WHAT YOU SHOULD
KNOW
The prostate, a walnut-sized gland that surrounds the
exit from the bladder, produces the fluid in semen. From the
age of 40 onward, this gland displays a tendency to grow
larger, causing problems with urination. After age 60, this
problem is joined by an increased risk of prostate cancer,
which strikes one older man in eight.
Most prostate cancers are discovered during a routine
rectal exam, or through a PSA (prostate-specific antigen)
screening test. Any enlargement or significant tumor (lump) can
be detected during the rectal exam. If the cancer has not yet
produced a lump, a high level of PSA may still give it
away.
Like all cancers, the disease is the result of
unrestrained multiplication of cells. Normal cells divide in a
planned way, creating more cells only when needed. Cancerous
cells grow and divide without control or order, often making
excess tissue that becomes a tumor. Cancer cells may grow into
nearby healthy tissue, or they may break away from the tumor
and travel through the blood stream or lymphatic system to
other parts of the body, such as the liver, bone, or brain.
Prostate cancer is one of the more curable forms of the disease
because it tends to grow slowly.
Causes
Scientists haven't discovered any specific triggers for
this disease. However, they do know that it tends to run in
families, and that it's more common among African American men.
Other risk factors include:
Signs/Symptoms
During the early stages of prostate cancer, there are
usually no symptoms.
Later, the symptoms are typically the same as those of an
enlarged prostate:
-
A need to urinate frequently,
especially at night
-
Trouble starting the flow of
urine or holding it back
-
Inability to
urinate
-
Pain or burning during
urination
-
Pain during
ejaculation
-
Blood in the urine or
semen
-
Pain or stiffness in the
lower back, hips, or upper thighs
Care
To find out what stage the cancer is in, your doctor will
measure the lump, check to see if the cancer has spread, take
other x-rays, and perform tests such as an ultrasound exam of
the area and a biopsy (microscopic examination) of a prostate
tissue sample. You might also be given a bone scan, CAT scan,
or MRI (magnetic resonance imaging) to see whether the cancer
has spread. The results of the tests will help you and your
doctor choose a treatment plan.
There are many different ways to treat prostate cancer.
The prostate needs testosterone, a male hormone, to make semen,
but testosterone may make the cancer grow. You may need to take
hormones to block the testosterone. You may also need surgery
or radiation. Often doctors use two or more types of treatment
together. For example, you may have medicine and radiation or
medicine and surgery.
-
Surgery: If the cancer hasn't moved beyond the
prostate, surgical removal of the entire gland is the usual
treatment. The doctor may also remove nearby lymph nodes as
insurance against any possible spread.
-
Hormone Therapy: The male hormone testosterone
promotes the growth of prostate cancer cells, so
eliminating this hormone can at least temporarily control
the cancer's spread. There are several hormonal medicines
that can block production of testosterone. If they fail to
do the job, surgical removal of the testicles or adrenal
glands may be necessary. In some cases, both surgery and
medicines are tried. Medicines are given by periodic
injections, as implants under the skin, or by
mouth.
-
Radiation: X-rays or gamma rays can kill cancer and
help prevent it from spreading. They can also be effective
in reducing pain, controlling bleeding, and shrinking
cancerous tumors. For prostate cancer, the radiation can be
administered through an external beam directed at diseased
tissue, or as small radioactive pellets implanted in the
gland and left there for life. Radiation may be used
instead of surgery if the tumor is small. It is also used
after surgery to kill any cancer cells that may have been
missed.
Risks
Left untreated, all cancers eventually will spread.
Almost all forms of cancer therapy have unpleasant side
effects, and may fail to halt the spread. However, the
prospects of curing prostate cancer are much better than
average, especially if the disease is discovered early
enough.
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