Diagnosing and Treating Prostate Cancer

Laura Mitchell's picture
By Laura Mitchell on November 30, 2018

Prostate cancer is the second most common cancer among men in the U.S. behind skin cancer, and the second most deadly, behind lung cancer. According to the American Cancer Society, nearly one in nine American men will be diagnosed with prostate cancer during their lifetime.
 
While those sound like grim statistics, when prostate cancer is diagnosed early enough that it has not spread far outside the prostate, if at all, the five-year survival rate is nearly 100 percent.
 
And early detection is both easy and the key to that high survival rate: Once prostate cancer spreads to lymph nodes, bones or other organs, the five-year survival rate drops to only 29 percent.

What Is the Prostate?

The prostate is a male reproductive gland that contributes to semen production and propulsion. It is located below the bladder and it surrounds the urethra, which carries urine out of the body.
 
Because of its position and function, changes to the prostate that result from infection, tumors or simply growing older can create problems with both sex and urination. Symptoms of prostate cancer can be similar to those for other, non-cancerous prostate problems, so it is important to consult your primary care provider if you have any of the following symptoms:

  • An urgent need to pass urine
  • Decreased urine flow
  • Burning sensation when urinating
  • Frequent sleep interruptions to urinate

Risk Factors and Prevention

Age and race are primary factors in the development of prostate cancer. The average age at diagnosis is 66, and African-American men are most at risk. Genetics also play a role.

The National Institute on Aging recommends that men in high-risk categories get screened for prostate cancer beginning at age 45, and all other men at age 50.

A healthy lifestyle is not a guarantee against prostate cancer, but maintaining a healthy weight, sticking to the Mediterranean diet and exercising regularly can strengthen your immune response and optimize your overall health.

Diagnosing Prostate Cancer

Your provider can determine if your symptoms are caused by prostate cancer by conducting a digital rectal examination and a blood test to check your levels of prostate-specific antigens (PSA test).

If necessary your provider will refer you to a urologist for specialty care, including a tissue biopsy. Your provider may also recommend an ultrasound examination to get a more complete view of the prostate.

PSA testing has risks as well as benefits, so it is important to discuss your options with your provider.

Treating Prostate Cancer

Unlike many other forms of cancer, prostate cancer is usually a slow-growing disease. Carilion Clinic urologist Christopher Reynolds, M.D., explains that as a result, depending on the results of a prostate biopsy and additional testing, one treatment option may include active surveillance.

"Active surveillance involves temporarily or permanently delaying treatment and, thus, the risks of more aggressive treatments for prostate cancer," said Dr. Reynolds. "The disease is monitored periodically to assess for worsening cancer."

Other treatment options would include:

  • Surgery to remove the entire prostate and some surrounding tissue
  • Radiation therapy to kill the cancer cells and shrink tumors
  • Hormone therapy to curtail testosterone production, especially for men undergoing radiation therapy or when cancer has spread beyond the prostate

"Common as it is, prostate cancer does not have to change your life for the worse," said Dr. Reynolds. "And if you are already having symptoms that interfere with urination or ejaculation, then a proper diagnosis can change your life for the better."