Prostate cancer

Prostate cancer is a malignant (cancerous) tumor (growth) that consists of cells from the prostate gland. The tumor usually grows slowly and remains confined to the gland for many years. During this time, the tumor produces little or no symptoms or outward signs (abnormalities on physical examination). As the cancer advances, however, it can spread beyond the prostate into the surrounding tissues (local spread). Moreover, the cancer also can metastasize (spread even farther) throughout other areas of the body, such as the bones, lungs, and liver.

Signs and Symptoms

Prostate cancer, in its early stages, may not cause any symptoms. But as it progresses, symptoms often appear.

Symptoms of prostate cancer include:

• Abdominal pain
• A need to urinate frequently, especially at night
• Difficulty starting urination or holding back urine
• Inability to urinate
• Weak or interrupted flow of urine (dribbling)
• Painful or burning urination
• Difficulty in having an erection
• Painful ejaculation
• Blood in urine or semen
• Frequent pain or stiffness in the back, hips, or upper thighs
• Pain with bowel movement

 

More about Prostate cancer

Causes

The cause of prostate cancer is unknown, but the cancer is thought not to be related to benign prostatic hypertrophy (BPH). The risk (predisposing) factors for prostate cancer include:

• advancing age,
• genetics (heredity),
• hormonal influences,
• environmental factors as toxins, chemicals, and industrial products.
• The chances of developing prostate cancer increase with age.

Thus, prostate cancer under age 40 is extremely rare, while it is common in men older than 80 years of age. As a matter of fact, some studies have suggested that among men over 80, between 50 and 80 percent of them may have prostate cancer!

Risk Factors

The following factors may increase an individual's risk for prostate cancer:

• Older age—prostate cancer is most common among men who are older than 55
• Race—African Americans have a greater risk of developing prostate cancer than European Americans who, in turn, have a greater risk than Native and Hispanic Americans
• Family history of prostate cancer—having a brother with prostate cancer makes an individual 4.5 times more likely of developing the disease; having a father with prostate cancer makes an individual 2.3 times more likely of developing prostate cancer; having a sister or mother with ovarian or breast cancer is also considered a risk
• High-fat diet—foods rich in saturated fat may increase testosterone levels
• Lack of exercise may increase the risk in those who eat a high-fat diet
• Occupation—people who are regularly exposed to the chemicals dimethyl formamide and acrylonitrate, and the metal cadmium (such as metal workers and farmers) have high rates of prostate cancer

Diagnosis

Two standard tests are used for early detection of prostate cancer:

• Digital rectal exam (DRE)—in this test, the physician inserts a gloved, lubricated finger into the patient's rectum in order to feel the prostate for bumps or other abnormalities.
• PSA test—blood test measuring the level of prostate-specific antigen (PSA), a protein produced in the prostate gland that keeps semen in liquid form. Prostate cancer cells produce elevated quantities of PSA, so measuring PSA levels allows physicians to detect cancer while it is still microscopic. Unfortunately, the test is not accurate enough to definitively rule out or confirm cancer. For example, advancing age and benign conditions such as enlarged prostate can also elevate PSA levels.
• Transrectal Ultrasound—a visual image of the prostate is obtained by using ultrasound
• Biopsy of the prostate—a tissue sample is obtained through the rectum and examined for cancerous cells under the microscope
• Imaging tests (CT and MRI)—computerized tomography (CT) or magnetic resonance imaging (MRI) scans may pinpoint the location of cancer that has spread beyond the prostate
• Bone scans and X rays—these look for spread of cancer to the bones
• Lymph node dissection—this is part of a surgical procedure to determine if the cancer has spread to the lymphatic system

Treatment Approach

There's more than one way to treat prostate cancer. For some men a combination of treatments — such as surgery followed by radiation or radiation paired with hormone therapy — works best. The treatment that is best for each man depends on several factors. These include how fast your cancer is growing, how much it has spread, your age and life expectancy, as well as the benefits and the potential side effects of the treatment.
The most common treatments for prostate cancer include the following

• External-beam radiation therapy (EBRT). External beam radiation treatment makes use of high-powered X-rays to kill cancer cells, using a machine to deliver the radiation beam. This type of radiation is effective at destroying cancerous cells, but it can also scar adjacent healthy tissue.
• Radioactive seed implants
• Hormone therapy - When you have prostate cancer, male sex hormones (androgens) can stimulate the growth of cancer cells. The main type of androgen is testosterone. Hormone therapy either uses drugs to try to stop your body from producing male sex hormones, or involves surgery to remove your testicles, which produce most of your testosterone.Drugs, used in hormone therapy decrease your body's production of testosterone - leuprolide (Lupron, Viadur) and goserelin (Zoladex).Drugs used in hormone therapy block your body's ability to use testosterone - flutamide (Eulexin), bicalutamide (Casodex) and nilutamide (Nilandron).
• surgical removal of your testicles (castration)
• Surgical removal of your prostate gland, called radical prostatectomy
• Chemotherapy - This type of treatment uses chemicals that destroy rapidly growing cells.
• Cryotherapy - This treatment is used to destroy cells by freezing tissue.

Medications

Prostate cancer Medications

• Casodex