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Prostate cancer symptoms
Talk to your doctor if you experience any of the following symptoms, which could indicate the presence of prostate cancer or several other diseases …
• Difficulty starting urination or holding back urine
• Weak or interrupted urine flow
• Painful or burning urination
• Difficulty having an erection
• Painful ejaculation
• Blood in urine or semen
• Frequent pain or stiffness in the lower back, hips or upper thighs
(Source: Prostate Cancer Foundation, www.pcf.org)
Factors affecting your risk for prostate cancer
Prostate cancer is the most common non-skin cancer in America, affecting one in six men. Several major factors influence your risk, some of them, unfortunately, cannot be changed.
• Age: The older you are, the more likely you are to be diagnosed with prostate cancer. Although only one in 10,000 men under age 40 will be diagnosed, the rate shoots up to one in 38 for ages 40 to 59, and one in 15 for ages 60 to 69. The average age at diagnosis of prostate cancer in the United States is 69 years. After that age, the chance of developing prostate cancer becomes more common than any other cancer in men or women.
• Race: African American men are 60% more likely to develop prostate cancer compared with Caucasian men and are nearly 2.5 times as likely to die from the disease. Conversely, Asian men who live in Asia have the lowest risk.
• Family history/genetics: A man with a father or brother who developed prostate cancer is twice as likely to develop the disease. This risk is further increased if the cancer was diagnosed in family members younger than age 55 or if it affected three or more family members. In addition, some genes increase mutational rates while others may predispose a man to infection or viral infections that can lead to prostate cancer.
• Where you live: For men in the United States, the risk of developing prostate cancer is 17%. For men who live in rural China, it's 2%. However, when Chinese men move to the western culture, their risk increases substantially. Men who live in cities north of 40 degrees latitude (north of Columbus, Ohio, and Provo, Utah, for example) have the highest risk for dying from prostate cancer of any men in the United States. This effect appears to be mediated by inadequate sunlight during three months of the year, which reduces vitamin D levels.
(Source; Prostate Cancer Foundation, www.pcf.org)
Other stories with our doctors
Prostate cancer...silent, but treatable
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Dr. Peter Lawrence uses robotic equipment at Jackson-Madison County General Hospital to perform a minimally invasive, robotic prostatectomy. |
Prostate cancer is one of the top three causes of cancer death in men. "In 2010, some 200,000 new cases will be diagnosed and more than 30,000 men will die from it," said Dr. Peter Lawrence, a board-certified urologist at Jackson Urological Associates. "Hardly a day goes by that I don't see at least one patient who is living with prostate cancer."
The prostate, part of the male reproductive system, supplies nourishment to sperm cells. As men get older, their chances of developing prostate cancer increase. Family history, ethnicity and where you live also can affect your risk of getting prostate cancer.
"African American males are 60 percent more likely to develop prostate cancer. Having a family member who has prostate cancer doubles your chances of developing the disease," said Dr. Lawrence. "If you live in the United States you have a 17 percent lifetime risk. On the other hand, if you live in rural China, you have a two percent chance. This is one reason why some feel that diet and lifestyle, along with genetics, play a role in developing the disease."
Since prostate cancer is typically a silent disease, most men show no symptoms until the disease has advanced and possibly spread. This reinforces the need for men to get annual prostate cancer screenings, said Dr. Lawrence. A basic screening includes a blood test to check for prostate-specific antigen (PSA) values and a digital rectal exam.
When to start screening is a matter of debate, said Dr. Lawrence, who recommends most patients have their first screening around age 45. For African American males or patients who have a family history of the disease, Dr. Lawrence starts screening at age 40.
Even though prostate cancer is one of the leading causes of cancer deaths, it is very treatable in most people, said Dr. Lawrence. In fact, he added, the overall five-year survival rate for prostate cancer patients in this country approaches 100 percent.
Prostate cancer usually is diagnosed as either a slow-acting form of the cancer or an aggressive form of the cancer, he explained. Two thirds of the men diagnosed with prostate cancer will have the slow-growing form. "Depending on their age, these patients are more likely to die with prostate cancer rather than from prostate cancer," said Dr. Lawrence.
The other third will have an aggressive form of the disease. Without treatment, these patients are much more likely to die from their cancer.
Your age, health and the aggressiveness of the prostate cancer contribute to the decision of what kind, if any, treatment is warranted, Dr. Lawrence said.
"With some patients, who have the slow-acting form of the cancer, we recommend no treatment, but keep an eye on the cancer by watching their PSA levels and giving them a rectal exam every six months. However, a low-risk tumor in a 50 year old is much different than a low-risk tumor in a 75 year old."
The most common treatments for prostate cancer are surgery and radiation, but both have risks that include urinary incontinence, erectile dysfunction and the development of recurrent disease, he said. "The challenge is determining the balance between a patient's benefit from treatment and the effects on a patient's quality of life."
His preferred method of surgery is a robotic prostatectomy. It is minimally invasive, uses a laparoscope and small incisions to remove the prostate and requires a general anesthesia. The patient typically stays in the hospital overnight and goes home the next day. This is compared to traditional surgery, which requires a larger incision to remove the prostate and often results in a longer hospital stay and longer recovery. Other treatments include cryotherapy, which freezes the tumor; high-intensity focused ultrasound (HIFU); and hormonal injections, which reduce testosterone levels and hold the cancer at bay.
"When making the decision on whether and how to treat prostate cancer, I start with a long conversation with the patient on the pros, the cons, the risks and the benefits of each treatment," said Dr. Lawrence. "We want to make sure that any treatment provides more benefit than harm."