What is prostate cancer?

The prostate is a small male gland. It's shaped like a walnut, and it's located below the bladder. It's nestled in front of the rectum and around the urethra, the tube that lets urine and semen flow from the penis. It's an important part of the male reproductive system because it creates the seminal fluid in semen. The prostate's muscles move semen into the urethra and force it out of the body.

Cancer in the prostate occurs when the cells change and rapidly grow, forming tumors. Doctors identify several types of prostate cancer, including adenocarcinoma, the most common type. It grows from the cells that make seminal fluid. Some prostate cancers grow fast and spread quickly. Most prostate cancer grows slowly.

This is the second most common cancer among men in America. Doctors will diagnose more than 164,500 men in 2018 according to estimates from the American Cancer Society. Odds are one in nine men will have prostate cancer at some point in their lives, although it's most common in older men.

Causes of prostate cancer

As men age, the prostate naturally changes its size. Prostate cancer might start as a precancerous condition, as the American Cancer Society suggests. These precancerous conditions may include:

  • Gene mutations passed down from earlier generations
  • Prostatic intraepithelial neoplasia, marked by abnormal cell growth
  • Proliferative inflammatory atrophy, marked by cells that are abnormally small

Risk factors of prostate cancer

Doctors haven’t found a cause. But they do know there are factors that put people at a higher risk of getting prostate cancer. These include:

  • Age — prostate cancer doesn’t happen often in men younger than 40, but after age 50 the chances increase.
  • Ethnicity — African-American and Caribbean men are at higher risk than other ethnic groups.
  • Where you live — prostate cancer is more common in North America than Asia or Africa.
  • Family history — if your dad or brother have or had prostate cancer, you’re more at risk.

Symptoms of prostate cancer

Like many cancers, prostate cancer doesn't always cause symptoms in its earliest stages. As the cancer advances, it often causes symptoms like:

  • Blood in semen or urine
  • A weak urine stream
  • Erectile dysfunction
  • Difficulty urinating
  • Painful ejaculation
  • Pain in the pelvis
  • Pain in bones

Diagnosis of prostate cancer

Many doctors perform screening for men after age 50 to catch the disease as early as possible. Screening tests often include a blood test that looks for the level of prostate-specific antigen (PSA) in your blood. High levels can be a sign of anything from infection to cancer. Doctors also perform digital rectal exams to feel for any changes in the size or shape of the prostate.

When diagnosing prostate cancer, doctors order further testing to get a better understanding of what's going on. These tests often include:

  • Ultrasounds to get a good picture of the prostate
  • Biopsies to gather cells to look at under a microscope
  • MRI fusions, relatively new tests that deliver detailed imaging

Your doctor may order further testing to see if the cancer spread. PET scans, CT scans, MRIs and ultrasounds are common.

Treatments for prostate cancer

You don't always have to start treatment right away. If you have low-risk prostate cancer that hasn't spread, your doctor might want to keep a close watch with blood tests and exams. In higher-risk cancers or more advanced cases, treatments include:

  • Surgery to remove the prostate
  • Freezing the cancer cells with cold gas
  • Hormone therapy to stop testosterone from feeding the cancer cells
  • Radiation therapy to kill the cancer cells with powerful beams of energy
  • Chemotherapy, often used for men with prostate cancer that spread to other body parts
  • Immunotherapy, which uses drugs to activate your immune system to fight the cancer

Recovery from prostate cancer

Having a strong support system and taking care of yourself after treatment can give you an easier recovery. For example, you want to keep your incision clean and dry after surgery. You might consider trying alternative treatments like dance or art therapy to help you manage stress.

The long-term prognosis depends on your health and the stage of the cancer. As with any cancers, the earlier you catch prostate cancer, the easier it is to treat. The five-year survival rate is 99% for men of all stages as noted by the American Cancer Society.

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