What is it?
Prostate cancer is a type of cancer that forms in the prostate. The prostate is a small walnut sized glad located under the bladder in men. The prostate produces seminal fluid and nourishes sperm. Prostate cancer is the most common type of cancer in men. About 1 man out of 6 will be diagnosed with prostate cancer in their lifetime. Prostate cancer is normally slow growing and may need no or minimal treatment but with close monitoring from a physician. There are types of prostate cancer can be aggressive and may metastasize and spread to surrounding areas like the lymph nodes, bladder, or rectum as well as other parts of the body.
Listen to an interview with Dr. Justin Harmon when Governor Tom Wolfe was diagnosed with prostate cancer.
Prostate cancer is very hard to detect in the early stages as patients may not experience any noticeable symptoms. As the disease furthers patients may experience the following symptoms:
Blood in the urine
Swelling in the legs
Urgency in urinating
Difficulty starting to urinate
An interrupted or weak urine stream
A nagging pain the back, hips or pelvis
Pain or burning sensation during urination
A feeling that the bladder isn’t completely empty
Problems during sexual intercourse or erectile dysfunction
Make an appointment with your doctor if you experience any of these symptoms.
Prostate cancer does not have a clear cause but has been linked to:
Family History – If your family has a history of prostate cancer, breast cancer, or if your family has the BRCA1 or BRCA2 gene mutation the risk for prostate cancer is higher.
Age (over 65)
Race – Black men are at a greater risk than do men of other races.
As with all cancers it is recommended not to smoke or use tobacco products and to minimize exposure to certain chemicals.
Doctors will perform a combination of queries to determine the patient’s condition. These could include:
Digital Rectal Exam (DRE) – The doctor will examine the prostate for any abnormalities by feeling the texture, shape, and size of the gland.
Prostate-specific antigen (PSA) test – A blood test is performed to test for PSA. PSA is a substance produced by the prostate and there is always a nominal amount in the bloodstream. The PSA test will show if there is an abnormal amount present. The results of the PSA test will only show that something is abnormal and that more investigation is needed. It will not show if the prostate is cancerous, enlarged, etc.
If any of those tests are questionable doctors may perform an ultrasound to view images of the prostate or a biopsy to collect and test a sample of the prostate tissue for cancer cells (prostate biopsy).
Treatments vary depending on the severity of the cancer.
Various surgical procedures are possible including:
Robotic laparoscopic surgery – This surgery, sometimes called a robotic-assisted prostatectomy, is one of the most innovative treatments for prostate removal. This type of surgery can offer better outcomes than traditional prostate cancer surgery because it allows the surgeon more precise movements than is possible by hand. Robotic laparoscopic surgery generally can preserve nerve function better resulting in less chance of erectile dysfunction (ED) and urinary incontinence.
Retropubic surgery – The prostate is removed through a small incision in the lower abdomen. This type of prostate removal has a low risk of nerve damage.
Perineal surgery – The prostate is removed through a small incision between the anus and scrotum. Although this type of surgery heals quickly there is a greater chance of nerve damage. It also makes lymph node removal more difficult.
Radiation Therapy utilizes high power energy beams precisely directed at the affected cancer cells to kill them from outside the body. The patient would need to go through multiple treatments.
Brachytherapy places a radioactive seed inside the body to deliver a low dose of radiation over a long period of time to kill the cancer cells from within.
Chemotherapy uses powerful medication to kill cancer cells. Chemotherapy can be applied intravenously (through a vein) or intravesical (directly through the urethra). Chemotherapy is very effective against cancer cells but can have negative side effects because it kills both good and bad cells alike. Some of the side effects include hair loss, nausea, vomiting, a weakened immune system, and fever.
A type of Immunotherapy has been developed called Provenge. Provenge treatment utilizes your own immune cells and strengthens them to fight prostate cancer. The cells are then injected back into the body intravenously.
The prostate cancer cells feed off of the male hormone testosterone. Stopping the flow of testosterone may cause cancer cells to die or grow slower.
Medications that contain luteinizing hormone-releasing hormone (LH-RH) agonists stop your body from producing testosterone.
Medications that contain anti-androgens prevent testosterone from reaching the cancer cells.
Other types of hormone therapy many include orchiectomy. Orchiectomy is the surgical removal of the testicles. This lowers testosterone levels more quickly than other treatments.
Talk to your doctor about the best treatment options.