Prostate Cancer

Prostate cancer is the uncontrolled abnormal growth of cells in the prostate gland, a walnut-sized organ found in the male reproductive system. The prostate is located just under the bladder and in front of the rectum, the lower part of the bowel.

Prostate cancer usually grows very slowly, although in some cases prostate cancer can grow and spread rapidly. Preceded only by lung and colorectal cancer, prostate cancer is the third leading cause of cancer death in men. Although one man in 6 will get prostate cancer during his lifetime, only 1 in 32 will die of the disease.

Prostate cancer is rare in men under 50, but its prevalence increases with age. Autopsies show that many elderly men who have died from other causes or disease also had prostate cancer that neither they nor their doctor were aware of.

Prostate Cancer Symptoms

Most men will not experience any symptoms related to prostate cancer especially if it is caught early.  Most men will be diagnosed based on yearly screening that will reveal either an elevated PSA (blood test) and/or an abnormal rectal exam. When symptoms do occur, they may include:

  • Frequent urination, especially at night
  • Difficulty starting & stopping urination
  • Weak or interrupted urine flow
  • Frequent pain or stiffness in the lower back, hips, or upper thighs
  • Painful or burning urination
  • Painful ejaculation
  • Blood in urine or semen
  • Difficulty in having an erection

In general, the prostate grows slowly after men reach 40 but may eventually interfere with urination when the prostate grows large enough to compresses the urethra. This enlargement of the prostate is often a noncancerous condition known as benign prostatic hyperplasia (BPH).

However, some doctors believe that prostate cancer begins with very small changes in the size and shape of the cells in the prostate gland. Known as prostatic intraepithelial neoplasia (PIN). These changes are classified as either low grade (almost normal) or high grade (abnormal). Men who have high-grade PIN should be watched carefully as it is likely cancerous cells are developing or have already developed in their prostate gland. For more information on PIN, click here.

Men who experience any of the above symptoms of prostate cancer should speak to their doctor. Although most patients will have urinary symptoms related primarily to BPH, a workup for prostate cancer may be indicated by a DRE or an abnormal Prostate Specific Antigen (PSA) blood test.

Prostate Cancer Risk and Prevention

Current studies are examining whether changes in diet and lifestyle can reduce risk for prostate cancer. For example, a high-fat diet is thought to be associated with increased risk of prostate cancer. Consuming a low-fat diet that includes adequate fruits and vegetables, combined with exercise, is believed to be good for prostate health and may help prevent prostate cancer. Other foods or supplements that may prevent prostate cancer include soy protein, green tea, cooked tomatoes (which contain lycopenes), vitamin E, vitamin D, and selenium.

Chemoprevention clinical trials of drugs that may prevent prostate cancer are ongoing. The NIH-sponsored trial of finasteride (Proscar) showed a 25 percent reduction in prostate cancer risk, but those patients who developed prostate cancer while on finasteride saw a 25 percent increase in the more aggressive types of prostate cancer. COX-2 inhibitors (non-steroidals) like Vioxx are also under study and have shown potential anti-cancer properties such as inhibiting cell growth, angiogenesis (developing blood vessels from neighboring tissue), apoptosis (programmed cell death), and invasiveness.

Prostate Cancer Survival Rates

The 5-year survival rate for men with prostate cancer found in its early stages is nearly 100 percent. When the prostate cancer has spread to other parts of the body, the survival rate is cut to one-third of that. As with other cancers, increased early detection rates and ongoing improvements in treatment options are helping many men diagnosed with prostate cancer survive longer and live better lives.

Learn more about cancer treatment options.

The Emory Department of Urology is affiliated with The Winship Cancer Institute of Emory University, Georgia's only National Cancer Institute-Designated Cancer Center and serves as the coordinating center for cancer research and care throughout the Emory University system. With NCI Designation Winship joins an elite group of 65 cancer centers in the United States to have earned this coveted status.

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