Prostate cancer begins when cells in a the prostate grow out of control and take over healthy cells. They grow into lumpy bundles of cells called tumors. Tumors disrupt the normal function of the prostate, and cells that come free from the tumor can travel elsewhere in the body, and begin to grow tumors there. This does not mean that men who have prostate cancer always have an enlarged prostate. Prostate cancer can spread from the prostate to nearby lymph nodes, bones and other organs. This spread is called metastasis. As a result of metastasis to the spine, some men experience back pain.

How Prostate Cancer Develops
Prostate cancer can be aggressive, which means it grows quickly and spreads to other parts of the body, but it is often slow-growing. Most patients with slow-growing cancer will never have symptoms. That’s why prostate cancer can be present for years without causing any symptoms and is often not detected until it is in an advanced stage. Three out of four cases of prostate cancer are of the slow-growing type.

If prostate cancer is detected early enough it is treatable and there is a great chance it can be cured. Treatment techniques are continually being refined to have less side effects. Approximately 1 out of 10 men will develop prostate cancer before they die. A misconceptions is that prostate cancer is an old man’s disease. Prostate cancer is common in men in their forties and fifties.

You are not alone
In the USA prostate cancer is the most common type of cancer among men, with an estimated 232,090 cases diagnosed each year. More than 30,300 men die annually of prostate cancer, making it the second-leading cause of cancer deaths among men after lung cancer. The overall prognosis for prostate cancer patients has dramatically improved over the years. Over the past 20 years, the overall survival rates for all stages of prostate cancer combined have increased from 67% to 97%.

The Causes of Prostate Cancer
The causes of prostate cancer are largely unknown. Close relatives of men who have had prostate cancer are also more likely to be affected. Ethnic origin appears to play a part: black men seem to be at highest risk, and men of Far Eastern descent the lowest.

Symptoms of Prostate Cancer
Prostate cancer often has no symptoms. Change in urination, including increased frequency, hesitancy or dribbling of urine may be experienced if a man has prostate cancer. These are the same symptoms as those produced by prostate enlargement (Benign Prostatic Hypertrophy).

Diagnosis of Prostate Cancer
Digital Rectal Examination(DRE) A DRE is an exam in which a specialist inserts a gloved, lubricated finger in the rectum to feel the back of the prostate gland through the rectal wall. Healthy prostate tissue is soft, malignant tissue is firm, hard, and often asymmetrical or stony. However, as many as one-third of patients diagnosed with prostate cancer have normal DRE results.

Transrectal ultrasound (TRUS) A TRUS is an exam in which an instrument is inserted into the rectum that emits ultrasonic impulses against the prostate. These ultrasonic impulses create echoes, which a computer uses to create an image called a sonogram. The images are projected on a monitor, so the specialist can examine the gland and surrounding tissue for tumors.

PAP Test A PAP test is a blood test that measures Prostatic Acid Phosphatase (an enzyme found primarily in men in the prostate gland and semen) to determine the health of the prostate gland. Prostate dysfunction results in the release of PAP into the blood. This test is no longer used routinely. The availability of the more sensitive and specific PSA test has largely replaced the PAP test’s clinical use.

PSA Test A PSA test is performed to detect the presence of PSA. PSA is a glycoprotein (a protein with a sugar attached) found in prostatic epithelial cells. It can be detected at a low level in the blood of all adult men. The PSA level is greatly increased in most men with prostatic cancer, but can also be increased somewhat in other disorders of the prostate.

Prostate Cancer Treatment
Whether tumors have spread or not determines for a great deal the kind of treatment. For tumors that are still inside the prostate, radiation therapy (using x-rays that kill the cancer cells) and a surgery called radical prostatectomy are common treatment options. For older men who have a higher risk of dying from something other than prostate cancer “Watchful waiting” might be the best approach. In this approach, no treatment is given until the tumor gets bigger. Generally, tumors that have grown beyond the edge of the prostate can’t be cured with either radiation or surgery. They can be treated with hormones that slow the cancer’s growth.

Radical Prostatectomy Radical prostatectomy is a surgery to remove the whole prostate gland and the nearby lymph nodes. After the prostate gland is taken out, a catheter is put through the penis into the bladder to carry urine out of the body until the area heals.

Radical prostatectomy may be done by open- or laparoscopic surgery. Laparoscopic radical prostatectomy is sometimes used as an alternative to open surgery. It involves inserting a lighted viewing instrument (laparoscope) into the pelvic region and allows examination and removal of the prostate without a large abdominal incision.

The main advantage of surgery is that it offers the most certain treatment. The surgery provides the specialist with accurate information about how advanced the cancer was.

The main risks of this surgery are incontinence and impotence. Only a very low percentage of men have severe incontinence after radical prostatectomy. Up to 35% of men have a little accidental leakage of urine during heavy lifting, coughing or laughing. The chance of impotence decreases if the cutting of nerves is avoided during the surgery. This may not be possible if the tumor is large. Your age and degree of sexual function before the surgery play also an important role. If you are under 50 years old, te possibility of regaining sexual function is higher than if you are older than 70.

Radiation Therapy Radiation therapy uses x-rays to kill or shrink the prostate cancer cells, and to decrease their ability to divide. Radiation is often used to treat prostate cancer that is still confined to the prostate gland, or has spread only to nearby tissue. If the disease is advanced, radiation may be used to reduce the size of the tumor and to provide relief from symptoms.

There are 2 types of radiation therapy. External beam radiation therapy is a therapy in which x-ray beams are directed at the cancer from outside the body. In another type, internal radiation therapy (also called “seed therapy”), small radioactive pellets are implanted directly into the prostate tumors. The pellets emit small amounts of radiation for a period of weeks or months. The External beam radiation therapy is usually given 5 days a week over 7 weeks. The side effects are milder than the side effects that can come with internal radiation therapy. However, internal radiation therapy can be done with just one hospital visit.

Radiation therapy can cause impotence. It can damage arteries that carry blood to the penis. It can also cause scar tissue near the prostate that reduces blood flow to the penis. Impotence as a result of radiation therapy may not be as immediate as with surgery. The problem may occur many months or even years after the treatment. About one half of patients become impotent within 2 years of having radiation therapy. About 15% to 30% of men who have radiation therapy have urinary problems, rectal bleeding, rectal discomfort or diarrhea during or shortly after the treatment.

Hormone Therapy Both normal and cancerous cells in the prostate gland rely on male hormones such as testosterone for growth. That’s why hormones can stimulate the growth of cancerous cells in the prostate gland. Hormone therapy aims to manage prostate cancer by reducing these male hormones. Options include injected and oral medications, or removal of those parts of the testicles that produce testosterone. Once the testosterone is out of the body, the prostate cancer usually shrinks.

Hormone treatments are most often used in patients with cancer that has already spread beyond the prostate gland. Side effects of hormone therapy include impotence, hot flashes, osteoporosis, weight gain and mood swings. Occasionally men will develop swelling of the breasts. While prostate cancer usually responds to 1 or 2 years of hormone therapy, after some time most tumors start to grow again. Once this happens, the treatment goal is to control symptoms.