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Prostate cancer 101
Answers and information about prostate cancer.
The prostate is a walnut-sized, doughnut-shaped gland that sits just below a man's bladder and encircles the urethra, the tube that urine flows through as it goes from the bladder to the penis. The prostate gland produces part of the seminal fluid—the liquid that helps protect and nourish sperm and carries sperm out of the body during ejaculation.
Cancer of the prostate is the second most common cancer in American men, according to the American Cancer Society (ACS), and the second leading cause of cancer death in men. Some 1 in 9 American men will develop this cancer in his lifetime, according to the ACS.
The strongest risk factor for prostate cancer is age, according to the National Cancer Institute (NCI). Most men diagnosed with this cancer are older than 65. Your risk is also higher if your father or brother had prostate cancer or if you're African American.
Some research also suggests that men who eat a lot of red meat or high-fat dairy foods are at higher risk for prostate cancer. These men are also more likely to eat fewer vegetables and fruits. Researchers aren't sure which factor is linked to the higher risk.
Cancer is not the only disease or condition that can affect the prostate. Most men have some degree of benign prostatic hyperplasia (BPH), or prostate enlargement, as they grow older. Though the prostate gland starts out about the size of a walnut, by age 40 it's generally the size of an apricot, and by age 60 it can be as large as a lemon. This growth can put pressure on the urethra and bladder, causing symptoms such as frequent urination, problems achieving or maintaining an erection, and trouble controlling urination.
Screening tests or symptoms may lead a doctor to suspect prostate cancer. Screening tests include PSA (prostate-specific antigen) blood testing and digital rectal exams (DREs).
The PSA test measures the level of a protein that often increases when prostate cancer develops.
DREs check for lumps or other unusual features on the prostate gland itself. A doctor checks the gland by inserting a gloved, lubricated finger into the rectum, which is just behind the prostate.
Early prostate cancer generally does not have symptoms, but in some men prostate cancer can be indicated by blood in the urine, pain in the pelvis or ribs, or problems with erections.
If tests or symptoms suggest that you may have prostate cancer, your doctor may recommend a biopsy. A biopsy involves removing and examining a sample of prostate tissue. It is the only definitive test for prostate cancer.
Because the research isn't clear on whether screening reduces prostate cancer deaths, recommendations differ.
The ACS recommends men and their doctors talk about the risks and benefits of screening starting at age 50—age 40 or 45 for men who are at high risk. The NCI recommends that each man make a personal decision about screening after talking with his doctor, and examining the costs and benefits.
Prostate cancer can be treated with surgery, radiation, chemotherapy, hormones or a combination of these methods. Some cases aren't treated right away, but are watched closely to see how quickly the cancer progresses. This is called watchful waiting, and it's most often recommended for men who are older than 70, men who have other serious medical problems, or for those whose prostate cancers are growing very slowly. In these situations, the side effects of treatment could cause more medical problems than the cancer itself.
If you have prostate cancer, ask your doctor about all of your treatment options, and the risks and benefits of each. The best treatment for you will depend on your age, your medical condition, your feelings about the side effects of treatment, how far the cancer has progressed and how quickly it's likely to grow.
The side effects of prostate cancer treatment vary by the treatment used. They're also different from one man to the next.
Men who have surgery for prostate cancer may have trouble controlling urination, or problems achieving or maintaining an erection.
Radiation therapy can irritate the skin or intestines, and sometimes leads to impotence.
Other treatments for prostate cancer can cause fatigue, weight gain, breast tenderness, weakening of the bones, increased risk of infections or other problems. It's very important to ask your doctor about the possible side effects of recommended treatments and if those side effects can be treated.
If you and your doctor decide that expectant therapy, or watchful waiting, is the best approach for you, you'll be asked to return for regular checkups. This allows your doctor to monitor the cancer closely. If it starts growing quickly or causing symptoms, active treatment can be started at any time.
To learn more about prostate cancer, visit the Prostate Cancer health topic center. You can also learn more at these websites: