Prostate Cancer

What's the Problem?

The prostate gland is part of the male reproductive system. It is located above the bladder, surrounding the urethra—the tube that empties the bladder of urine. If the prostate becomes enlarged, urination can be difficult.

After skin cancer, prostate cancer is the most common cancer effecting men in the U.S. The American Cancer Society estimates that approximately 200,000 new cases of prostate cancer are diagnosed each year with approximately 30,000 men dying of the disease. Because prostate cancer generally occurs in older men who are also at increased risk of heart disease and stroke, many men die with prostate cancer and not of the disease. Less than 10% of men die of prostate cancer within 5 years of their diagnosis.

Who's at Risk?

The factors that influence a man's risk of prostate cancer include: age, family history, race, and ethnicity. About 80% of the men with clinically diagnosed prostate cancer are 65 years of age or older. A man is at increased risk for developing the disease if his father or brother had prostate cancer. African-American men have a higher rate of prostate cancer compared with any other racial or ethnic groups. They are also more likely to die of their disease. The reasons for this are unknown.

Can It Be Prevented?

Although there are known risk factors, the actual cause of prostate cancer remains unknown. Current research is investigating factors that might reduce the risk of developing prostate cancer. Investigators are studying factors such as the use of herbal supplements including selenium or vitamin E, men's hormonal profiles, exposure to certain infectious diseases, and diet.

The digital rectal exam (DRE) and the prostate-specific antigen (PSA) blood test are used to screen for prostate irregularities. Early prostate cancer may not cause any symptoms. Some problems associated with prostate cancer include:

• frequent urination;
• difficulty urinating;
• weak or interrupted flow of urine;
• pain or burning associated with urination;
• difficulty having an erection;
• painful ejaculation; and
• blood in the urine.

These symptoms may be related to cancer or a less serious condition. Men experiencing any of these symptoms should consult a urologist.

The Bottom Line

Prostate cancer is a disease that generally occurs in older men. The prostate gland is located near the bladder; symptoms of prostate cancer can include pain, difficulty, and frequency associated with urination. Although the exact cause of prostate cancer is unknown, there are known risk factors that include age, family history, race, and ethnicity. Approximately 200,000 men are diagnosed with prostate cancer each year and about 30,000 will die of their disease.

Case Example

Jack, a 60-year-old former hippie, makes guitars for a living. He also does yoga and grows his own fruits and vegetables. Because he maintains such a healthy lifestyle, he's surprised when he experiences problems with urination. He wakes up many times during the night, but produces little urine. Jack's daughter encourages him to see a doctor. Although Jack is distrustful of traditional medicine, he finally consults a urologist. After a series of tests, Jack is diagnosed with early stage prostate cancer. Because of his beliefs, Jack rejects being treated with surgery or radiation. After considering the options, Jack decides on "watchful waiting" or frequent monitoring of his disease by a urologist. He also investigates a clinical trial that uses herbal supplements and other alternative therapies for the treatment of prostate cancer.