PROSTATE CANCER

What is it?

Cancer is really a number of diseases caused by the abnormal growth of cells. Normally, the cells that make up the body divide and reproduce in an orderly manner, so that we can grow, replace worn-out tissue, and repair any injuries. Sometimes, however, cells get out of control. They divide too much and form masses known as tumors. Some tumors may interfere with body functions and require surgical removal, but they do not spread to other parts of the body. These are known as benign tumors. Malignant--or cancerous--tumors not only invade or destroy normal tissue, but, by a process known as metastasis, cells break away from the original tumor and migrate to other parts of the body. There they may form more malignant tumors.

The rates of growth and spread of prostate cancer vary widely. Some tumors grow rapidly. Others grow so slowly they do not even produce symptoms during a man's lifetime.

Who gets it?

Cancer of the prostate is the most common type of cancer among men and the second leading cause of cancer deaths among them. It's estimated that one out of every 10 men will develop prostate cancer before age 85.

The risk of developing prostate cancer greatly increases with age. It rarely occurs in men younger than 50. The average age is 72. The cause of prostate cancer is unknown.

The cause of prostate cancer remains unknown. Several factors associated with a higher rate of prostate cancer, however, have been identified. The risk of developing prostate cancer increases as a man ages. Almost all patients with prostate cancer are more than 50 years old and 80% are over age 65.

For reasons not known currently, black Americans have the highest incidence rate in the world. A family history of prostate cancer in a brother or father also doubles ones chances of getting prostate cancer.

There is no convincing evidence to date that diet and/or nutrition play a role in developing prostate cancer.

What are the symptoms?

In the very early stages of prostate cancer, there usually are no symptoms. When symptoms do develop, they vary according to the size and location of the tumor, and are often the same as those for benign prostate conditions. In fact, it is more likely that any of these symptoms would indicate prostate enlargement, known as benign prostatic hypertrophy, infection, or other conditions rather than cancer. Still, any symptom should be checked by a physician. Only a physician conducting the proper tests can determine for sure whether the condition is cancerous or benign. Symptoms of prostate problems include:

• Weak or interrupted urine flow
• Inability to urinate
• Difficulty in starting or stopping urination
• Need to urinate frequently, especially at night
• Blood in the urine
• Painful or burning urination
• Continuing pain in lower back, pelvis, or upper thighs

What tests will the Doctor want to do?

Removal of a small tissue sample and its examination under a microscope, a procedure known as a biopsy, is the ONLY way to determine conclusively if a growth is cancerous. For prostate cancer, tissue samples are usually obtained by inserting an ultrasound probe into the rectum to visualize the prostate on a TV monitor. A thin needle is placed through the probe into the prostate. This procedure is known as needle biopsy. No anesthesia is needed for a needle biopsy of the prostate. It is an outpatient procedure, usually done in the doctor's office.

If prostate cancer is found, your doctors will need more information about the extent of the cancer. That is, has the cancer spread farther than the prostate? The treatment of prostate cancer and the expected outcome depend greatly on the stage, or extent, of disease.

What is the treatment?

Until recently, there were only two basic forms of treatment, surgery and external radiation therapy aimed at the prostate gland.

In the early 1970s, a new approach was developed to confine radiation exposure to the prostate gland, increase radiation dosage to the tumor in order to kill the cancer, and minimize side effects. Although other radioactive agents are available, I-125 appears to be well suited for prostate implantation. It gives off very low energy radiation, or X-rays, that do not travel outside the prostate gland and pose no threat to patients or those in close contact with them. In fact, up to 90% of I-125 seed radiation is used up by six months, with all of it gone in 1 year.