The Lowdown on Prostate Cancer

Prostate cancer. The mere mention of it makes most men squirm. It occurs in the prostate, a walnut-sized gland at the base of the bladder that assists in the production of semen.

Prostate cancer is the most common cancer in American men, excluding nonmelanoma skin cancers. It is also the second leading cause of cancer death in men, exceeded only by lung cancer. According to the American Cancer Society, an estimated 180,400 new cases of prostate cancer will be diagnosed this year and nearly 32,000 men will die from the disease in the United States. Often a silent disease, prostate cancer affects one in 10 men over the course of a lifetime.

However, men diagnosed with prostate cancer enjoy a very high survival rate when the disease is treated. Eighty-nine percent of men diagnosed with prostate cancer survive at least 5 years and 63 percent survive at least 10 years. When prostate cancer is discovered before it has spread to other parts of the body, the odds of surviving at least five years are 100 percent.

While researchers have not been able to determine an exact cause of prostate cancer, they have found several factors consistently associated with an increased risk of developing the disease:

• Age - The chance of having prostate cancer increases rapidly after age 50. More than 80 percent of all prostate cancers are diagnosed in men over the age of 65.
• Race - Prostate cancer is about twice as common among African-American men as it is among white American men. Prostate cancer is most common in North America and northwestern Europe and less common in Asia, Africa, Central America, and South America.
• Genetics/Family History - Prostate cancer seems to run in some families, suggesting an inherited or genetic factor. A man whose father or brother has been diagnosed with prostate cancer is twice as likely to develop the disease himself. The risk is even higher for men with several affected relatives, particularly if their relatives were young at the time of diagnosis.
• Diet - Studies suggest that men who eat a lot of fat in their diet have a greater chance of developing prostate cancer. However, it is not known whether the culprit is the fat itself, or whether the higher risk is because men with a high-fat diet tend to eat fewer fruits and vegetables and more animal products.
• Physical activity - Regular physical activity and maintaining a healthy weight may help reduce prostate cancer risk.
• Hormonal factors - There is evidence that high levels of androgens (male hormones) may contribute to prostate cancer risk in some men. A national study is under way to examine whether drugs that lower the level of these hormones will reduce the risk of prostate cancer.

Although a man cannot control his age, race and family history, he may be able to improve his odds by controlling his diet and exercise. The American Cancer Society recommends lowering the fat content in the diet and eating more vegetables, fruits, and grains. Not only does an improved diet reduce the risk of prostate cancer, but it also provides a number of other important health benefits.

A man may want to consider screening, particularly if he is African American or has a strong family history of prostate cancer. A patient should discuss his own risk factors and the potential benefits of early detection and treatment with his physician, so he can make an informed decision about whether or not to be screened for prostate cancer. Should a man decide to be tested, the two primary methods for screening are the prostate-specific antigen (PSA) blood test and the digital rectal examination. The PSA blood test measures the level of PSA, a protein made by prostate cells. Higher levels of PSA may indicate prostate cancer. During a DRE, a doctor will perform a rectal exam to feel for any irregularities or abnormalities in the prostate, which is adjacent to the rectum.

If a cancer is detected and diagnosed, a variety of treatments may be recommended. Prostate cancer is most frequently treated with surgery or radiation therapy, both of which are highly successful but may be associated with serious side effects, such as impotence and urinary incontinence.

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©2006 Texas Medical Center

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