About Cancer

Prostate cancer is the most commonly diagnosed non-skin cancer, has overtaken lung cancer as the leading cancer affecting all men and followed by colorectal cancer.

Statistically, 80 percent of prostate cancers occur in men over the age of 65. Although this cancer can also occur in younger individuals, it is very rare under the age of 50. As males age the prostate can develop problems.

Annually, one out of six American men will develop it in the course of his lifetime. Little did we know the fact a man is 33% more likely to develop prostate cancer than a woman is to get breast cancer.

In 2004, it is estimated that 234,000 new cases of prostate cancer diagnose in the United States. That makes it the most common cancer among American men, next to the skin cancer. More than 27,000 deaths due to prostate cancer are expected to occur annually.

One new case every 2 1/2 minutes. One new case every 150 seconds.

While in UK, nearly 35,000 men are diagnosed and about 10,000 men die from prostate cancer annually. This means over one man die every hour in UK.

Today, about two million men are fighting prostate cancer, and over the next decade, as baby boomer men reach the target ripen age for prostate cancer, about three million more will be compelled to join the battle. It is estimated that by 2012, the number of new cases in the U.S. is expected to increase to more than 300,000 new cases per year by 2012.

One new case every 100 seconds. One man dead every 13 minutes.

What is prostate?

Prostate is a male sex gland, the size of a walnut, located behind pubic bone in front of the rectum that encompasses lower part of a bladder. The tube that carries urine (the urethra) runs through the prostate. At birth the gland size is small like a pea and it continue to grow until age of 20 when a man reaches adulthood. Male hormones (called androgens) is responsible for this growth. The gland size will not change until 45, when it starts to grow again.

Its primary function is to produce thick fluids that nourish the sperm, as well as helping propel sperm through the urethra and out of the penis to reach and fertilize an egg. Even though prostate is not a primary component of urinary tract, but it is very important for urinary health.

In older men, the part of the prostate around the urethra may keep on growing. This causes BPH (benign prostatic hyperplasia) which cause problems passing urine. BPH is a problem that must be treated, but it is not cancer.

What is prostate cancer?

The body is made up of different types of cells. Normally, cells grow, divide and then die. Sometimes, cells mutate and begin to grow and divide more quickly than normally. Instead of dying, these abnormal cells clump together to form tumors. If these tumors are cancerous or so-called malignant tumors, they can invade and kill healthy tissues in the body. From these tumors, cancer cells can metastasize (spread) and form new tumors in other parts of the body. In contrary, non-cancerous tumors or so-called benign tumors do not spread to other parts of the body.

Prostate cancer is abnormal cells grow out of control forming small nodules or bumps (overgrowth tissue) on the surface of in the prostate gland. In some cases, the overgrowth tissue is benign and this prostate condition is called Benign Prostatic Hypertrophy (BPH). Other times, abnormal cancerous cells characterize the overgrowth of tissue, and this is referred to as a malignancy or prostate cancer.

As its close proximity to the bladder, prostate disorder might interfere with urination and causing bladder or kidney problems. It is also located immediately next to the nerves responsible for erections hence it might interfere with sexual function as well.

Although more than 70% of all prostate cancer cases are diagnosed in men over the age of 65, doctors recommend that every man above the age of 50 should have a PSA test and a rectal exam. According to statistic African-American have almost twice as much prostate cancer incidence rates as Caucasian American, hence they should start getting tested at age 40. The same is true if you have a
family history of prostate cancer.

One-third of men over the age of 50 have some cancer cells within their prostate and nearly all men over the age of 80 have a small area of prostate cancer. In most men, these cancers grow extremely slowly, particularly in elderly men, and it will never cause any problems. Even without treatment, many of them will not die of the prostate cancer, but who, but rather live and die of some other unrelated cause before the disease takes its toll.

However, similar to most types of cancer, if left completely unchecked prostate cancer can be aggressive, grow more quickly and may spread (metastasized) to other parts of the body, particularly lymph nodes or the bones. This makes treatment much more difficult.

What are the symptoms?

Prostate cancer often does not cause any symptoms for years. When symptoms do occur, usually the cancerous cells have spread beyond the prostate, this is why regular check up for men age of 40 and above is necessary and recommended. The symptoms include:

• Urinary problems:
• Dull pain in the lower pelvic area, hips, or upper thighs
• Not being able to urinate
• Sensation that your bladder doesn't empties
• Having a hard time starting or stopping the urine flow
• Problems with urgency of urination and difficulty in starting
• Frequent urination, especially at night
• Weak flow of urine
• Urine flow that starts and stops
• Pain or burning during urination
• Difficulty having an erection
• Pain at ejaculation
• Genital pain
• Blood in the urine or semen

Note: Other health issues such as urinary infection or inflammation; bladder problems or kidney stone can cause exactly the same symptoms. Hence, should those symptoms occurred and accompanied with blood in your urine, painfully ejaculation and general pain in your lower back, hips and leg bones, significant lost of weight - you must inevitable visit your urologist for a thorough check up.

Who are at risk?

Risk factors consistently associated with prostate cancer include:

• Age: After the age of 50, the chance of developing prostate cancer is higher. More than 80 percent of all prostate cancers occur in men 65 years and older.
• Race: African American men have a 60% higher risk of prostate cancer than white men, including Hispanic men
• Ethnicity: More common in North America and northwestern Europe and occurs less frequently in Asia, Africa, Central America and South America.
• Family history: Appears to have a genetic link. Having family history of prostate cancer, a father or brother with the disease doubles a man's risk of developing it. Man whose brother had a prostate cancer have 4.5 times higher risk of prostate cancer and 2.5 time higher if his father had a prostate cancer.
• Vasectomy: Men who have undergone vasectomy (a surgical procedure that renders them sterile) may have an increased risk.
• Men who have diabetes have less risk of getting the disease, although no one really knows why.

How to prevent?

Maintaining a healthy lifestyle is the best way to reduce the risks from all forms of cancer:

• Diet: The results of most studies show s diet high in animal fats and low in fresh fruit and vegetables have an increased chance of developing prostate cancer.
• Studies show a diet high in lycopenes (found in higher levels in colorful fruits and vegetables), selenium, goji berry, broccoli and turmeric may lower the risk of developing prostate cancer.
• Exercise: Maintaining a healthy weight along with regular physical activity may reduce the risk of prostate cancer.
• Get plenty of rest- regularly scheduled bed time is important for overall health.

How is prostate cancer detected?

There are three common screening methods for prostate cancer:

• Digital rectal examination (DRE) A digital rectal examination as part of an annual physical exam in men age of 50 or older (and in younger men who are at increased risk). During this test, a doctor inserts a gloved and lubricated finger into the rectum to feel for abnormalities. While the rectal exam may be a bit unpleasant, it is done quickly.
• Blood test for prostate specific antigen (PSA) The PSA is a blood test which measures a protein in prostate gland cells. The American Cancer Society recommends the test to be executed once a year for men 50 and older, and for younger men with higher prostate cancer risk.

Results under 4 are usually considered normal. Results above 10 are considered high. Values between 4 and 10 are considered borderline. The greater the PSA level, the greater the chance that prostate cancer exists.

The test need to be validated further with a biopsy as the PSA test cannot be used as a foolproof test for prostate cancer:

• 2 out of 3 men with a high PSA values show no cancerous cells in their prostate biopsy.
• 1 in 5 men with prostate cancer will have a normal PSA result.
• Transrectal ultrasound (TRUS) TRUS will be done if the digital rectal exam or PSA levels are abnormal. A probe is inserted into the rectum and pictures are recorded using sound waves, which create an image of the prostate gland. The test is usually done in outpatient setting and usually takes less than 30 minutes. Based on results from these screenings, additional tests may be recommended.

A positive biopsy is needed to confirm the diagnosis. If a biopsy reveals cancer, additional testing is done to see if it has spread to other organs:

• Blood tests- may be taken to see if the cancer has spread
• Bone scan- to determine if the cancer has spread to the bones
• CT scan- a series of x-ray images taken of the pelvis or abdomen, often used to determine general signs of disease
• Chest x-ray- to determine if cancer has spread to the lungs
• MRI- magnetic resonance imaging to detect cancer in lymph nodes and other internal organs

What is the usual treatment for prostate cancer?

There are several treatments to treat prostate cancer: These include surgery, radiotherapy and various forms of drug treatment. Hormone therapy is commonly used. It blocks the action of testosterone, a sex hormone that prostate cancers need in order to grow.

Three treatment options are generally accepted for men with localized
prostate:

• Radical prostatectomy: A surgical procedure to remove the entire prostate gland and nearby tissues. In some cases the lymph nodes in the pelvic area are also removed. This procedure is performed using nerve-sparing surgery which might prevent damage to the nerves needed for an erection. However, nerve-sparing surgery is not always possible.
• Radiation therapy: Using energy to the prostate using an external beam of radiation. Patients with high-risk prostate cancer are candidates for adding hormonal therapy to standard radiation therapy.
• Active Surveillance may be an option recommended for patients with early-stage prostate cancer, particularly those who have low-grade tumors with only a small amount of cancer seen in the biopsy.

Are there any side effects?

As with all disease, treatment may result in side effects. The most concern side effects of are impotence, or erectile dysfunction, and incontinence.

Researchers still do not fully understand what causes prostate cancer, or how it develops - and they urgently need to improve on current treatments.