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Prostate Cancer


Topic Overview

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For information on cancer that has come back or spread to other parts of the body, see the topic Prostate Cancer, Advanced or Metastatic.

What is prostate cancer?

Prostate cancer is the abnormal growth of cells in a man's prostate glandClick here to see an illustration.. The prostate sits just below the bladder. It makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. It usually grows larger as you grow older.

Prostate cancer is common in men older than 65. It usually grows slowly and can take years to grow large enough to cause any problems. As with other cancers, treatment for prostate cancer works best when the cancer is found early. Often, prostate cancer that has spread responds to treatment. Older men with prostate cancer usually die from other causes.

Experts don't know what causes prostate cancer, but they believe that your age, family history (genetics), and race affect your chances of getting it. What you eat, such as foods high in fats, may also play a part.

What are the symptoms?

Prostate cancer usually does not cause symptoms in its early stages. Most men don't know they have it until it is found during a regular medical exam.

When problems are noticed, they are most often problems with urinating. But these same symptoms can also be caused by an enlarged prostate (benign prostatic hyperplasia). An enlarged prostate is common in older men.

See your doctor for a checkup if:

  • You have urinary problems, such as:
    • Not being able to urinate at all.
    • Having a hard time starting or stopping the flow of urine.
    • Having to urinate often, especially at night.
    • Having pain or burning during urination.
  • You have difficulty having an erection.
  • You have blood in your urine or semen.
  • You have deep and frequent pain in your lower back, belly, hip, or pelvis.

How is prostate cancer diagnosed?

The most common way to check for prostate cancer is to have a digital rectal exam, in which the doctor puts a gloved, lubricated finger in your rectum to feel your prostate, and a prostate-specific antigen (PSA) blood test. A higher level of PSA may mean that you have prostate cancer, but it could also mean that you have an enlargement or infection of the prostate.

If your PSA is high, or if your doctor finds anything during the rectal exam, he or she may do a prostate biopsyClick here to see an illustration. to figure out the cause. A biopsy means your doctor takes a sample of tissue from your prostate gland and sends it to a lab for testing.

Should you have regular tests for prostate cancer?

It is important to have regular health checkups, including a digital rectal exam. But experts agree that PSA testing is not right for all men. Testing could lead you to have cancer treatments that you do not need. Cancer treatments may cause other health problems, such as loss of bladder control and not being able to have an erection.

So talk with your doctor. Ask about your risk for prostate cancer, and discuss the pros and cons of PSA testing.

How is prostate cancer treated?

Your treatment will depend on what kind of cancer cells you have, how far they have spread, your age and general health, and your preferences.

You and your doctor may decide to treat your cancer with surgery, radiation, hormone therapy, or a combination. Or if you have cancer that is low-risk and has not spread (early stage), you may be able to wait and watch with active surveillance to see what happens. During active surveillance (watchful waiting), you will have regular checkups with your doctor to see if your cancer has changed.

Choosing treatment for prostate cancer can be confusing. Talk with your doctor to choose the treatment that is best for you.

How can treatment affect your quality of life?

Your age and overall health will make a difference in how treatment may affect your quality of life. Any health problems you have before you are treated, especially urinary, bowel, or sexual function problems, will affect how you recover.

Both surgery and radiation can cause urinary incontinence (not being able to control urination) or impotence (not being able to have an erection). The level of urinary incontinence and how long it lasts and the quality of the erections a man has after treatment will depend on whether the cancer has spread. These also depend on what treatment is used.

Nerves that help a man have an erection are right next to the prostate. Surgery to remove the cancer may damage these nerves. Many times a special form of surgery, called nerve-sparing surgery, can preserve the nerves. But if the cancer has spread to the nerves, they may have to be removed during surgery.

These same nerves can also be damaged by the X-rays that are used in radiation therapy.

Medicines and mechanical aids may help men who are impotent because of treatment. Some men recover part or most of their ability to have an erection several months or even years after surgery.

Frequently Asked Questions

Learning about prostate cancer:

Being diagnosed:

Getting treatment:

Ongoing concerns:

Living with prostate cancer:

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