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What is Prostate Cancer?

Prostate cancer is a disease that develops in a man’s prostate gland. The prostate is a small gland located just below the bladder and in front of the rectum that produces a fluid that is part of semen. Prostate cancer is the second most common type of cancer in men in the United States, affecting approximately 1 in 7 men.1

Though some types of prostate cancer are aggressive and fast growing, the majority are usually slow growing. Prostate cancer prognosis is generally favorable, especially when it’s found early and hasn’t spread beyond the prostate gland.

What is Prostate Cancer?

Prostate cancer is a disease that develops in a man’s prostate gland. The prostate is a small gland located just below the bladder and in front of the rectum that produces a fluid that is part of semen. Prostate cancer is the second most common type of cancer in men in the United States, affecting approximately 1 in 7 men.1

Though some types of prostate cancer are aggressive and fast growing, the majority are usually slow growing. Prostate cancer prognosis is generally favorable, especially when it’s found early and hasn’t spread beyond the prostate gland.

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Prostate Cancer Statistics

Prostate cancer is the second most common cancer affecting American men behind skin cancer. It is estimated that approximately 161,360 men will be diagnosed with prostate cancer in 2017 and there will be approximately 26,730 deaths from prostate cancer over the course of the year.1

The following are other important prostate cancer statistics:

  • Approximately 6 in 10 prostate cancer cases develops in men 65 or older1
  • The average age at time of diagnosis is around 661
  • In 2013, black males had the highest risk of prostate cancer, followed by white, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander males.1

The following are statistics related to prostate cancer survival rates:

  • 5-year relative prostate cancer survival rate is nearly 100 percent2
  • 10-year relative prostate cancer survival rate is approximately 98 percent2
  • 15-year relative prostate cancer survival rate is approximately 95 percent2

These are estimates – prostate cancer survival rate is impacted by factors such as the stage of the cancer, age, and more. The outlook for cancer is commonly given as 5-year survival rates, which are based on the percentage of people still alive 5 years after diagnosis. Many of these people live longer than 5 years with many living many more years.2

Approximately 6 in 10 prostate cancer cases develops in men 65 or older

The average age at time of diagnosis is around 66

Prostate Cancer Screening

Prostate Cancer Screening3

Prostate cancer screening should be part of a man’s regular physical beginning around age 50 or earlier in men with risk factors, such as a family history of prostate cancer. Prostate cancer screening entails a digital rectal exam performed by a doctor. This quick exam is performed in-office to check for any abnormalities. The doctor will be able to feel if the prostate is enlarged or if there are any lumps. An enlarged prostate may cause pain during the exam. If any abnormalities are felt, an ultrasound may be recommended.

A prostate-specific antigen (PSA) blood test may also be used as a screening tool. PSA is a protein that is produced by the prostate gland. A man’s PSA level may be higher than normal when the prostate gland is inflamed or enlarged due to cancer. An infection and other causes of inflammation of the prostate gland can also affect PSA levels.

Men with a strong family history of prostate cancer may be given a prostate cancer gene (PCA3) test. A urine sample is used to measure the amount of the gene in the urine. It may also be used on men who have had a high PSA level and a biopsy that was negative for cancer. In this case, a repeat biopsy will be ordered if the PCA3 test is positive. The PCA3 test may also be used as a monitoring tool in men who have undergone prostate cancer treatment.

Prostate Cancer Types4

There are different types of prostate cancer, with prostatic adenocarcinoma accounting for the majority of prostate cancers. The following is a brief overview of the different types of prostate cancer:

Prostatic adenocarcinoma

This type of tumor accounts for 90 to 95% of prostate cancer cases. It most often develops in the peripheral region of the prostate which is where two thirds of the prostate gland tissue is located.  In most cases, prostatic adenocarcinoma is slow growing and often curable when found early.

Small cell carcinoma

This is a very aggressive type of cancer that can be hard to detect because it doesn’t cause a change in a man’s PSA (prostate specific antigen) level, which is used in prostate cancer screening. Often, this type of prostate cancer is diagnosed in advanced stages.

Squamous cell carcinoma

This is a non-glandular prostate cancer that is very aggressive and doesn’t lead to an increase in PSA, making it harder to detect.

Prostatic sarcomas

This is a very rare type of cancer that accounts for less than 0.1 percent of primary prostate cancer cases. This type of prostate cancer tends to affect younger men (35 to 60) and is made up of cells that are more likely to spread to other tissues and organs.5

Men can also develop benign prostate tumors known as benign prostatic hyperplasia (BPH). These are common, non-cancerous tumors that grow large enough to squeeze the urethra and impede the normal flow of urine. In some cases, surgery may be required to improve symptoms.6

Prostate Cancer Stages7

Prostate cancer stages are used to help determine the best possible treatment course, as well to predict prostate cancer prognosis. Various tests will be used to determine the stage, including some of the tests that are used to diagnose the cancer. These may include:

  • Digital rectal exam
  • Biopsy
  • Blood PSA levels
  • Imaging, such as X-ray, CT scan, MRI to determine how far the cancer has spread

The following provides a brief overview of the different prostate cancer stages:

  • Stage I – The cancer is found only in the prostate
  • Stage II – The cancer is more advanced than stage I, but has not spread beyond the prostate
  • Stage III – The cancer has spread outside of the prostate and possibly to the seminal vesicles.
  • Stage IV – The cancer has spread past the seminal vesicles to nearby tissue or organs, such as the pelvic wall or rectum, or to nearby lymph nodes, or distant parts of the body, such as bones.

Prostate Cancer Symptoms6

It its early stages, prostate cancer may not cause any signs or symptoms. Symptoms are more likely to develop as the cancer grows. Symptoms of prostate cancer can include:

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Difficulty or inability to urinate

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Increased need to urinate, especially at night

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Decreased stream of urine

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Sensation of not having emptied the bladder after urinating

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Pain or burning during urination

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Blood in the urine (hematuria)

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Pelvic pain and discomfort

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Painful ejaculation

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Blood in the semen

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Decreased amount of semen when ejaculating

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Erectile dysfunction

Advanced prostate cancer signs and symptoms may also include:

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Bone pain

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Weakness

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Fatigue

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Low red blood cell count (anemia)

Prostate Cancer Causes and Risk Factors8

Doctors do not yet know what causes prostate cancer. Prostate cancer results from abnormal changes in prostate cells that cause the cells to grow and divide at a faster rate than normal cells. Leading them to accumulate and form a tumor.

Certain factors can increase a man’s risk of developing prostate cancer. Prostate cancer risk factors include:

Family history of prostate cancer – Though prostate cancer can develop in men with no family history of the disease, a man’s risk more than doubles if he has a brother or father who has had prostate cancer. Having multiple family members who have had prostate cancer or family members diagnosed at a young age raises your risk even higher.

Age – Prostate cancer rarely develops in men under the age of 40, but the risk increases with age, especially after the age of 50. Most prostate cases occur in men older than 65.

Family history of breast cancer – Having a strong history of breast cancer (in women or men) or having a family history of the genes linked to breast cancer (BRCA1 or BRCA2) also raises your risk of prostate cancer.

Ethnicity – Prostate cancer is more common in black men than any other race. A poorer prostate cancer prognosis is also considerably higher in African American males. The reasons for this are still unclear.

Other factors that raise the risk of prostate cancer include being obese and other inherited gene mutations.

Researchers are actively looking into other possible risk factors including:

  • Smoking
  • Diet
  • Sexually transmitted infections (STIs)
  • Exposure to certain chemicals
  • Inflammation of the prostate
Prostate Cancer Causes and Risk Factors

Prostate Cancer Treatments

The most important factor considered when choosing your treatment for prostate cancer is the stage of your cancer. Other things to consider include your age, overall health, and life expectancy.

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