Prostate Cancer

Prostate cancer is a disease in which  malignant (cancer cells) form in the tissues of the prostate.  The prostate is a gland in the male  reproductive system located in the pelvis just below the bladder and in front of  the rectum.  The size of the gland varies  from patient to patient but is typically the size of a walnut.  It surrounds the urethra (the tube that  empties urine from the bladder), and produces fluid that makes up part of the  semen.

According to the American Cancer Society,  prostate cancer is the first most common form of cancer affecting men in the United States,  with an estimated 218,890 men diagnosed in 2007.  About 1 in 10 men in the United States will be diagnosed  with prostate cancer in their lifetime.  It  is the third leading cause of cancer death in the United States, with an estimated 27,050  deaths from prostate cancer in 2007.  This represents approximately 2.5% of male  deaths (from all causes) in the United    States annually.

There are no noticeable symptoms of  prostate cancer while it is still in the early stages.  In order to find prostate cancer in its most  treatable form, it must be caught before symptoms appear.  In more advanced stages, symptoms may include  difficult or frequent urination, blood in the urine or bone pain.

Risk Factors

  • The risk of prostate cancer increases with age.  Prostate cancer is rare for men under the age of 40 and most cases occur in men over the age of 65.
  • Men with a father or brother with prostate cancer are twice as likely to get the disease.  Men with three relatives diagnosed with prostate cancer are even more likely to get it.
  • African American men have a 60% higher risk of getting prostate cancer than Caucasian men, and are at twice the risk of dying from it.
  • Hispanic men have a risk of getting prostate cancer similar to the general population, but rates of death due to the disease have not declined over recent years as they have for Caucasians and African American men.
  • Veterans of Asian Theaters (Vietnam and Korea) who were exposed to Agent Orange are at increased risk.
  • Obese men – those with a body mass index of over 32.5 – are 33% more likely to die from prostate cancer if diagnosed.

If a bump or abnormality is found, or if  the PSA level is inordinately high, a biopsy is needed to determine whether  prostate cancer exists.

Prostate Cancer Screening Considerations:
Annual screening should start at age 50 for the general population
Men with 1 risk factor should start annual screening at age 45.
Men with more than 1 risk factor should start screening at age 40.
Some men choose to have a baseline examination and blood test between the ages of 35 and 40.
Both the absolute PSA level and the rate of rise over time are important in predicting the presence of prostate cancer.
The two screening tests (DRE and PSA level) are not perfect, but together they detect about 85% of patients with prostate cancer.

Prostate Cancer Prevention:
There is evidence to suggest that the use  of Proscar (a 5-alpha reductase inhibitor) results in a reduced risk of  prostate cancer.  The first assessment of  this drug in the Prostate Cancer Prevention Trial indicated that while cancer  risk is reduced, those who developed prostate cancer tended toward a more  aggressive form of it.  This data was  recently reanalyzed (in Cancer Prevention Research ), and it’s now thought that there is not this greater proclivity towards a more aggressive form of cancer, only total risk reduction.

A vaccine against prostate cancer has long  been in research and development, though no product has been made available  yet.

Adopting a healthy lifestyle consisting of  regular exercise and limiting consumption of saturated fat found in red meat  and dairy products may lower your risk of cancer.  This may also improve your cardiovascular  health, overall quality of life, and longevity.   Much attention has been given to diets rich in Vitamin E, Selenium, soy,  green tea, and tomatoes, though there is no conclusive evidence that these  nutrients lower prostate cancer risk.

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