 Overview
Coping
Prostate cancer is the most common cancer in men in the United States (other than skin cancer). Of all the men diagnosed with cancer each year, one-fourth have prostate cancer.
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
The causes of prostate cancer are not well understood. Doctors cannot explain why one man gets prostate cancer and another does not. Currently, researchers are studying factors that may increase the risk of this disease. Some of the risk factors for prostate cancer are:
- Age. In the United States, prostate cancer is found mainly in men over age 55. The average age of patients at the time of diagnosis is 70.
- Family history of prostate cancer. A man's risk for developing prostate cancer is higher if his father or brother has had the disease.
- Race. This disease is much more common in African American men than in white men. It is less common in Asian and American Indian men.
- Diet and dietary factors. Some evidence suggests 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 are in progress to learn whether men can reduce their risk of prostate cancer by taking certain dietary supplements.
Although a few studies suggested that having a vasectomy might increase a man's risk for prostate cancer, most studies do not support this finding. Scientists have studied whether benign prostatic hyperplasia, obesity, lack of exercise, smoking, radiation exposure, or a sexually transmitted virus might increase the risk for prostate cancer. At this time, there is little evidence that these factors contribute to an increased risk.
Watchful waiting is closely monitoring a patient's condition but withholding treatment until symptoms appear or change. This is usually used in older men with other medical problems and early stage disease.
Surgery is usually offered to patients in good health who are younger than 70 years old. The following types of surgery are used:
- Pelvic lymphadenectomy: A surgical procedure to take out lymph nodes in the pelvis to see if they contain cancer. If the lymph nodes contain cancer, the doctor will not remove the prostate and may recommend other treatment.
- Radical prostatectomy: Surgery to remove the entire prostate. Radical prostatectomy is done only if tests show the cancer has not spread outside the prostate.
- Transurethral resection of the prostate: A surgical procedure to remove tissue from the prostate using an instrument inserted through the urethra. This operation is sometimes done to relieve symptoms caused by the tumor before other treatment is given. Transurethral resection of the prostate may also be done in men who cannot have a radical prostatectomy because of age or illness.
Impotence and leakage of urine from the bladder or stool from the rectum may occur in men treated with surgery. In some cases, doctors can use a technique known as nerve-sparing surgery. This type of surgery may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery.
Radiation therapy is the use of x-rays or other types of radiation to kill cancer cells and shrink tumors. It may involve external radiation using a machine outside the body or internal radiation which places radioisotopes (materials that produce radiation) through thin plastic tubes into the area where cancer cells are found.
Prostate cancer is treated with external and internal (implant) radiation. Radiation therapy may be used alone or in addition to surgery. Impotence and urinary problems may occur in men treated with radiation therapy.
Currently 3D Conformal and IMRT (Intensity Modulated Radiation Therapy) are considered the standard of care for external radiation therapy treatment.
Hormone therapy: Hormones are chemicals produced by glands in the body and circulated in the bloodstream. Hormone therapy is the use of hormones to stop cancer cells from growing. Male hormones (especially testosterone) can encourage prostate cancer growth. To stop the cancer from growing, female hormones or drugs that decrease production of male hormones may be given.
Hot flashes, impaired sexual function, and loss of desire for sex may occur in men treated with hormone therapy.
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