Prostate Cancer

Cancer is made of changed cells that grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. And they can spread to other parts of the body. This is called metastasis.

Cancer that starts in the prostate is called prostate cancer. The prostate is a gland in men about the size and shape of a walnut. It can grow larger as men age. It surrounds the upper part of the urethra. This is the tube that carries urine from the bladder. The prostate makes some of the thick fluid that’s part of semen. Semen is the fluid that carries sperm. During orgasm, semen leaves the body through the urethra and comes out at the end of the penis.

Nearly all types of prostate cancer start in the gland cells. These are the cells that make some of the prostate fluid or semen. These types of cancer are called adenocarcinoma. They are the most common. Other types of cancer that can start in the prostate are small cell carcinoma, transitional cell carcinoma, and sarcoma. These types of cancer are rare.

“Aside from skin cancer, prostate cancer is the most common cancer affecting men in terms of incidence and it is the second highest in terms of mortality—patients must become proactive when it comes to the prostate,” says Nilesh Patil, MD, UC Health urologic surgeon and assistant professor in the Department of Surgery at the University of Cincinnati College of Medicine.

The good news is prostate cancer can be successfully managed if detected during early stages. Early prostate cancer usually does not present symptoms, however, it is very important for men to be aware of risk factors and proactive about screening.

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known, but risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change. 

The risk factors for prostate cancer include:

• Being a man.

• Older age.

• Being African American.

• Family history of prostate cancer.

• Diet high in red meat or high-fat dairy foods and low in vegetables and fruits.

• Obesity.

• Chemicals in the workplace.

• Certain inherited gene changes.

Talk with your healthcare provider about your risk factors for prostate cancer and what you can do about them.

There is no sure way to prevent prostate cancer. Some risk factors for prostate cancer are not in your control. These include your age and family history. It’s not clear how diet and exercise can affect prostate cancer risk. But you can do some things that might lower your risk of getting prostate cancer. These include:

• Eating fruits and vegetables every day.

• Not eating high-fat meats or high-fat dairy foods.

• Staying at a healthy weight.

• Being active for at least 30 minutes on most days.

• Talk with your healthcare provider about your risk factors for prostate cancer and what you can do about them.

A healthy lifestyle is crucial for prevention of not just prostate cancer, but all cancers. That is always the number-one recommendation—to be aware of your health and take care of your body because every positive change matters if your goal is to live longer and with a higher quality of life.

If you are at high risk for prostate cancer, your healthcare provider may talk to you about medicines that may lower your risk.

Prostate cancer may be found with a screening test. Screening tests are done to check for disease in people who don’t have symptoms. This may find some types of cancer early, when they’re often easier to treat. The screening tests used for prostate cancer are: 

• Prostate-specific antigen (PSA) blood test.

• Digital rectal exam.

Talk with your healthcare provider to make an informed decision about screening.

Prostate cancer often causes no symptoms in its early stages. By the time symptoms start, the cancer may have spread outside the prostate. When that happens, it’s harder to treat. These are the symptoms that can occur:

• A need to urinate often, especially at night.

• Weak or interrupted urine flow.

• Trouble starting to urinate.

• Trouble emptying the bladder.

• An inability to urinate.

• Accidental urination.

• Pain or burning when you urinate.

• Blood in your urine or semen.

• Pain or stiffness in your lower back, hips, ribs, or upper thighs.

• Loss of ability to have an erection.

• Weakness or numbness in legs or feet.

Many of these may be caused by other health problems, but it is important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

If your healthcare provider thinks you may have prostate cancer, you will need certain exams and tests to be sure. Your healthcare provider will ask you about your health history, your symptoms, risk factors, and family history of disease. He or she will also give you a physical exam. You will also have a biopsy.

A biopsy is the only way to confirm cancer. Small pieces of tissue are taken out from your prostate and checked for cancer cells. You may be numbed first with a local anesthetic. The samples are sent to a lab. Your results will come back in about one week.

After a diagnosis of prostate cancer, you’ll likely need other tests. They can help determine the stage of the cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. It is one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

Your treatment choices depend on the type of prostate cancer you have, test results, and the stage of the cancer. The goal of treatment may be to cure you, control the cancer, and help ease problems caused by cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be. Other things to think about are if the cancer can be removed with surgery and your overall health.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy is a systemic treatment. You may have just one treatment or a combination of treatments.

Prostate cancer may be treated with:

• Surgery.

• Radiation therapy.

• Cryotherapy.

• Hormone therapy.

• Chemotherapy.

• Vaccine therapy.

• Bone-directed therapy.

In some cases, your healthcare provider may recommend active surveillance. The goal of active surveillance is to watch a cancer that is growing very slowly and will not likely do any harm for a long time, if ever. It is done because the treatments for prostate cancer can cause more harm than living with the disease. This may be a plan for you if your cancer is only in the prostate, does not cause symptoms, and is not likely to shorten your life. Active surveillance often includes PSA tests, rectal exams, and biopsies done on a regular schedule.  If the cancer starts growing faster or begins to cause symptoms, treatment can be started.

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your healthcare provider before making a decision.

Cancer treatment such as chemotherapy and radiation can damage normal cells. This can cause side effects such as hair loss, mouth sores, and vomiting. 

Talk with your healthcare provider about side effects you might have and ways to manage them. There may be things you can do and medicines you can take to help prevent or control side effects.

Possible side effects from surgery may include trouble controlling urination (incontinence). It may take time for some men to regain control of their bladder after surgery for prostate cancer. As healing continues, incontinence often happens less, but some men may have long-term problems. Special exercises should help lessen the problem and may make it go away completely. Erectile dysfunction (ED) is a common side effect of prostate cancer surgery. ED means having trouble getting or keeping an erection. Having nerve-sparing surgery may prevent long-lasting (permanent injury) to the nerves that control erection, but it may not be a choice in all cases. Treatments can help men who have ED because of surgery for prostate cancer.

Talk with your healthcare provider about the chances of side effects affecting you after surgery. Also talk about other treatment options and their side effects. There may be things you can do and medicines you can take to help prevent or control side effects.

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about problems or concerns you may have. Work together to ease the effects of cancer and its symptoms on your daily life.

Also:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse.

• Signs of an infection, such as a fever.

• Side effects of treatment that affect your daily function or don’t get better with treatment.

Ask your healthcare provider what signs to watch for and when to call. Know how to get help after office hours and on weekends and holidays.