Prostate Cancer
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Each year, more than 120,000 new cases of prostate cancer occurs in USA and more than 30,000 deaths are caused annually by this disease. Approximately, one out of every 10 men will develop this form of cancer - it is second only to lung cancer as the leading cause of death in men - and the likelihood of developing it increases with age. An estimated 232,090 cases of prostate cancer will be diagnosed in U.S. men in 2005.
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Every man over the age of 50 should know that he is at risk for prostate cancer. African Americans have the highest risk of developing this disease. Having a father or brother with prostate cancer also greatly increases a man's likelihood of developing it. In addition, studies have shown that a diet high in fat may contribute to the development of this cancer.
Most prostate cancers begin in the outer part of the prostate. The cancer must grow fairly large before it presses on the urethra and interferes with the urination. In the early stages, prostate cancer is curable. With prompt treatment the percentage of men who survive longer than 10 years is roughly equal to that of men who have never had prostate cancer.
If prostate cancer is allowed to develop without treatment, it may spread to other organs, causing disability and sometimes death. Advanced prostate cancer is more likely to cause symptoms, which may lead a man to see a urologist for diagnosis. Unfortunately, by the time prostate cancer has reached this stage, it is less responsive to treatment.
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If the results of DRE suggest the presence of cancer, your urologist may recommend that other test be performed which help detect prostate cancer or indicate the extent of the cancer's growth. To confirm the presence of cancer, the urologist may perform a biopsy obtaining a small sample of the suspected cancer for examination under a microscope by a pathologist.
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If a diagnosis of prostate cancer is made, the urologist will generally recommend treatment. How prostate cancer is treated depends upon the stages of cancer, the aggressive nature of the cancer, the age of the patient, the patient's overall health and side effects of different treatments. Because so many different options exists, the treatment of prostate cancer should be carefully weighed by you and your urologist. One of the treatment options, no matte what the stage is "watchful waiting".
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Since the prostate cancer grows slowly, symptoms may not appear for years. Men generally develop this disease late in life, so a period of watchful waiting (period of observation) may be a choice. But studies have shown that after the age of 40, there is no fixed rule for cancer of prostate to develop.
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Various treatment options are employed: these include surgery, radiation therapy, hormonal therapy and occasionally chemotherapy. The urologist will advise on the treatment most appropriate for each particular case depending upon the stage of disease.
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Pathophysiology
Prostate cancer occurs when cells within the prostate grow uncontrollably, creating small tumors. Most cells in the body are constantly dividing, maturing, and then dying in a tightly controlled process. Unlike normal cells, the growth of cancer cells is no longer well regulated. Instead of dying, as they should, cancers cells outlive normal cells and continue to form new, abnormal cells. The term "primary tumor" refers to the original tumor; secondary tumors are caused when the original cancer spreads to other locations in the body. Prostate cancer typically is comprised of multiple very small, primary tumors within the prostate. At this stage, the disease is often curable (rates of 90% or better) with standard interventions such as surgery or radiation that aim to remove or kill all cancerous cells in the prostate. Unfortunately, at this stage the cancer produces few or no symptoms and can be difficult to detect.
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Metastatic prostate cancer
If untreated and allowed to grow, the cells from these tumors can spread in a process called metastasis. In this process, prostate cancer cells are transported through the lymphatic system and the bloodstream to other parts of the body, where they lodge and grow secondary tumors. Once the cancer has spread beyond the prostate, cure rates drop dramatically
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Causes & Risk Factors
The major known risk factors for prostate cancer are are
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Age
The chance of having prostate cancer increases rapidly after age 50. In fact, about 80% of all prostate cancers are diagnosed in men over the age of 65.
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Race:
More African-American men develop prostate cancer than Caucasian-American men. Asian men living in Asia have the lowest incidence.
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Family history:
Approximately 25% of men with prostate cancer have a history of the disease within their family. -
It is believed that only 9% of all prostate cancers are purely hereditary.
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Obesity:
Recent studies have shown that men who are overweight or obese are at significantly higher risk for developing prostate cancer.
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Prevention
Some risk factors – such as race, family history or age -cannot be modified, while others, especially diet and weight, can be controlled.
The prostate cancer Foundation suggests that men wanting to reduce their risk of prostate cancer
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Eat fewer red meats and high-fat dairy products,
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Eat five or more servings of vegetables and fruits each day,
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Exercise regularly and
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Maintain a normal weight.
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Screening & Diagnosis
Screening for prostate cancer can be performed quickly and easily in a physician’s office using two simple tests:
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The Prostate Specific Antigen (PSA) blood test, and the
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Digital Rectal Exam (DRE).
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PSA
A PSA level above 4.0 ng per milliliter of serum may trigger a prostate biopsy to search for cancer.
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