Prostate Cancer Overview: Signs, Symptoms, Screening, and Treatment

I'm going to give you a detailed prostate cancer overview. The signs, symptoms, screening, diagnosis, and treatment options. So, if you have a prostate, or if you have a loved one who has a prostate, keep reading.

Prostate cancer is one of the most common cancers among men. And it is called "the silent" cancer because usually there are no symptoms until it's too late and the cancer has already spread. African American men are at a higher risk for developing aggressive prostate cancer, and African American men are at a higher risk of dying from prostate cancer. The good thing is that prostate cancer can be prevented.

What is the prostate?

The prostate is the small gland located below the bladder and in front of the rectum. Only men have prostates. A normal prostate is the size and the shape of a walnut, and it wraps around the urethra, which is that tube that carries urine from the bladder to the outside world. Most people wonder what the purpose of a prostate is. Well, it actually is very functional, the prostate is a reproductive organ. It is responsible for making the fluid that carries sperm during sexual activity.

What is prostate cancer?

Prostate cancer is a tumor or a collection of malignant or cancerous cells in the prostate. It is one of the most common cancers among men, but fortunately, most men who are diagnosed with prostate cancer do not die of prostate cancer. And this is because prostate cancer tends to be an indolent, very slow growing cancer. That being said, in some populations, specifically in African American men,  prostate cancer tends to be more aggressive. And more African Americans die from prostate cancer. So, indeed it is very serious.

Who is at risk for prostate cancer?

- African American Males

Again, African Americans are at a higher risk. If you are African American and a man, you are twice as likely to have a more aggressive form of prostate cancer. And you are twice as likely to actually die from the prostate cancer.

- Age is a big risk factor.

The older you are as a man, the more likely you are to develop prostate cancer. In fact, it's very seldom that men less than 50 actually develop prostate cancer.

- Family history is an important risk factor for developing prostate cancer.

If you have a first degree relative with prostate cancer, meaning a father, a brother, or a son, then you are at higher risk. Also, if you have a female first-degree relative who has breast cancer that's associated with the BRCA gene, you may also be at a higher risk for prostate cancer. Some studies suggest that diet plays a role as well. So, if you have a diet that is low in vegetables and high in animal fat, you may be at increased risk for prostate cancer.

Signs and symptoms of prostate cancer

Men typically do not have symptoms early on in prostate cancer. By the time you develop symptoms, the cancer has probably already spread and is far gone. You can, however, get symptoms associated with some benign prostate conditions. For example, BPH, benign prostatic hyperplasia. This is when that prostate has grown and actually started to squeeze around the urethra, the tube that carries urine from the bladder to the outside world.

When this happens, you can find that you have urgency where you feel like you have to urinate. But you get to the restroom, you don't really have to go, or you're just kind of dribbling out urine. Or you may find that it takes you a while to get your urine stream going.  So, it takes you much longer to urinate than it used to.

These signs can be associated with BPH, which is benign. And you can also get prostatitis, or inflammation of the prostate. Prostatitis can cause pain, or discomfort when you're urinating.  If you have prostate cancer, you do not necessarily have symptoms. So, again, men, if you have no symptoms at all related to your prostate, or urination, or pain, do not be fooled. Don't think that that means that you don't have prostate cancer. You still need to consult your physician to find out how and if you need to be screened.

Screening for prostate cancer.

The way that we as physicians discover signs of prostate cancer is by prostate cancer screening. The PSA, or the prostate-specific antigen, is a blood test that can be used to screen for prostate cancer. PSA is a protein that's produced in the prostate, and if it is very elevated, that could be consistent with prostate cancer.

That being said, there are some other conditions of the prostate which can cause the PSA to be elevated even if you don't have prostate cancer. For example, if you have BPH, you can have an elevated PSA.  Also, if you have prostatitis or inflammation of the prostate, you can have an elevated PSA. And even trauma can cause a high PSA. So, for you men who like to do those cycling classes, or you do a whole lot of bike riding, that can be traumatic to your prostate, and you could have an elevated PSA as well.

The point is that having an elevated PSA does not in and of itself mean that you have prostate cancer, but it can be an indication. So, again, consult your physician, or your urologist, and find out if and when you need to have a PSA as a screening tool for prostate cancer.

Another way to screen for prostate cancer is a digital rectal exam or a DRE.

Remember, the prostate gland is located right in front of the rectum, so in a digital rectal exam your physician would actually in a gloved hand insert his or her digit, or finger into your rectum and literally feel your prostate. We palpate the prostate and find out if you have nodules on your prostate, or if there are some firm areas that are not normal. We can also determine the size of the prostate.

Many men are not thrilled about having prostate exams. They don't love the idea of having a digital rectal exam. In fact, many many jokes over time have been made around prostate exams. However, it's really not a laughing matter. So, be sure again to consult your primary care physician, or your urologist and to find out if a digital rectal exam is a good screening tool for you. It can potentially be a life-saving tool. Talk to your doctor.

Transrectal ultrasound for prostate cancer screening

So, the same way that pregnant ladies get ultrasounds of their bellies, or sonograms of their bellies, you are literally getting a sonogram of your prostate. And this actually can give some better pictures and show us signs of whether or not you have potential prostate cancer. And some physicians offer an MRI of the prostate to see if you have possible prostate cancer.

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How is prostate cancer diagnosed?

In order to make a definitive diagnosis of prostate cancer, you must have a prostate biopsy. That's when a sample of the prostate, or the suspicious area of the prostate, is taken and the sample is reviewed by a pathologist under a microscope to see if indeed it is prostate cancer.

If it's prostate cancer, then it's determined how aggressive the cancer is through a Gleason scoring system. And other tests are done as well to determine what stage of prostate cancer you have.

Prostate Cancer Treatment

The treatment for prostate cancer depends on how aggressive your prostate cancer is, and what stage you have. So, treatments can range from surgical, where you have a prostatectomy or surgical removal of the prostate.

Treatment can involve radiation. Radiation therapy is concentrated on the areas of the prostate with cancer. And you may even be offered a hormonal therapy, especially if the prostate cancer has already spread. This depends on the individual patient, and it depends on the level of aggressiveness.

At this point, you would definitely need to be in conversation with your urologist to find out what treatment plan is best for you.

This ends my prostate cancer overview. Remember, prostate cancer is one of the most common causes of cancer in men. But, it is potentially preventable and treatable. So, please make sure you have your consultations with your primary care physicians and your urologist, and find out when it is appropriate for you to be screened for prostate cancer.

As always, I want you to prioritize yourself, take care of you, and do your best to live your healthiest, happiest life. Be sure to leave a comment about your experience with prostate cancer, your story could save a life!