Prostate Cancer

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Introduction

What is prostate cancer?

The prostate is a walnut-sized male reproductive organ located in the pelvis, where it rests just under the bladder and wraps around the urethra, the tube that drains the bladder. The prostate produces fluid that nourishes and protects sperm.

Cancer of the prostate occurs when abnormal prostate cells reproduce in an uncontrolled fashion. Cancer of the prostate is a common cancer among older men. It is estimated that around 200,000 men develop this cancer every year in the Unites States (Source: ACS).

Prostate cancer shares many symptoms with benign prostatic hypertrophy (BPH), which is a noncancerous enlargement of the prostate, although BPH does not cause prostate cancer. Whether caused by cancer or BPH, prostate enlargement can interfere with the normal flow of urine and can lead to urinary hesitancy, dribbling, and incomplete bladder emptying. More advanced prostate cancers may cause blood in the urine and lower back or pelvic pain.

The prostate-specific antigen (PSA) blood test and digital rectal exam are two important screening tests that can help detect prostate cancer before it spreads. Once detected, a biopsy is performed of the suspicious area to determine its exact characteristics, including how aggressive the tumor is likely to be. Other tests are used to reveal the extent to which the cancer has spread. Treatments range from watchful waiting with careful follow-up for less aggressive cancers to combinations of surgery, radiation therapy, chemotherapy, and hormonal therapy for more aggressive or widespread cancers.

Prostate cancer is a serious disease. Although it rarely creates conditions that need to be evaluated in an emergency setting, tell your doctor right away if you suspect you may have prostate cancer. Seek prompt medical care if you notice changes in your urine flow or if you develop lower back pain or pelvic pain or notice blood in your urine.

Symptoms

What are the symptoms of prostate cancer?

At the time of diagnosis most men with prostate cancer report no symptoms. When they occur, many of the symptoms of prostate cancer are related to constriction of the urethra and involve changes in urine flow. Prostate cancer can also cause pain in the pelvis or lower back and blood in the urine. Cancer that has spread can cause additional symptoms based on the location of spread.

Common symptoms of prostate cancer

Common symptoms of prostate cancer include:

  • Bloody or pink-colored semen (hematospermia)
  • Bloody or pink-colored urine (hematuria)
  • Difficulty urinating and urinary retention
  • Incomplete bladder emptying
  • Pain in the pelvis or lower back
  • Slow or weak urine stream
  • Urinary leakage or dribbling

Symptoms that might indicate a serious condition

Prostate cancer can lead to serious conditions such as urinary tract infection, bleeding, and other complications based on the spread of the disease. Seek prompt medical care if you, or someone you are with, have any of these symptoms:

  • Bloody or pink-colored semen (hematospermia)
  • Bloody or pink-colored urine (hematuria)
  • Difficult or painful urination, or burning with urination (dysuria)
  • Foul-smelling urine
  • High fever (higher than 101 degrees Fahrenheit)
  • Pale skin or pallor
  • Swelling in the leg
  • Unexpected weight loss
Causes

What causes prostate cancer?

Cancer occurs when abnormal cells reproduce in an uncontrolled fashion. The specific cause of prostate cancer is not known, but several factors that increase the risk of developing cancer of the prostate have been identified.

What are the risk factors for prostate cancer?

A number of factors increase the risk of developing prostate cancer. Not all people with risk factors will get prostate cancer. Risk factors for prostate cancer include:

  • African American race
  • Age over 60
  • Certain occupational and other chemical exposures
  • Chronic alcohol use or abuse
  • Family history of prostate cancer
  • High-fat diet

Reducing your risk of prostate cancer

You may be able to lower your risk of prostate cancer by:

  • Being aware of and taking precautions against occupational exposures to toxins or chemicals
  • Eating a healthy diet
  • Reducing alcohol intake
Treatments

How is prostate cancer treated?

Treatment of prostate cancer begins with seeking regular medical care throughout your life. Regular medical care allows a health care professional to provide early screening tests. Regular medical care also provides an opportunity for your health care professional to promptly evaluate symptoms and your risks for developing prostate cancer.

Treatment of cancer is based on its aggressiveness, the extent to which it has spread, and patient wishes. For some men, it is a slow-growing cancer that can be closely observed over time. For others, it is more aggressive and may have spread to other areas of the body, in which case more intensive therapy is warranted.

Goal of cancer treatment

For early cancers, the goal of prostate cancer treatment is to permanently cure the cancer or to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in the body, although it may recur or relapse later. In the later stages, the goal is often to control cancer spread, alleviate symptoms, provide comfort, and extend life.

Common treatments for prostate cancer

Many options are available for treating prostate cancer including:

  • Chemotherapy to attack cancer cells
  • Hormonal therapy to slow the growth of the cancer
  • Participation in a clinical trial testing promising new therapies for prostate cancer
  • Radiation therapy to attack cancer cells
  • Surgery to remove the cancer
  • Targeted therapy to attack cancer cells
  • Watchful waiting to identify when to start treatment if necessary

Other treatments for prostate cancer

Other therapies may be added to help with your general state of health and any complications of the cancer or its treatment. These therapies include:

  • Antinausea medications if nausea occurs
  • Dietary counseling to help maintain strength and nutritional status
  • Pain medications as needed to increase comfort

Complementary treatments

Some complementary treatments may help some people to better deal with prostate cancer and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

  • Acupuncture
  • Massage therapy
  • Nutritional dietary supplements, herbal remedies, tea beverages, and similar products
  • Yoga

Hospice care

In cases in which prostate cancer has progressed to an advanced stage and has become unresponsive to treatment, the goal of treatment may shift away from curing the disease and focus on measures to keep a person comfortable and maximize the quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support as well as services to support the patient’s family.

What are the potential complications of prostate cancer?

Complications of untreated prostate cancer can be serious as the disease advances. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of prostate cancer include:

  • Adverse effects of prostate cancer treatment
  • Anemia (low red blood cell count)
  • Bladder outlet obstruction
  • Bone pain
  • Broken bones and spinal cord compression
  • Kidney failure
  • Leg lymphedema (fluid collection and swelling due to blockage of lymphatic vessels)
  • Low white blood cell counts and decreased resistance to infections
  • Spread of cancer to other areas of the body such as the bones
  • Urinary incontinence
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 30
  1. Prostate cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/types/prostate
  2. Prostate cancer. PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001418/
  3. Wilson KM, Kasperzyk JL, Rider JR, et al. Coffee consumption and prostate cancer risk and progression in the Health Professionals Follow-up Study. J Natl Cancer Inst 2011; 103:876.
  4. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013; 63:11.
  5. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.
  6. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
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