Dr. Kevin Zorn is a dual-board-certified (US and Canada), minimally-invasive uro-oncology, fellowship trained urologist at the University of Chicago. His main focus of clinical and scientific interest is in the surgical treatment of renal and prostate cancer. He is also an expert in performing surgery with the DaVinci Surgical Robotic System to manage localized prostate cancer and small renal masses. Dr. Zorn studied medicine and urology at McGill University in Montréal.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The prostate is a glandular organ of the male reproductive system. It is often described as the same size of a walnut, normally about 3 cm long (slightly more than 1 inch); it weighs about 30 g (1 ounce) and is located at the neck of the bladder and in front of the rectum. The prostate surrounds the urethra, which is a tubular structure that carries the urine (produced by the kidney and stored in the bladder) out of the penis during voiding, and the sperm (produced in the testicle) during ejaculation. In addition, during ejaculation a thin, milky fluid produced by the prostate is added to the mix. This ejaculate that also includes fluid from the seminal vesicles, constitutes the male semen.
Physiopathology:
In prostate cancer, normal cells undergo a transformation in which they not only grow and multiply without normal controls, but they also differentiate and can invade adjacent tissues. Tumors overwhelm surrounding tissues by invading their space and taking vital oxygen and nutrients. Tumors can eventually invade remote organs via the bloodstream and the lymphatic system.
This process of invading and spreading to other organs is called metastasis. Common metastatic locations include pelvic lymph nodes, bones, lung, and the liver.
Almost all prostate cancers arise from the secretory glandular cells in the prostate. Cancer arising from a glandular cell is known as adenocarcinoma. Therefore, the most common type of prostate cancer is an adenocarcinoma and accounts for more than 95% of all prostate cancer. The most common nonadenocarcinoma is transitional cell carcinoma. Other rare types include small cell carcinoma and sarcoma.
Older men commonly have an enlarged prostate, a benign (noncancerous) condition called benign prostatic hyperplasia (BPH). BPH can cause urinary symptoms but is not associated with prostate cancer (see BPH).
Anatomy of the male pelvis, genitals, and urinary tract.
Epidemiology:
In the U.S., prostate cancer is the most common cancer in men and is the second leading cause of cancer death in men (the first being lung cancer). However, most prostate cancer does not cause death. Only 3% of men with prostate cancer die from the disease.
It is estimated that 241,740 new cases of prostate cancer will be diagnosed in 2012, while 28,170 patients will die from this disease. This comparatively low death rate suggests that increased public awareness with earlier detection and treatment has begun to affect mortality from this prevalent cancer.
Prostate cancer has seemed to increase in frequency, due in part to the widespread availability of serum prostate specific antigen (PSA) testing. However, the death rate from this disease has shown a steady decline, and currently more than 2 million men in the U.S. are still alive after being diagnosed with prostate cancer at some point in their lives.
The estimated lifetime risk of being diagnosed with the disease is 17.6% for Caucasians and 20.6% for African Americans. The lifetime risk of death from prostate cancer similarly is 2.8% and 4.7%, respectively. Because of these numbers, prostate cancer is likely to impact the lives of a significant proportion of men that are alive today.
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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.
