Prostate cancer is one of the most common types of cancer in men. There are different types of prostate cancer. Most often prostate cancer grows slowly and stays inside the prostate gland. In these cases, it may not spread and cause harm to other parts of your body and may need little or no treatment. However, some prostate cancers are more likely to spread quickly and cause serious harm.
What is the Prostate?
The prostate is a small (walnut-sized) gland in men located between the bladder and the penis, just in front of the rectum – the end of the large intestine that temporarily holds poop (feces). The urethra is a tube (duct) that passes through the middle of the prostate from the bladder to the penis. In men, the urethra lets urine and sperm flow out of the body.
The prostate also makes a fluid (seminal fluid) that protects sperm. During ejaculation, the prostate squeezes this fluid into the urethra. This fluid mixes with sperm and flows out of the penis as semen (cum).
Signs and Symptoms
In early stages, prostate cancer may have no signs and symptoms. More advanced stages may have signs and symptoms, including:
- Difficulty urinating, including trouble forcing urine out harder (may be unable to increase the force of your urine)
- Blood in your semen
- Discomfort in your pelvic area
- Bone pain
- Difficulty getting or keeping an erection
The cause(s) of prostate cancer is still not known. However, some prostate cancer risk factors include the following:
- Age – Risk increases as you get older.
- Race – African American men have a greater risk of prostate cancer than men of other races. The cancer is also more likely to be fast growing or an advanced stage. The reason(s) African American men are more affected is not known.
- Family history – If men in your family had prostate cancer, your risk may be higher. Also, if you have a very strong family history of breast cancer or the genes that cause breast cancer, your risk of prostate cancer may be greater than average.
Obesity – Obese men with prostate cancer may be more likely to suffer an advanced stage that is harder to treat.
Medical organizations do not seem to agree on whether to screen for prostate cancer in healthy men with no symptoms. The risks may outweigh the benefits.
- Benefits of screening – When prostate cancer is detected early, before it has a chance to spread, successful treatment is more likely.
- Drawbacks and risks of prostate screening – Prostate cancer screening has risks and drawbacks, most often false positive test results (showing you have cancer, when you do not) and overtreatment (treating cancer with extra methods that can be harmful when it does not need to be treated). Other risks include:
- Finding prostate cancer may not improve your health or help you live longer.
- Follow-up tests, such as a prostate biopsy, may have complications.
Some medical organizations recommend screening in men 50 and older, or sooner for men with risk factors for prostate cancer.
Discuss your personal situation with your doctor. He or she can provide the benefits and risks of screening with you. Together, you can decide if a prostate cancer screening is right for you.
There is no standard screening test for prostate cancer. Different screening tests each have their own pros and cons. Your doctor will weigh the risk versus most benefit with you. Standard screening tests include:
- Digital rectal exam (DRE) – Your doctor or nurse places a gloved finger into your rectum to feel the prostate for lumps or anything unusual.
- Prostate-specific antigen (PSA) test – Prostate-specific antigen, or PSA, is a protein produced by both healthy and cancerous cells of the prostate gland. The PSA test measures the level of PSA in your blood. A high PSA level may indicate prostate cancer. However, an enlarged prostate (BPH) or other prostate problems may also cause you to have a high PSA level.
- PSA controversy exists in the medical community and may not be recommended for all men, especially healthy men with no symptoms.
- Even when done, screening may only be done every two years or longer to avoid false-positive results.
If you have PSA screening results that are not normal, your doctor may do more testing, such as imaging tests (ultrasound or MRI), or a prostate biopsy. Ultrasound and a prostate biopsy are often performed together.
In a prostate biopsy, a needle is inserted into the prostate to remove a small amount of tissue. The needle is inserted into the prostate through your rectum. The removed tissue will be analyzed for cancer cells.
You and your doctor should talk about your risk for prostate cancer and consider the pros and cons of the screening tests for your personal situation. When you have all the facts, you will be able to make an informed decision whether prostate cancer screening is right for you.
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