September is Prostate Cancer Awareness Month. Prostate cancer is the third most common cause of death from cancer in men, but is rarely found in men under age 40. This cancer starts in the prostate gland, a walnut-sized structure that wraps around the urethra and produces fluid for semen.
The cause of prostate cancer is unknown. Some studies have shown a relationship between high dietary fat intake and increased testosterone levels. There is no known association with an enlarged prostate. Levels of prostate specific antigen are often high in men with prostate cancer, but PSA can also be high with other prostate conditions.
Since the PSA test became common, most prostate cancers are found before they cause symptoms. The symptoms below can occur with prostate cancer, but are more likely to be associated with noncancerous conditions.
Aca,!Ac Delayed or slowed start of urinary stream
Aca,!Ac Urinary dribbling after urinating
Aca,!Ac Urinary retention
Aca,!Ac Pain with urination or ejaculation
Aca,!Ac Lower back pain or pain with bowel movement
Aca,!Ac Urinary incontinence or excessive urination at night
Aca,!Ac Bone or abdominal pain or tenderness
Aca,!Ac Blood in the urine
Aca,!Ac Low red blood cell count
A variety of tests may be done to diagnose prostate cancer. A rectal exam will often show an enlarged prostate with a hard, irregular surface. A prostate biopsy is the only test that can confirm the diagnosis.
Treatment options include hormonal therapy, surgery to remove the prostate, external beam radiation therapy, radioactive seed implants, chemotherapy, freezing the cancerous prostate tissue, or monitoring without active treatment. The decision about which treatment to choose can be difficult. Some therapy can interfere with sexual performance. Drugs that reduce the testosterone level often work very well at preventing further growth and spread of the cancer. Chemotherapy is often used to treat prostate cancers that are resistant to hormonal treatments. Ask questions and be aware of the benefits and risks of the procedures before making a treatment choice.
There is no known way to prevent prostate cancer. Following a vegetarian, low-fat diet may lower your risk. Early identification is possible by screening men over age 40 annually with a digital rectal examination and PSA blood test. Men over 40 should see their healthcare provider if they have never been screened for prostate cancer, not annual exams, and have a family history of prostate cancer. PSA testing in all men is in debate since a high PSA level does not always mean that a patient has prostate cancer. Doctors are detecting and treating some very early-stage prostate cancers that may never have caused the patient any harm. The decision to use PSA testing to screen for prostate cancer should be based on a discussion between the patient and his doctor.
For more information, visit these sites:
Aca,!Ac National Institute of Health, http://www.nlm.nih.gov/medlineplus/ency/article/000380.htm
Aca,!Ac Centers for Disease Control and Prevention, http://www.cdc.gov/Features/ProstateCancer/.
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