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Prostate Cancer: Symptoms, Diagnosis & Treatments

prostate cancer, prostate gland
The prostate gland is located beneath a man's bladder.
Credit: Alila Medical Media | Shutterstock

Prostate cancer is one of the most common forms of cancer in men: Almost 240,000 men in the United States are diagnosed with prostate cancer each year, according to the National Cancer Institute.

The prostate is a gland located beneath a man's bladder, toward the front of the rectum. About the size of a walnut, it surrounds the urethra, the tube that carries urine from the bladder. The prostate produces seminal fluid, which nourishes and transports sperm.

Prostate cancer usually grows slowly and is often confined to the prostate gland. When it's detected early, the chances of successfully treating prostate cancer are greater.

Risks and symptoms

There are no early warning signs of prostate cancer, according to the Mayo Clinic. In more advanced stages — when the prostate has enlarged — symptoms may include trouble urinating, blood in the urine or semen, erectile dysfunction or pain in the lower back, hips or thighs.

According to the American Cancer Society, about 1 man in 7 will be diagnosed with prostate cancer during his lifetime. The disease is more prevalent in men older than 50 years, and about 6 cases in 10 occur in men older than 65 years.

For reasons that are not well understood, prostate cancer is more common among African-American men and Caribbean men of African ancestry. It's less common, however, in Asia, Africa, Central and South America than it is in Europe, North America, Australia and other regions.

Researchers have also found that prostate cancer can run in families, suggesting a genetic link. A low-fiber diet that is high in meat and dairy products and workplace exposure to certain toxins have also been linked to a higher risk of prostate cancer.

In 2014, about 29,480 men are expected to die of prostate cancer, though most men diagnosed with the condition do not die from it, according to the American Cancer Society. More than 2.5 million men with prostate cancer are still alive today.

Diagram of the male prostate gland.

Screening and diagnosis

There is no universally agreed-upon schedule or timeframe for screening men who may be at risk for prostate cancer. Some medical organizations recommend screening all men over the age of 50, and earlier screening for men who may be at higher risk, such as African-Americans or men with a family history of prostate cancer.

Men who have a weak urine stream, difficulty stopping a urine stream, a dribbling stream or blood in their urine or semen may wish to talk to their health care provider about those or any related symptoms, regardless of age.

It should be noted that some of the symptoms of prostate cancer — weak or dribbling urine stream — are similar to the symptoms of benign prostatic hyperplasia, or BPH, a common condition that's sometimes referred to as prostate gland enlargement.

Your doctor or health care provider will probably request a urinalysis (urine test) to rule out an infection or other condition, according to the Mayo Clinic. A digital rectal exam (DRE), in which your doctor will insert a gloved finger into your rectum to check your prostate, is also commonly performed.

A prostate-specific antigen (PSA) test is a blood test that determines the amount of PSA in your bloodstream. PSA is a substance produced by the prostate; elevated PSA levels may be an indication of infection, inflammation, enlargement or cancer.

If any of these procedures detects an abnormality, your doctor may recommend additional tests, such as an ultrasound of your prostate or a biopsy of tissue collected from your prostate. [5 Things You Should Know About Prostate Cancer]

Treatment

Treatment of prostate cancer depends in part on your age, general health and the degree to which the cancer has spread, or its stage. Stage I prostate cancer is described as a very early cancer that's non-aggressive and confined to a small area of the prostate.

Stage II prostate cancer is more aggressive and may have spread to both sides of the prostate gland. Stages III and IV describe cancer that has spread beyond the prostate gland to other tissues or organs, according to the National Cancer Institute.

Many doctors recommend active surveillance or "watchful waiting" — including blood tests, rectal exams, biopsies and other procedures — to see if more aggressive treatment is necessary. Surveillance may be an option when prostate cancer is very slow growing or limited in scope.

There are two types of radiation therapy used to treat prostate cancer. External beam radiation uses a large machine to direct radiation to the prostate and other affected tissue. Brachytherapy, in which numerous small implants (about the size of a grain of rice) are placed inside the body, delivers a low dose of radiation over a long period of time.

Prostate cancer cells rely on the male hormone testosterone to grow. Hormone therapy can reduce the amount of testosterone in your body, thereby limiting the growth of cancer cells. Some doctors recommend drugs that stop the body from producing testosterone; other drugs may be used to block the hormone from reaching cancer cells.

Some doctors may also recommend surgery to remove the testicles (which produce testosterone) in a procedure known as an orchiectomy.

Surgery to remove the prostate gland (prostatectomy) is an option at all stages of prostate cancer. In most cases, the surgery will involve the remove of the entire prostate gland and nearby lymph nodes. A prostatectomy can result in urinary incontinence and erectile dysfunction.

For advanced cases of prostate cancer, some doctors recommend chemotherapy to kill cancer cells, or immunotherapy, which stimulates the immune system to destroy cancer cells. [Related: Prostate Cancer Treatments: Radiation vs. Surgery]

Life after prostate cancer treatment

Regular checkups and other procedures are usually scheduled for people who have been treated for prostate cancer. These may include a DRE, a PSA test or other procedures. Your doctor will also be able to offer help in coping with the side effects of prostate cancer treatment.

Prostate cancer can recur following treatment. Your health care provider will address any changes and suggest additional treatments as appropriate.

Men who have had prostate cancer may benefit from cancer support groups, individual counseling, stress management classes, help from social workers or alternative therapies such as relaxation techniques, spiritual guidance, meditation and exercise. [Related: Prostate Cancer Surgery May Lengthen Life for Young Men]

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Marc Lallanilla, LiveScience Staff Writer

Marc Lallanilla

Marc Lallanilla has been a science writer and health editor at About.com and a producer with ABCNews.com. His freelance writing has appeared in the Los Angeles Times and TheWeek.com. Marc has a Master's degree in environmental planning from the University of California, Berkeley, and an undergraduate degree from the University of Texas at Austin. To find out what his latest project is, you can follow Marc on .
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