What to Know About Prostate Cancer Diagnosis and Treatment

In the US, the National Cancer Institute estimates that 1 in 9 men will be diagnosed with prostate cancer. For those of African descent, the number is more startling — 1 in 5 men are projected to develop the disease.

Prostate cancer is the most common non-skin cancer in the US, and estimates suggest there are more than 3 million American men living with the disease.

The prostate is about the size of a walnut and is part of the male reproductive system. It is located in front of the rectum and under the bladder. It surrounds the urethra. If it grows too large, it squeezes the urethra and may stop or decrease the flow of urine from the bladder to the penis.

The Prostate Cancer Foundation urges men in any at-risk groups, or those older than 50, to discuss prostate screening options with their primary care physicians. Many men do not like to discuss the screening with their physicians because of discomfort about the inspection of the prostate, for instance. But with the types of early detection methods now available, prostate cancer is 99 percent treatable, according to the PCF. Screening for prostate cancer can often occur via a simple blood test, rather than an invasive, and often embarrassing, physical exam.

Learning more about the disease, if you are diagnosed, can help you take an active part in your treatment and recovery. According to the National Cancer Institute, no known cause exists. There are risk factors, however, that may increase the chance of getting the disease.

The top risk factors for prostate cancer include:

• Age 65 and older: Age is the primary risk factor for prostate cancer. The disease is rare in men younger than 45.
• Family history: The risk is increased if your father, brother, or son had prostate cancer.
• Race: It is more common among black men than white or Hispanic/Latino men. It is less common among Asian/Pacific Islanders and American Indian men.

Having one of the risk factors, which also include some cell abnormalities, does not mean a person will develop prostate cancer. There can be prostate growths that are benign, but still, cause issues for men. Benign prostatic hyperplasia, or BPH, is a non-cancerous growth of prostate cells. In this case, the prostate grows larger and squeezes the urethra. It is a common problem in men older than 50. These growths are rarely life-threatening and don’t spread to other parts of the body.

However, malignant, or cancerous, tumors may be life-threatening, can invade and damage nearby tissues and organs, and may spread.

Prostate cancer is also unusual in that a man may not have any symptoms. But for those who do, they may include urinary problems; difficulty in having an erection; blood in the urine or semen, and frequent pain in the lower back, hips, or upper thighs.

These symptoms don’t necessarily mean you have cancer. They could also be attributed to an infection or other health problem. But it’s important to discuss any usual symptoms with your physician.

Your physician may also check for prostate cancer if you are older than 50. The physician may do a physical exam of the prostate, checking for hard or lumpy areas. A blood test may also be performed. The test can check for the level of “prostate-specific antigen,” or PSA, in your blood. Prostate cancer may cause a high PSA level in the blood.

The digital exam and blood test can detect problems in the prostate, but not whether the problem is cancer or something else. A physician may order a transrectal ultrasound or a transrectal biopsy. If either of those is suggested, you may consider asking these questions: Where will the procedure take place; how long will it take; will I be awake; will it hurt; what are the risks; how do I prepare for it; how soon will I know the results; if I have cancer, who will talk to me about the next steps, and more.

If cancer is found, a pathologist will consider the “grade” of the tumor, which helps determine how fast it might grow and/or spread. To help the physician learn the extent of the disease, you may also have a bone scan, a CT scan, or an MRI.

If you do have cancer, there are many treatment options, including active surveillance, surgery, radiation therapy, hormone therapy, and chemotherapy. You’ll need to discuss the various choices with your physician. You’ll discuss your age, the stage of your tumor, your symptoms, your health, and more.

You will work with your physician to create the best treatment plan for your medical and personal needs. Your doctor may also refer you to a specialist, or you can ask for a referral. You may ask about seeing a urologist, or a urologic oncologist.

It’s important to make sure you have access to information about not only the medical aspects of prostate cancer but the psychological impacts as well. The National Cancer Institute has information about coping with the disease at www.cancer.gov/cancertopics/coping, or at www.cancer.gov/help, which includes live chat guidance.