of urine

while coughing, sneezing, laughing

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Radiation Therapy• External radiation

– Machine is outside the body

• Internal radiation– Brachytherapy– Radioactive implants placed directly

into tumor

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New Procedure• Focal cryosurgery

– Focused freezing of only the portion affected with cancer

• “Male lumpectomy”

• Cancer needs to be confined to one prostate lobe