I knew it has to be something gross. After all, I can’t be happy for such a long time. Great job, sexy wife, kids passing exams, we even had a holiday in Phuket last month.
Then came the pain, and the doc announced it as prostate cancer! Phew. Is my life going to change? Prostate cancer is a disease all men need to be concerned with, even if they do not have a family history of the disease. Did you know that over 225,000 men will be diagnosed in 2012 with prostate cancer, making it the most common type of cancer in men? The bottom line is that 1 in 6 men will develop the disease. Prostate cancer is the third 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 age 75. Prostate cancer is rarely found in men younger than 40.
What is prostate cancer?
To understand prostate cancer, it helps to know something about the prostate and nearby structures in the body. The prostate is a gland found only in males. It is located in front of the rectum and below the urinary bladder. The size of the prostate varies with age. In younger men, it is about the size of a walnut, but it can be much larger in older men.
The prostate’s job is to make some of the fluid that protects and nourishes sperm cells in semen, making the semen more liquid. Just behind the prostate are glands called seminal vesicles that make most of the fluid for semen. The urethra, which is the tube that carries urine and semen out of the body through the penis, goes through the center of the prostate.
The prostate starts to develop before birth. It grows rapidly during puberty, fueled by male hormones (called androgens) in the body. The main androgen, testosterone, is made in the testicles. The enzyme 5-alpha reductase converts testosterone into dihydrotestosterone (DHT). DHT is the main hormone that signals the prostate to grow.
The prostate usually stays at about the same size or grows slowly in adults as long as male hormones are present.
Benign prostatic hyperplasia (BPH)
The inner part of the prostate (around the urethra) often keeps growing as men get older, which can lead to a common condition called benign prostatic hyperplasia (BPH). In BPH, the prostate tissue can press on the urethra, leading to problems passing urine.
BPH is not cancer and does not develop into cancer. But it can be a serious medical problem for some men. If it requires treatment, medicines can often be used to shrink the size of the prostate or to relax the muscles within it, which usually helps with urine flow. If medicines aren’t helpful, some type of surgery, such as a transurethral resection of the prostate (TURP) may be needed.
Symptoms of Prostate Cancer
There are often no symptoms associated with early-stage prostate cancer. However, most cases of prostate cancer are diagnosed before symptoms develop through screening.
- Inability to urinate
- Discontinuous or weak urine flow
- Difficulty in starting or stopping urine flow
- Frequent urination, especially at night
- Blood in urine
- Pain or burning with urination
- Continuous back, pelvis, or upper thigh pain
A physician should be consulted if they persist. It is important to note, however, that these symptoms may be caused by factors unrelated to prostate cancer.
What tests can detect prostate cancer?
Prostate cancer can often be found early by testing the amount of prostate-specific antigen (PSA) in a man’s blood. Another way to find prostate cancer early is the digital rectal exam (DRE). For this exam, the doctor puts a gloved finger into the rectum to feel the prostate gland. These 2 tests are described in more detail in the section.
If the results of early detection tests – the prostate-specific antigen (PSA) blood test and/or digital rectal exam (DRE) – suggest that you might have prostate cancer, your doctor will do a prostate biopsy to find out.
A biopsy is a procedure in which a sample of body tissue is removed and then looked at under a microscope. A core needle biopsy is the main method used to diagnose prostate cancer. It is usually done by urologist, a surgeon who treats cancers of the genital and urinary tract, which includes the prostate gland.
Signs and symptoms of prostate cancer
Early prostate cancer usually causes no symptoms. Some advanced prostate cancers can slow or weaken your urinary stream or make you need to urinate more often, especially at night. But non-cancerous diseases of the prostate, such as benign prostatic hyperplasia (BPH) are a more common cause of these symptoms.
If the prostate cancer is advanced, you might develop blood in your urine (hematuria) or trouble getting an erection (impotence). Advanced prostate cancer commonly spreads to the bones, which can cause pain in the hips, back (spine), ribs (chest), or other areas. Sometimes cancer that has spread to the bones of the spine will press on the spinal cord or its nerves, causing weakness or numbness in the legs or feet, or even loss of bladder or bowel control. Other diseases can also cause many of these same symptoms. It is important to tell your doctor about any of them so that the cause can be determined and treated, if needed.