Prostate Cancer

THE MOST EXPERIENCED ROBOTIC UROLOGY SURGEONS IN NORTH CAROLINA

Prostate Cancer

Adenocarcinoma of the prostate is the clinical term for a cancerous tumor on the prostate gland. As prostate cancer grows, it may spread to the interior of the gland, to tissues near the prostate, to sac-like structures attached to the prostate (seminal vesicles), and to distant parts of the body (e.g., bones, liver, lungs). Prostate cancer confined to the gland often is treated successfully.

For a detailed discussion of the diagnosis and management of prostate cancer, click here for the American Urological Association’s clinical guidelines.

The prostate gland is located in the pelvis, below the bladder, above the urethral sphincter and the penis, and in front of the rectum in men. It is made up of glandular tissue and muscle fibers that surround a portion of the urethra. The gland is covered by a membrane (called the prostate capsule) that produces prostate-specific antigen.

According to the American Cancer Society (ACS), prostate cancer is the most common type of cancer in men in the United States, other than skin cancer. The ACS estimates that about 230,900 new cases will be diagnosed in 2004 and about 29,900 men will die of the disease. Prostate cancer is the second leading cause of cancer death in men, exceeded only by lung cancer.

Prostate cancer occurs in 1 out of 6 men. Reports of diagnosed cases have risen rapidly in recent years and mortality rates are declining, which may be due to increased screening.

African American men have the highest incidence of prostate cancer, and Asian and Native American men have the lowest incidence. Rates for Asian and African men increase sharply when they emigrate to the United States, suggesting an environmental connection (e.g., high-fat diet, smoking).

In 2009, it was estimated that 27,360 men would die from prostate cancer and 192,280 men would be diagnosed with it (American Cancer Society Facts & Figures 2009). The incidence of prostate cancer increases with age, with nearly two out of three prostate cancer cases being diagnosed in men over the age of 65.

The prostate is a gland in the male reproductive system located just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder). The prostate gland produces fluid that makes up part of the semen.

Prostate cancer is found mainly in older men. As men age, the prostate may get bigger and block the urethra or bladder. This may cause difficulty in urination or can interfere with sexual function. The condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, surgery may be needed to correct it. The symptoms of benign prostatic hyperplasia or of other problems in the prostate may be similar to symptoms for prostate cancer.

A doctor should be consulted if any of the following problems occur:

  • Weak or interrupted flow of urine.
  • Frequent urination (especially at night).
  • Difficulty urinating.
  • Pain or burning during urination.
  • Blood in the urine or semen.
  • Nagging pain in the back, hips, or pelvis. Painful ejaculation.

Causes

  • Age – The most common risk factor for prostate cancer is age. The incidence of prostate cancer increases greatly after age 50. Nearly 2 out of 3 prostate cancers are found in men over the age of 65.
  • Race – Prostate cancer is most prevalent in African-American men. Additionally, advanced stage prostate cancer diagnosis is more likely for African-American men and because of this they are more than twice as likely to die of prostate cancer as white men. Non-Hispanic whites are more likely to be diagnosed with prostate cancer than Asian-American and Hispanic/Latino men. The reasons are unclear for these racial and ethnic differences.
  • Genetic – Prostate cancer appears to run in some families, which suggests there may be an inherited or genetic factor. A man whose father or brother has prostate cancer is more than twice as likely to develop the disease. The risk is much higher for men with several relatives affected by prostate cancer, especially if their relatives were young at the time the cancer was found.
  • Diet – While the role of diet in prostate cancer has been studied, the exact correlation is unclear. A number of studies have shown that men who consume a lot of calcium (through food or supplements) may have a higher risk of developing advanced prostate cancer. The majority of studies have not found such a link with the calcium levels found in the average diet, and it’s important to remember that calcium is known to have other important health benefits.