The prostate gland is a walnut-sized structure that makes up part of a man's reproductive system. The cause of prostate cancer is unknown, but it is the second most common cause of death from cancer in men of all ages and is the most common cause of death from cancer in men over 75. Prostate cancer is rarely found in men younger than 40.
Screening and Diagnosis
A yearly rectal exam by your doctor can often reveal an enlarged prostate. Symptoms of prostate cancer may include problems passing urine, such as pain, difficulty starting or stopping the stream, or dribbling; low back pain; and pain with ejaculation.
Since the development of the prostate-specific antigen (PSA) test, a prostate cancer screening method that measures the amount of PSA in a man's blood, it has become easier to spot prostate cancer early. A high PSA level has been linked to an increased chance of having prostate cancer, but does not mean that the person definitely has it. Several conditions besides cancer can cause the PSA level to rise. These include urinary tract infection, benign prostatic hypertrophy (BPH — an enlarged prostate), and prostatitis (inflammation of the prostate, often from a bacterial infection). Since the PSA test became common, most prostate cancers are found before they cause symptoms.
Physicians now use a prostate-cancer grading formula called the Gleason system that assigns prostate cancers a score from 2 to 10. The higher your Gleason score, the more likely it is that your cancer will grow and spread quickly.
For prostate cancer that has not spread outside the prostate gland or nearby area, the most common treatment options are:
- Watchful Waiting: For men over 70 with a low Gleason score, the most common recommendation is to defer treatment and watch closely for signs the disease is progressing.
- Surgery (also known as prostatectomy): This is the surgical removal of part or all of the prostate, and other nearby areas if necessary.
- Radiation therapy: This is aimed at killing cancer cells, either with an external beam of radiation or by implanting tiny radioactive "seeds" in the body.
For advanced prostate cancer that has spread to other parts of the body, the most common treatment options are hormone therapy, which starves prostate cancer cells of testosterone by using drugs that inhibit testosterone production or by removing the testicles, or chemotherapy and radiation therapy.