Understanding Prostate Cancer

By Jordan Brady, MD 

Prostate cancer is a condition often heard about, but perhaps seldom fully understood. In recognition of National Prostate Cancer Awareness Month, I’ve answered some of the most frequently asked questions concerning this common form of cancer. 

What is the prostate? 
The prostate is a gland that is only found in men, located just below the bladder and in front of the rectum. It is an important reproductive tool because it produces some of the fluid (semen) that protects and nourishes sperm, and it surrounds the urethra – the tube that carries urine and semen out of the body. It’s about the size of a walnut but tends to increase in size as men age. 

What is prostate cancer? 
With the exception of skin cancer, prostate cancer is the most common type of cancer found in American men. According to the Prostate Cancer Foundation, one out of every eight men in the U.S. will be diagnosed with prostate cancer in his lifetime. Most men with the condition are 65 and older and do not die from it, although it is still the second leading cause of cancer death among U.S. men. The good news is that most prostate cancers are highly treatable when detected early. 

Am I at risk for prostate cancer? 
While any man can develop prostate cancer, your chances increase as you grow older: 60 percent of cases are diagnosed in patients over age 65. Other risk factors are genetic. African American men and men with a history of prostate cancer in their family are at increased risk for developing the disease. 

What are the symptoms of prostate cancer? 
Symptoms can vary from person to person, and some men with prostate cancer will not present with any symptoms at all. Many men with prostate cancer are diagnosed before they have symptoms because of routine screening with a Prostate Specific Antigen (PSA) test. 

Some signs to be on the lookout for include: 

• Difficulty with urination, including trouble starting or holding back urination, a weak or interrupted uninterrupted urine flow, pain or burning during urination, difficulty emptying your bladder fully, and frequent urination, especially at night. Many times, these symptoms are related to benign enlargement of the prostate due to aging but are worth noting. 

• Blood in the urine or semen 

• Painful ejaculation 

• Weight loss 

• Pain in the back, hips or pelvis that does not go away 

We are able to treat symptoms of prostate enlargement that can cause some of these symptoms but are not cancer. It’s worth having a conversation with your doctor. It’s important to note that these symptoms are not exclusive to prostate cancer and could be caused by another condition. 

Should I be screened for prostate cancer? 
Before making a decision to get screened for prostate cancer, you should discuss with your primary care provider whether it’s right for you. You and your doctor should take into consideration if you have a history of prostate cancer in your family or existing medical conditions and carefully weigh the pros and cons of screening based on these and other specific risk factors. 

What does a prostate screening look like?  
Two tests are commonly used. A PSA test measures the presence of a certain substance made by your prostate. A Digital Rectal Examination (DRE) is when your provider inserts a gloved, lubricated finger into your rectum to feel if the prostate is enlarged or irregularly shaped. In either case, abnormal exam results won’t necessarily mean you have prostate cancer. Instead, your doctor may request repeating the test after an interval of time or schedule another test such as an MRI or biopsy, to determine if cancer is present. 

Can I help prevent prostate cancer? Many of the risk factors such age, family history and ethnicity are beyond your control. That said, you can strengthen your body’s ability to fight cancer by improving your health and immune system. Most of the healthy lifestyle habits your provider recommends – such as regular physical activity, a healthy diet, reducing stress and cutting down on drinking and smoking – can help reduce your cancer risk.   

If you have any concerns regarding prostate cancer, or general questions about prostate health, have a discussion with your primary care provider.