Prostate cancer is a cancerous tumor in the prostate gland, a small walnut-sized gland in men that makes seminal fluid, which helps carry sperm out of the body. The prostate is located beneath the bladder and surrounds the urethra, the tube that carries urine out through the penis.
Prostate tumors can be benign or cancerous. With benign tumors, the prostate gets bigger and squeezes the urethra, interrupting the normal flow of urine. This condition, called benign prostate hyperplasia (BPH), is common and not usually life threatening. Prostate cancer, one of the most common kinds of cancer in men, can spread beyond the prostate gland and be life threatening.
Prostate cancer is the third most common cause of cancer deaths in men of all ages and the most common cause in men over 75 years old. Men younger than 40 do not usually get prostate cancer. Some are at higher risk, including African-American men older than 60, farmers, tire plant workers, painters, and men exposed to cadmium.
Most cancerous tumors in the prostate grow slowly and either do not spread or do not cause harm for decades. When caught early, prostate cancer can be treated successfully in more than 90% of cases. Men 50 years old and older should talk to their doctors about screening for prostate cancer.
Many people with prostate cancer have no symptoms at all, especially in the early stages.
Some symptoms that may indicate prostate cancer include:
When the cancer has spread to other parts of the body, symptoms can include:
Experts do not know what causes prostate cancer. Several things, including genes, diet, ethnicity, hormones, and your environment, may play a part.
Some studies have shown a link between a high-fat diet and higher testosterone levels. Testosterone stimulates growth of the prostate. Some doctors think that testosterone replacement therapy might make existing prostate cancer grow faster, and men who use testosterone therapy may be more likely to get prostate cancer than those with lower levels of the hormone.
Genes may come into play because prostate cancer tends to happen in men who are related to one another. In addition, researchers have found a gene that is associated with 30% of family-related prostate cancers.
Asian men tend to have a lower rate of prostate cancer, while African-American men have one of the highest rates in the world.
These factors may increase a man's risk for prostate cancer:
The American Cancer Society recommends that men talk with their doctors about screening tests for prostate cancer starting at age 50, or age 45 for African-American men, or men with a brother or father who had prostate cancer. Two standard tests are used to find prostate cancer early:
If either the DRE or PSA test suggests that cancer might be present, your doctor may recommend the following tests:
If the biopsy shows the presence of cancer, you may need more tests to see if the cancer has spread:
The American Cancer Society suggests men talk with their doctors about the benefits and risks of prostate cancer screening. While the PSA test and the DRE can find cancers early on, they usually cannot tell how dangerous the cancer is.
Some prostate cancers grow very slowly, while others are aggressive. Right now doctors cannot be sure who needs treatment and who does not. That means some men who do not need treatment may get it. Prostate cancer treatments can have unwanted side effects, such as erectile dysfunction and incontinence.
Studies also suggest that the following lifestyle changes may help reduce your risk of prostate cancer:
There are several options, depending on how fast the cancer is growing, whether it has spread, how old you are, and the benefits and drawbacks to treatment.
If prostate cancer is found early, treatment usually involves either surgery to remove the prostate or radiation therapy. For more advanced cases, or if cancer spreads beyond the prostate, hormone medications may be used.
In some cases, if you have a slow-growing tumor, the doctor may suggest "watchful waiting." Watchful waiting means closely monitoring the situation and giving treatment only if your condition worsens.
Making changes in your diet and considering certain herbs and supplements along with treatment may help either reduce risk of prostate cancer or make treatment work better. If you have prostate cancer, you should not use herbs or supplements by themselves to treat it. Prostate cancer should be treated with conventional medicine. DO NOT take any herbs or supplements without your doctor's supervision, because they can interfere with your treatment.
Acupuncture can relieve pain and the side effects of surgery. Meditation and massage may reduce stress and anxiety.
Your doctor may recommend hormone therapy or chemotherapy to stop the growth of cancer cells in the prostate. You may also take medications with or before surgery or radiation to shrink large tumors, especially if your prostate cancer has spread.
Hormone therapy causes your body to make less testosterone, or not be able to use it as well. Lowering testosterone levels shrink tumors or slow their growth. It is usually reserved for men whose prostate cancer has spread. These medications include:
Luteinizing hormone-releasing hormone (LH-RH) agonists. LH-RH is a natural hormone made by your body that lowers the production of testosterone. These drugs encourage your body to release this natural hormone. Side effects include hot flashes, weight gain, development of male breast tissue, breast pain, and nausea.
Antiandrogens. Stop testosterone from reaching cancer cells by blocking the action of androgens, or male sex hormones. Side effects can include lower sex drive, fatigue, nausea, erectile dysfunction, diarrhea, and hot flashes.
Chemotherapy may reduce symptoms in men whose cancer is advanced.
Removal of the prostate (radical prostatectomy): Used to treat prostate cancer that has not spread. There are two types of radical prostatectomy. In retropubic surgery, surgeons remove the prostate and surrounding lymph nodes through an incision in the lower abdomen. In perineal surgery, doctors remove the prostate through an incision made between the anus and scrotum (the perineum). Side effects can include incontinence and erectile dysfunction. In some cases, a technique called nerve-sparing surgery can have fewer sexual side effects.
Robot-assisted laparoscopic radical prostatectomy (RALRP): RALRP is a newer procedure that uses a laparoscope, a long, thin tube with a camera, to magnify the area. Smaller incisions allow a quicker healing time.
Resection of the prostate (called TURP or transurethral resection of the prostate): Removal of prostate tissue to let urine flow freely. It is sometimes used to relieve symptoms of benign prostatic hyperplasia and may be used in men with prostate cancer who cannot have a radical prostatectomy.
Removal of the testes (orchiectomy): Lowers testosterone levels, but side effects can include erectile dysfunction and hot flashes. Most men choose hormone therapy instead.
Radiation: Uses radiation to kill cancer cells. There are two types of radiation therapy:
Preliminary studies suggest that some nutritional supplements may reduce the symptoms of some prostate cancers, or lower your risk of developing it. Ask your team of health care providers about the best ways to use these therapies in your overall treatment plan. Always tell your health care provider about the herbs and supplements you are using or considering using. DO NOT try to treat prostate cancer with supplements on your own.
Follow these tips to reduce your risk of developing prostate cancer:
These nutrients may have cancer-fighting properties:
Herbs may strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting treatment. DO NOT use herbs by themselves to treat prostate cancer, and do not take any herbs without your doctor's supervision. Some herbs can interfere with cancer treatment.
Acupuncture may provide relief from side effects of orchiectomy, removal of the testes. Studies also support using acupuncture to relieve pain that often happens when cancer has spread, particularly to the bones. Many health authorities also support acupuncture to reduce nausea from chemotherapy.
Evidence suggests acupuncture can be valuable for cancer-related symptoms, particularly nausea and vomiting that often goes with chemotherapy treatment. Studies have also found that acupuncture may help reduce pain and shortness of breath. Acupressure, or pressing on rather than needling acupuncture points, may also help control breathlessness, and it is something people can learn and use to treat themselves.
Studies suggest that massage reduces stress and boosts immune function, so it may help relieve anxiety for men being treated for prostate cancer.
Pelvic floor exercises, tightening and releasing muscles that start and stop the flow of urine, may help with incontinence caused by prostatectomy (removal of the prostate).
Meditation may reduce stress, ease anxiety, and allow men with prostate cancer to regain a sense of self control.
Most complications come from specific treatments. These include:
The outlook for a man with prostate cancer depends on his age, the stage of tumor growth, whether he has any underlying medical illnesses, and his PSA levels. The prognosis is good if the cancer has not spread. Most of these cancers are curable, and after 15 years the same number of these men will be alive as those who never had prostate cancer.
If the cancer spreads beyond the prostate and does not respond to hormone medications, the prognosis is poor. Still, most prostate tumors are slow growing, and even men with advanced prostate cancer may survive for 5 years or more.
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Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by the A.D.A.M. Editorial team.
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