Prostate, << PROS tayt, >> cancer is an uncontrolled division of cells in the prostate gland, a walnut-sized internal organ of the male reproductive system. In the United States, prostate cancer kills more men than any other cancer except lung cancer. African American men have the highest rate of prostate cancer in the world. Individuals have an increased risk of prostate cancer if other men in their families have also had the disease.
A cancerous prostate gland may become enlarged and press on the urethra, the tube through which urine leaves the body. The expanding gland may also put pressure on the bladder. Many prostate cancer patients consult a doctor because this pressure causes frequent urination or difficulty passing urine.
Doctors must perform tests to determine if these symptoms are due to cancer or to noncancerous enlargement of the prostate, another common condition. The first such test is often a digital rectal examination. In this procedure, a doctor feels the prostate gland directly by inserting a finger, covered with a lubricated glove, into the patient’s rectum. A lump or an area of hardness may indicate cancer. Another means of diagnosing prostate cancer is a blood test that measures a protein called prostate-specific antigen (PSA). Elevated levels of PSA, which is produced only in the prostate gland, may indicate cancer.
A suspicious digital exam or PSA test is often followed by an ultrasound examination, which uses sound waves to create a detailed image of the prostate. This image aids a doctor in obtaining small surgical samples of tissue from the gland. If the tissue is cancerous, more tests are needed to determine if the cancer is confined to the prostate or has spread elsewhere in the body.
Doctors can often cure cancer that remains confined to the prostate by radiation therapy or by surgical removal of the gland. Both treatments may interfere with a man’s ability to have sexual relations or may cause urinary incontinence (inability to hold back urine). Surgeons have developed an operation that may avoid sexual problems by preserving nerves important in sexual functioning. Doctors extend the lives of patients whose cancer has spread beyond the prostate gland with treatments that reduce levels of male hormones. Prostate cancer cells need male hormones to survive and grow.
Doctors recommend that middle-aged men have an annual digital rectal examination to detect any prostate cancer before it causes symptoms. Many doctors also recommend an annual PSA test, which can detect small tumors before they can be felt. Some doctors fear that this use of the PSA test will find some slow-growing cancers that would never become life-threatening. Treating such cancers may subject patients to the risks of unnecessary surgery or other procedures. But doctors cannot yet predict which tumors will become life-threatening.
