Health Break | Published June 8, 2012 | Written by Mary E. Riglin, RN

Symptoms and treatments of prostate cancer

Early detection is important.

Prostate cancer is the most common cancer of American men, and although it is a serious disease, the good news is that it is treatable. Approximately 200,000 new prostate cancer cases will be diagnosed this year in the United States and 30,200 men will die of this disease. In most cases, prostate cancer is a slow growing cancer, so early detection is important.

Prostate cancer generally affects older men and is rare to get before the age of 50. However, men in their 30s and 40s can also contract it. African-American men have the highest incidence, as well as the highest death rate, from prostate cancer. Having a family history of prostate cancer puts men at high risk.

In some parts of the world, such as Africa, Asia and Latin America, prostate cancer is rare. There seems to be no definitive reason why this is the case, although dietary fat has been linked to increased prostate cancer, and it could be that there is less substantial amounts of dietary fat in these regions of the world.

The prostate gland, found only in men, is located just below the bladder and surrounds the upper part of the urethra, the tube that carries urine from the bladder. This gland is about the size of a walnut, and its function is to produce some of the seminal fluid that protects and nourishes sperm cells. This function is regulated by the sex hormone, testosterone, produced mainly in the testicles.

Most prostate cancers are adenocarcinomas, meaning they develop from glandular cells. Generally, this cancer grows slowly within the prostate gland, often causing no symptoms until its advanced stages. The tumor can grow and spread directly to organs and tissues near the prostate gland once it penetrates the outer rim of the gland. Over a period of time, the cancer cells spread (metastasize) to other parts of the body, often to the lymph nodes in the pelvis first. When it has spread outside the gland, it grows more rapidly and is more dangerous.

Although there are no early signs or symptoms of prostate cancer, once the malignant (cancerous) tumor causes the gland to swell or go beyond the prostate, the following symptoms may be present:

  • Difficulty starting the urinary stream
  • A weak urinary stream
  • Frequent need to urinate, often at night
  • Blood present in urine or semen
  • Painful or burning urination
  • Dull, deep pain or stiffness in the pelvis, lower back or upper thighs
  • Weight loss and appetite loss
  • Nausea and/or vomiting
  • Fatigue

Early detection testing for prostate cancer should begin at age 50. Men with a strong family history of prostate cancer and African-American men should begin testing at age 45. Many doctors recommend an annual digital rectal exam (DRE) and a prostate-specific antigen (PSA) blood test, both of which are very good screening tests for early detection of prostate cancer. There are many different tests used when routine screening arouses suspicion. Other tests range from X-rays, ultrasound, CT scans, bone scans, biopsies, or other imaging tests. Once the diagnosis is made, decisions are made as to how to treat the disease. There will be factors to consider, such as age of the patient, the patient's general health, and how advanced the cancer is. Depending on how advanced the cancer is, men often have more than one option for treatment. Types of treatments include:

  • Chemotherapy: Uses anticancer drugs to kill cancer cells. This is used for patients whose prostate cancer has spread outside the prostate gland.

  • Radiation therapy: Uses high-energy rays to kill cancer cells. These can be internal or external radioactive pellets, called seeds. These seeds are directly implanted into the prostate and give off radiation for weeks.

  • Radical prostatectomy: This involves removal of the entire prostate gland, plus some surrounding tissue. This procedure usually requires an average of three days in the hospital.

  • Orchiectomy: This operation removes the testicles to remove the source of the male hormone.

  • Hormone therapy: Often given for those cancers that have spread outside the prostate or have recurred after treatment.

Early detection of prostate cancer is very important to ensure the best chances of successfully treating it. Patients may dread the procedure for early detection - the annual digital rectal exam - but it may save their lives.