PROSTATE CANCER

The causes of prostate cancer are not well understood. Doctors cannot explain why one man gets prostate cancer and another does not.

What are the risk factors of prostate cancer?

Researchers are studying factors that may increase the risk of this disease. Studies have found that the following risk factors are associated with prostate cancer:

• Age - In the United States, prostate cancer is found mainly in men over age 55. The average age of patients at the time of diagnosis is 70.
• Family history of prostate cancer - A man's risk for developing prostate cancer is higher if his father or brother has had the disease.
• Race - This disease is much more common in African American men than in white men. It is less common in Asian and American Indian men.
• Diet and dietary factors - Some evidence suggests that a diet high in animal fat may increase the risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk.

Although a few studies suggested that having a vasectomy might increase a man's risk for prostate cancer, most studies do not support this finding. Scientists have studied whether benign prostatic hyperplasia, obesity, lack of exercise, smoking, radiation exposure, or a sexually transmitted virus might increase the risk for prostate cancer. At this time, there is little evidence that these factors contribute to an increased risk.

What are the Symptoms of Prostate Cancer?

Early prostate cancer often does not cause symptoms. But prostate cancer can cause any of these problems:

• A need to urinate frequently, especially at night
• Difficulty starting urination or holding back urine
• Inability to urinate
• Weak or interrupted flow of urine
• Painful or burning urination
• Difficulty in having an erection
• Painful ejaculation
• Blood in urine or semen
• Frequent pain or stiffness in the lower back, hips, or upper thighs

Any of these symptoms may be caused by cancer or by other, less serious health problems, such as BPH or an infection. A man who has symptoms like these should see his doctor or a urologist (a doctor who specializes in treating diseases of the genitourinary system).

How is Prostate Cancer Diagnosed?

If a man has symptoms or test results that suggest prostate cancer, his doctor asks about his personal and family medical history, performs a physical exam, and may order laboratory tests. The exams and tests may include a digital rectal exam, a urine test to check for blood or infection, and a blood test to measure PSA. In some cases, the doctor also may check the level of prostatic acid phosphatase (PAP) in the blood, especially if the results of the PSA indicate there might be a problem.

The doctor may order exams to learn more about the cause of the symptoms including transrectal ultrasonography, intavenous ultrasonography, cystoscopy, and biopsy.

If cancer is found in the prostate, the doctor needs to know the stage, or extent, of the disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. The doctor may use various blood and imaging tests to learn the stage of the disease. Treatment decisions depend on these findings.

What is the Treatment for Prostate Cancer?

Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some patients receive a combination of therapies. In addition, doctors are studying other methods of treatment to find out whether they are effective against this disease.

Watchful waiting may be suggested for some men who have prostate cancer that is found at an early stage and appears to be slow growing. Also, watchful waiting may be advised for older men or men with other serious medical problems. For these men, the risks and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits.

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