Prostate Cancer Defined
The body is made up of many types of cells. Normally, cells grow, divide, and produce more cells as needed to keep the body healthy and functioning properly. Sometimes, however, the process goes wrong -- cells become abnormal and form more cells in an uncontrolled way.

These extra cells form a mass of tissue, called a growth or tumor. Tumors can be benign, which means not cancerous, or malignant, which means cancerous. Prostate cancer occurs when a malignant tumor forms in the tissue of the prostate, a gland in the male reproductive system. In its early stage, prostate cancer needs the male hormone testosterone to grow and survive.

The prostate is about the size of a large walnut. It is located below the bladder and in front of the rectum. The prostate's main function is to make fluid for semen, a white substance that carries sperm.

Prostate cancer is one of the most common types of cancer among American men. It is a slow-growing disease that mostly affects older men. In fact, more than 65 percent of all prostate cancers are found in men over the age of 65. The disease rarely occurs in men younger than 40 years of age.

Sometimes, cancer cells break away from a malignant tumor in the prostate and enter the bloodstream or the lymphatic system and travel to other organs in the body.

When cancer spreads from its original location in the prostate to another part of the body such as the bone, it is called metastatic prostate cancer -- not bone cancer. Doctors sometimes call this "distant" disease.

Today, more men are surviving prostate cancer than ever before. Treatment can be effective, especially when the cancer has not spread beyond the region of the prostate.

Quiz
1. Cancer is a disease in which cells divide and grow normally.

FALSE is the correct answer. Cancer is a disease in which cells become ABNORMAL and keep dividing and forming more cells without order or control. Under the microscope, a cancer cell will usually appear larger and less regular in shape than a normal cell.
2. Prostate cancer often grows or spreads very quickly.

FALSE is the correct answer. Prostate cancer is usually a slow-growing disease that mostly affects older men. In fact, more than 65 percent of all prostate cancers are found in men over the age of 65.
3. Metastatic prostate cancer is cancer that has spread from the prostate to another part of the body.

TRUE is the correct answer. Prostate cancer may spread to other organs of the body, such as the bones, brain, or liver. When it does this, doctors say it has metastasized. When cancer spreads from its original location in the prostate to another part of the body such as the brain, it is called metastatic prostate cancer, not brain cancer.
4. Today, more men are surviving prostate cancer than ever before.

TRUE is the correct answer. Today, more men are surviving prostate cancer than ever before. Since the 1990s the number of deaths from this disease has been dropping. In fact, a man is more likely to die with prostate cancer than from it because it usually occurs at an age when other conditions like heart disease and stroke cause death.

Causes and Risk Factors
Scientists don't know exactly what causes prostate cancer. They cannot explain why one man gets prostate cancer and another does not. However, they have been able to identify some risk factors that are associated with the disease. A risk factor is anything that increases your chances of getting a disease.

Age is the most important risk factor for prostate cancer. The disease is extremely rare in men under age 40, but the risk increases greatly with age. More than 65 percent of cases are diagnosed in men over age 65. The average age at the time of diagnosis is 70.

Race is another major risk factor. In the United States, this disease is much more common in African American men than in any other group of men. It is least common in Asian and American Indian men.

A man's risk for developing prostate cancer is higher if his father or brother has had the disease.

Diet also may play a role. There is some evidence that a diet high in animal fat may increase the risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk. Studies to find out whether men can reduce their risk of prostate cancer by taking certain dietary supplements are ongoing.

Scientists have wondered whether an enlarged prostate, a condition also known as benign prostatic hyperplasia or BPH, might increase the risk for prostate cancer. They have also studied obesity, lack of exercise, smoking, radiation exposure, and a sexually transmitted virus to see if they might increase risk. But at this time, there is little evidence that any of these factors contribute to an increased risk.

Quiz
1. Prostate cancer

A. is rare in older men.
B. affects mostly older men.
C. often occurs in men under 40.

B is the correct answer. Prostate cancer is found primarily in older men. More than 65 percent of cases are diagnosed in men over age 65. The average age at the time of diagnosis is 70. The disease is extremely rare in men under age 40.

2. A man's risk of prostate cancer goes up if

A. his father or brother has had the disease.
B. he is active in sports.
C. he uses vitamins.

A is the correct answer. A man's risk for developing prostate cancer is higher if his father or brother has had the disease. There is no evidence that being active in sports or taking vitamins increases a man's risk for prostate cancer.

3. In the United States, prostate cancer is much more common in

A. Asian American men.
B. American Indian men.
C. African American men.

C is the correct answer. In the United States, prostate cancer is more common in African American men than in any other group of men. In fact, African American men have the highest rates of this cancer in the world. African American men are also far more likely to die of the disease than men in other groups.

4. A diet that is high in fat

A. will definitely increase a man's risk of getting prostate cancer.
B. may increase a man's risk of getting prostate cancer.
C. has no effect on a man's prostate cancer risk.

B is the correct answer. Some studies suggest a link between diet and prostate cancer, but the studies are not conclusive. They show that prostate cancer is more common in populations that consume a high-fat diet -- particularly one high in animal fat -- and in populations that have diets lacking certain nutrients. It is not known whether a diet low in fat will prevent prostate cancer.


Symptoms and Diagnosis
Most cancers in their early, most treatable stages don't cause any symptoms. Early prostate cancer usually does not cause symptoms.

However, if prostate cancer develops and is not treated, it can cause these symptoms:

a need to urinate frequently, especially at night
difficulty starting urination or holding back urine
Possible symptoms of prostate cancer:

inability to urinate
weak or interrupted flow of urine
painful or burning urination
Possible symptoms of prostate cancer:

difficulty in having an erection
painful ejaculation
blood in urine or semen
pain or stiffness in the lower back, hips, or upper thighs.
Any of these symptoms may be caused by cancer, but more often they are due to enlargement of the prostate, which is not cancer. If you have any of these symptoms, see your doctor or a urologist right away to find out if you need treatment. A urologist is a doctor who specializes in treating diseases of the genitourinary system.

The doctor will ask questions about your medical history and perform a digital rectal exam to try to find the cause of the prostate problems. In this exam, the doctor feels the prostate through the rectal wall. Hard or lumpy areas may mean cancer is present.

The doctor may also suggest a blood test to check your prostate specific antigen, or PSA, level. PSA levels can be high not only in men who have prostate cancer, but also in men with an enlarged prostate gland and men with infections of the prostate. PSA tests may be very useful for early cancer diagnosis. However, PSA tests alone do not always tell whether or not cancer is present.

Neither of these screening tests for prostate cancer is perfect. Screening tests check for disease in a person who shows no symptoms. Most men with mildly elevated PSA do not have prostate cancer, and many men with prostate cancer have normal levels of PSA. A recent study revealed that men with low prostate specific antigen levels, or PSA, may still have prostate cancer. Also, the digital rectal exam can miss many prostate cancers.

The doctor may order other exams, including ultrasound and x-rays, to learn more about the cause of the symptoms. But to confirm the presence of cancer, doctors must perform a biopsy. During a biopsy, the doctor uses needles to remove small tissue samples from the prostate and then looks at the samples under a microscope.

If a biopsy shows that cancer is present, the doctor will report on the grade of the tumor. Doctors describe a tumor as low, medium, or high-grade cancer, based on the way it appears under the microscope.

One way of grading prostate cancer, called the Gleason system, uses scores of 2 to 10. Another system uses G1 through G4. The higher the score, the higher the grade of the tumor. High-grade tumors grow more quickly and are more likely to spread than low-grade tumors.

Quiz
1. Early signs of cancer are often painful.

FALSE is the correct answer. Most cancers in their early, most treatable stages don't cause any symptoms.
2. A PSA, or prostate specific antigen test, may be useful for early cancer diagnosis.

TRUE is the correct answer. PSA tests may be useful for early cancer diagnosis. PSA levels are higher in most men with prostate cancer, but other prostate disorders such as an enlarged prostate can also cause PSA levels to rise. PSA tests alone do not always tell whether or not cancer is present.
3. A man must have a biopsy to confirm the presence of prostate cancer.

TRUE is the correct answer. A doctor may use a variety of tests to find out the source of a man's prostate problems, including a digital rectal exam, PSA tests, and ultrasound. But to make a definitive diagnosis of prostate cancer, a doctor must perform a biopsy. During a biopsy, the doctor removes small tissue samples from the prostate and looks at the samples under a microscope to see if cancer is present.
4. Common signs of prostate cancer include problems with urination.

TRUE is the correct answer. Problems with urination can be a sign of prostate cancer, but they can also be caused by other conditions like an enlarged prostate. Besides urination problems, other signs of prostate cancer can be painful ejaculation, blood in the urine or semen; pain or stiffness in the lower back, hips, or upper thighs; or problems having an erection.