Cancer InDepth: Prostate Cancer
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Prostate cancer is a disease in which cells in the prostate become cancerous and multiply, initially forming a tumor in the prostate and then, in some cases, spreading to other parts of the body. The prostate is a gland that surrounds the urethra, the tube that carries urine from the bladder to the end of the penis in men. In babyhood, the prostate is the size of a pea; it grows to the size of a walnut by adulthood. Women do not have a prostate gland.
The Prostate Gland
The prostate produces seminal fluid, which is needed to keep sperm healthy. The prostate releases the seminal fluid into the urethra where it combines with sperm to make semen. The prostate is also responsible for converting some of a man’s testosterone (male hormone) into a very potent type of testosterone, called dihydrotestosterone. The presence and processing of this testosterone in the prostate gland is thought to be involved in the development and progression of prostate cancer; in fact, anti-testosterone agents are often used in the treatment of prostate cancer.
How Cancer Occurs
Normally, the cells of the prostate divide in a regulated manner. However, if cells begin dividing in an unregulated manner, a mass of tissue forms. This mass is called a tumor. A tumor can be benign or malignant.
A benign tumor is not cancerous. It will not spread to other parts of the body. In many older men, the prostate enlarges in this benign manner and is called benign prostatic hyperplasia (BPH). BPH can cause problems by pushing on the urethra and bladder and preventing the free flow of urine out of the body; this is a common and progressive problem in older men.
A malignant tumor does contain cancer cells. Cancer cells divide in a rapid, disorganized fashion, and can invade and damage tissue around them. They can also enter the bloodstream and spread to other parts of the body. This is called metastasis, and can be life threatening.
With prostate cancer, the most common sites for metastasis include the bladder, the rectum, bone, and lymph nodes in the pelvis. In most case, prostate cancer is very slow-growing. Therefore, as long as the cancer is caught at an early stage, there is a good chance that the cancer will not be life threatening.
Who Is Affected
Some estimates place prostate cancer as the most common cancer diagnosed in men, and the second most deadly cancer in men (after lung cancer). One man in six will get prostate cancer in his lifetime, and in 2002, about 189,000 new cases of prostate cancer were diagnosed in the U.S. Approximately 30,200 men in the U.S. died of prostate cancer in 2002.
Compared with white men, African-American men have a higher rate of prostate cancer, and also tend to be diagnosed at a later stage; therefore, they have a higher death rate from prostate cancer. Hispanic-American and Native-American men have lower rates of prostate cancer than do white men. Worldwide, the lowest rates of prostate cancer are in Asian countries; the highest rates of prostate cancer are in Northern European countries.
In the United States, prostate cancer is found mainly in men over age 55. The average age of patients at the time of diagnosis is 70. In fact, some statistics suggest that by the time a man is between age 80 and 90, a microscopic examination of his prostate tissue would be 70% to 90% likely to show evidence of prostate cancer. Not all of these prostate cancers will cause problems or symptoms, or even become apparent during the person’s lifetime.
Other factors that may increase a man's risk of developing prostate cancer include:
- A family history of prostate cancer
- A number of dietary factors, especially high intake of animal fats
Prostate cancer is potentially curable when diagnosed at an early stage. The majority of men diagnosed with prostate cancer have minimal or no symptoms at the time of diagnosis due to screening tests that detect the disease early in its course. When prostate cancer progresses, however, it can cause devastating symptoms, including obstruction of urine, pain due to invasion of the tissues surrounding the prostate, spread to bones resulting in pain and bone fractures, and compression of the spinal cord leading to paralysis.
Optimistic Outlook for Prostate Cancer
The good news about prostate cancer is that it is often slow-growing, there are screening tools available for early detection, and there are a variety of effective treatment options.
This Report Covers the Following:
American Cancer Society
National Cancer Institute
American Academy of Family Physicians
Last reviewed February 2003 by
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