Prostate Cancer

For many men a diagnosis of prostate cancer can be frightening not only because of the threat to their lives, but because of the threat to their sexuality. In fact, the possible consequences of treatment — which include bladder control problems and erectile dysfunction (ED) or impotence — can be a great concern for some men.

Prostate cancer is cancer of the prostate gland. This is the small, walnut-shaped gland that surrounds the bottom portion ("neck") of a male's bladder and about the first inch of the urinary tube (urethra), the channel that drains fluid from the bladder. It's located behind the pubic bone and in front of the rectum. The prostate's primary function is to produce seminal fluid, the fluid that nourishes and transports sperm.

This type of cancer is the most common cancer in American men. The American Cancer Society estimates that about 230,000 men are diagnosed with prostate cancer annually in the United States and that about 29,000 men die of the disease.

If prostate cancer is detected early — when it's still confined to the prostate gland — you have a better chance of successful treatment with minimal or short-term side effects. Successful treatment of cancer that has spread beyond the prostate gland is more difficult. But treatments exist that can help control the cancer.

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Prostate cancer often doesn't produce any symptoms in its early stages. That's why many cases of prostate cancer aren't detected until they've spread beyond the prostate.

When signs and symptoms do occur, they may include the following:

• Urgency of urination
• Difficulty starting urination
• Pain during urination
• Weak urine flow and dribbling
• Intermittent urine flow
• A sensation that your bladder isn't empty
• Frequent urination at night
• Blood in your urine
• Painful ejaculation
• General pain in your lower back, hips or upper thighs
• Loss of appetite and weight
• Persistent bone pain

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Cancer is a group of abnormal cells that grow more rapidly than normal cells and that refuse to die. Cancer cells also have the ability to invade and destroy normal tissues, either by growing directly into surrounding structures or after traveling to another part of your body through your bloodstream or lymph nodes. Microscopic cancer cells grow into small clusters that continue to grow, becoming more densely packed and hard.

Prostate cancer usually grows slowly and remains confined to the prostate gland, where it usually doesn't cause serious harm. But not all cancers act the same. Some forms of prostate cancer are aggressive and can spread quickly to other parts of your body.

What causes prostate cancer and why some types behave differently are unknown. Research suggests that a combination of factors may play a role, including heredity, ethnicity, hormones, diet and the environment.

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Knowing the risk factors for prostate cancer can help you determine if and when you want to begin prostate cancer screening. The main risk factors include:

• Age. As you get older, your risk of prostate cancer increases. After age 50, your chance of having prostate cancer increases substantially.
• Race or ethnicity. For reasons that aren't well understood, African-American men are more likely to get and die of prostate cancer than are men of any other group in the United States. Prostate cancer occurs almost 70 percent more often in black men than it does in white American men. Black men are twice as likely to die of prostate cancer.
• Family history. If a close family member — your father or brother — has prostate cancer, your risk of the disease is greater than that of the average American man.
• Diet. A high-fat diet and obesity may increase your risk of prostate cancer. Researchers theorize that fat increases production of the hormone testosterone, which may promote the development of prostate cancer cells.
• Surgery to become infertile (vasectomy). Although some studies suggest that men who've had a vasectomy are at increased risk for prostate cancer, no conclusive evidence to support such research has been found. Research on this issue remains in progress.

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Prostate cancer can't be prevented, but you can take measures to reduce your risk or possibly slow the disease's progression. The most important steps you can take to maintain prostate health — and health in general — are to eat well, keep physically active and see your doctor regularly.

Eating Well

High-fat diets have been linked to prostate cancer. Therefore, limiting your intake of high-fat foods and emphasizing fruits, vegetables and whole fibers may help you reduce your risk. Foods rich in lycopenes, an antioxidant, also may help lower your prostate cancer risk. These foods include raw or cooked tomatoes, tomato products, grapefruit and watermelon. Garlic and cruciferous vegetables such as arugula, bok choy, broccoli, brussels sprouts, cabbage and cauliflower also may help fight cancer.

Soy products contain isoflavones that seem to keep testosterone in check. Because prostate cancer feeds off testosterone, isoflavones may reduce the risk and progression of the disease.

Vitamin E has shown promise in reducing the risk of prostate cancer among smokers. More research is needed, however, to fully determine the extent of these benefits of vitamin E.

Getting Regular Exercise

Regular exercise can help prevent a heart attack and conditions such as high blood pressure and high cholesterol. When it comes to cancer, the data aren't as clear-cut, but studies do indicate that regular exercise may reduce your cancer risk, including prostate cancer.

Exercise has been shown to strengthen your immune system, improve circulation and speed digestion — all of which may play a role in cancer prevention. Exercise also helps to prevent obesity, another potential risk factor for some cancers.

Regular exercise may also minimize your symptoms and reduce your risk of prostate gland enlargement, or benign prostatic hyperplasia (BPH). Men who are physically active usually have less severe symptoms than men who get little exercise do.

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Prostate cancer usually is treated with radiation therapy or surgery. You may also choose watchful waiting (surveillance). Your decision about treatment depends on:

• Your age, overall health, and life expectancy.
• The grade of the cancer, or how clearly the cancer cells can be distinguished from normal cells. Higher-grade cells are more likely to grow rapidly and spread to other parts of the body (metastasize).
• The extent of growth (stage) of the cancer.
• The side effects of treatment.
• Your personal beliefs and concerns.

Prostate cancer is curable if it is discovered and treated in an early . However, prostate cancer, unlike many other cancers, is usually slow-growing. Most men will die with prostate cancer but not of prostate cancer. Decisions about additional testing and treatment start with the decision to get a screening test, which in many cases will result in the discovery of slow-growing prostate cancer.

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According to the ACS:

Among men diagnosed with prostate cancer, 98% survive at least 5 years, 84% survive at least 10 years, and 56% survive at least 15 years. These figures include all stages and grades of prostate cancer but do not account for men who die from other causes. In other words, many of the men who died before 15 years, died from causes other than prostate cancer.

About 86% of all prostate cancers are found in the local and regional stages (local means it is still confined to the prostate; regional means it has spread from the prostate to nearby areas, but not to distant sites such as other organs). The 5-year relative survival rate for all of these men is nearly 100%.

Of the men whose prostate cancers have already spread to distant parts of the body at the time of diagnosis, 34% will survive at least 5 years.

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* Text Resources: The Mayo Clinic Staff