prostate cancer FAQs

How common is prostate cancer?

If you, a loved one, or a close friend has been diagnosed with prostate cancer, you are not alone. Prostate cancer is the most common non-skin cancer in the United States, affecting 1 in every 6 men.

In the year 2010, some 218,000 men are going to be diagnosed with prostate cancer, and more than 32,000 men will die from the disease. A new case of prostate cancer will occur every 2.4 minutes and a death from prostate cancer happens every 16.4 minutes.

It is estimated that today there are over 2 million American men living with prostate cancer, many undiagnosed at this writing.

How does prostate cancer compare?

As we've said, prostate cancer is common. A man is 35% more likely to be diagnosed with prostate cancer than a woman is to be with breast cancer. A non-smoker is more likely to be stricken with prostate cancer than colon, bladder, melanoma, lymphoma and kidney cancers combined.

Are there factors making some men more likely to be diagnosed?

Older age, African American race, and a family history of the disease can all increase the likelihood of a man being diagnosed with the disease.

As men increase in age, their risk of developing prostate cancer increases exponentially. Although only 1 in 10,000 under age 40 will be diagnosed, the rate shoots up to 1 in 39 for ages 40 to 59, and 1 in 14 for ages 60 to 69. More than 65% of all prostate cancers are diagnosed in men over the age of 65.

African American men are 56% more likely to develop prostate cancer compared with Caucasian men and nearly 2.5 times as likely to die from the disease.

Also a family history of the disease can increase the risks of being diagnosed with the disease.

What are the Signs and Symptoms of Prostate Cancer?

In it's early stages, prostate cancer may not cause and warning signs or symptoms. As it advances unchecked (this is what early screening is so important) prostate cancer may cause such signs and symptoms such as:

• Trouble urinating, including painful urination
• Less powerful urine stream
• Blood in the urine, or
• Blood in the semen
• Swelling to the legs
• Discomfort or pain in the pelvis
• Bone pain
• Lower back pain
• Erectile dysfunction or impotence

What are the symptoms of Enlarged Prostate: BPH?

Benign prostatic hyperplasia (BPH) is an enlarged prostate gland. Symtoms include trouble with urination, a weak urine stream, and not feeling empty after urination. Treatments usually include lifestyle changes, medicine (drugs), and sometimes, surgery.

An enlarged prostate is not a sign of prostate cancer, but is sometimes confused with it. Many men will exhibit little or no symptoms, and the severity of the enlargement of the prostate will not always be related to the severity of the symptoms.

Symtoms of enlarged prostate are:

• Weak urine stream
• Trouble with urination
• Not feeling empty after urination

What is radiation therapy?

Radiation therapy uses focused and high-powered energy (like X-rays) to kill cancer cells. Radiation for prostate cancer is usually delivered in two ways:

• Outside the body (external beam radiation). When using external beam radiation, you will lie on a table while the machine using the radiation will move around your body, directing its beams at your prostate cancer. This therapy will typically last for five weeks, five days a week.
• Radiation inside the body (brachytherapy). Brachytherapy involves putting several rice-sized radioactive seeds into your prostate. These deliver a low dose of radiation over a long period of time. The implanted seeds will eventually stop giving off radiation and won't need to be removed.

Side effects can include:

• Painful urination
• Loose stools
• Erectile dysfunction

How does hormone therapy work?

Hormone therapy prevents your body from producing the male hormone testosterone. Testosterone is known to fuel the growth of prostate cancer cells, so by cutting off the supply the hope is the cancer cells, starved by fuel, will die or at least grow more slowly. Hormone therapy is used to shrink the cancer in men with advanced prostate cancer and to slow the growth of tumors.

Hormone therapy includes:

• Medications stopping testosterone producing. Medications known as luteinizing hormone-releasing hormone (LH-RH) agonists will prevent the testicles receiving messages to produce testosterone. These drugs include triptorelin (Trelstar), histrelin (Vantas), leuprolide (Lupron, Eligard,), goserelin (Zoladex) and degarelix (Firmagon).
• Medications that block testosterone from reaching cancer cells. Medications known as anti-androgens prevent testosterone from reaching your cancer cells. Examples include bicalutamide (Casodex), flutamide, and nilutamide (Nilandron). These drugs typically are given along with an LH-RH agonist or given before taking an LH-RH agonist.
• Surgery to remove the testicles (orchiectomy). Removing the testicles reduces testosterone levels in your body. This is something of a last resort operation, but it has been know to reduce hormone levels faster than medication.

How is prostate cancer treated?

Prostate cancer is usually treated with a combination of surgery, chemotherapy and radiation.

Surgery to remove the prostate

Surgery involves removing the prostate gland (radical prostatectomy), a certain amount of surrounding tissue and a few lymph nodes. The procedure can include:

• Incision in your abdomen. During retropubic surgery, the prostate gland is taken out through the lower abdomen. Retropubic prostate surgery might carry a smaller risk of nerve damage than other surgeries.
• Incision between anus and scrotum. Perineal surgery. This involves an incision between the anus and scrotum to access the prostate. This approach to may allow for quicker recovery times, but makes removing the nearby lymph nodes, avoiding nerve damage, that much more difficult.
• Robot to assisted surgery. Not just for science fiction, at least not anymore. During robotic laparoscopic surgery, the instruments are attached to a robot. The surgeon will use hand controls to guide the robot to move the instruments.
• Laparoscopic prostatectomy. During this surgery, several small incisions are made into the abdomen. Laparoscopic surgery may offer a shorter hospital stay and quicker recovery than traditional surgery. The doctor inserts the surgical tools through this incision, including a small camera that will guide them in the operation.

Each of these procedures has their pros, cons and side effects. Our doctors can consult with you about which one would be best for your cancer treatment.

Chemotherapy

Chemotherapy uses drugs to kill the rapidly growing cells, including cancer cells. Chemotherapy has long been an accepted treatment, known as safe if administered correctly. Chemotherapy may be an option for men whose prostate cancer that has metastasized to other areas of the body. Chemotherapy might also be used for cancers that don't respond to normal hormone therapy.

Chemotherapy does have side effects and must be monitored by medical professionals.