What Is Prostate Cancer
Prostate cancer is a tumor of the prostate. The gland sits in front of the rectum, above the base of the penis, and below the bladder. The prostate surrounds the first part of the urethra. The prostate helps make the milky fluid called semen. Semen carries sperm out of the body when a man ejaculates. Prostate cancer is typically slow growing with few symptoms, Some types may be aggressive and spread rapidly.
Prostate cancer is the most common form of cancer in American men. It is most prevalent in men over age 65 and common in men 50-64 years old. However, prostate cancer can occur in men younger than 50. Prostate-specific antigen screening has dramatically improved the diagnosis of prostate cancer. As a result, men below the age of 65 years show an increased incidence of this disease.
Risk factors of prostate cancer include:
- Age
- Family history of prostate cancer
- Diet high in fats from red meat
- History of sexually transmitted disease
Prostate cancer shows few symptoms until its advanced stages. These symptoms include:
- Blood in urine or semen
- Lower back, pelvic or hip pain
- Urination issues
- Erectile dysfunction
In some cases of early prostate cancer, there are no symptoms. Routine screening with PSA blood test and/or digital rectal examination often discovers prostate cancer.
How Might An Enlarged Prostate Affect My Life
Having an enlarged prostate affects men in different ways. Some men can manage mild symptoms and dont need treatment. Other men find they need to stay near a toilet. This can make it difficult to work, drive, be outdoors and attend social events. If you need the toilet a lot during the night, this can affect your sleep and make you feel more tired during the day.
Some men with an enlarged prostate find their symptoms improve over time without treatment. But for most, the symptoms will stay the same or slowly start to cause more problems over time unless they have treatment.
Do Cancers Really Disappear Spontaneously Or Are They Just Eluding Us
Cancer specialists are comfortable with the terms partial remission and complete remission when patients undergo some sort of aggressive therapy such as radiation or chemo.
But the concept of spontaneous remission is more problematic, especially with low-risk prostate cancers in patients like me on active surveillance who have had no treatment at all.
Back in May, Michael Scott, a patient advocate and layman with loads of expertise with prostate cancer, went out on a limb to suggest in his blog that spontaneous remission was real and worthy of the attention of serious researchers.
Scott, founder of Prostate Cancer International and its Active Surveillance Virtual Support Group, mentioned my case and that of a man whose name he couldnt recall.
I asked other men in two virtual support groups for men on AS if they had experienced spontaneous remission. James Simms, 72, a retired banker from Tampa, was the only one to reply. As it happens, he had described his case at Scotts group.
Simms and Scott gave me a new perspective on what might have happened with my lame cancer, as my urologist calls it.
My case
So my cancer potentially disappeared sometime in 2011, though that was not acknowledged at that time.
My urologist, Brian Helfand, MD, PhD, of NorthShore University HealthSystem in Glenview, Illinois, joked last year that if my PHI were any lower, I wouldnt have cancer at all. Was he inadvertently on to something?
Simms case
Pathologists weigh in
Recommended Reading: Viagra For Enlarged Prostate
Comparison Of Tumor Volume Parameters On Prostate Cancer Biopsies
Esther I. Verhoef, Charlotte F. Kweldam, Intan P. Kümmerlin, Daan Nieboer, Chris H. Bangma, Luca Incrocci, Theodorus H. van der Kwast, Monique J. Roobol, Geert J. L. H. van Leenders Comparison of Tumor Volume Parameters on Prostate Cancer Biopsies. Arch Pathol Lab Med 1 August 2020 144 : 991996. doi:
Prostate biopsy reports require an indication of prostate cancer volume. No consensus exists on the methodology of tumor volume reporting.
To compare the prognostic value of different biopsy prostate cancer volume parameters.
Prostate biopsies of the European Randomized Study of Screening for Prostate Cancer were reviewed . Tumor volume was quantified in 6 ways: average estimated tumor percentage, measured total tumor length, average calculated tumor percentage, greatest tumor length, greatest tumor percentage, and average tumor percentage of all biopsies. Their prognostic value was determined by using either logistic regression for extraprostatic expansion and surgical margin status after radical prostatectomy , or Cox regression for biochemical recurrence-free survival and disease-specific survival after RP and radiation therapy .
All tumor volume parameters had comparable prognostic value and could be used in clinical practice. If tumor volume quantification is a threshold for treatment decision, calculated tumor length seems preferential, slightly outperforming the other parameters.
What Causes A Prostate Nodule
A nodule is a lump or area of hardness under the surface of the prostate. In some cases, a prostate stone, which is similar to a kidney stone, can be felt under the surface. It may seem like a nodule, but its really a tiny formation of calcified minerals. A stone is usually harmless. A true prostate nodule is an abnormal growth of cells that may or may not be cancerous.
Recommended Reading: Perineural Invasion Prostate
Diagnosing Benign Prostate Enlargement
You might have several different tests to find out if you have an enlarged prostate.
A GP may do some of these tests, such as a urine test, but others might need to be done at a hospital.
Some tests may be needed to rule out other conditions that cause similar symptoms to BPE, such as prostate cancer.
Monitoring And Pharmacologic Therapy
Ordinarily, in patients in whom only a single focus of PIN, particularly HGPIN, has been identified, therapy may not be necessary. In patients with multiple areas of HGPIN or ASAP on the initial biopsy or on subsequent biopsies, therapy may be considered, as the risk of cancer in these patients is 15 times that in patients without these entities. Prostate cancerprevention studies indicate that 5-alpha reductase inhibitors, antiandrogens, and selective estrogen receptor modulators are usually not effective in eliminating HGPIN and ASAP,. .
Also Check: Tamsulosin Side Effects Ejaculation Problems
What Causes Benign Prostatic Hyperplasia
The cause of benign prostatic hyperplasia is not well understood however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty. For this reason, some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia.
Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.
Another theory focuses on dihydrotestosterone , a male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia.
What Is The Prostate
The prostate is a walnut-shaped gland that is part of the male reproductive system. The main function of the prostate is to make a fluid that goes into semen. Prostate fluid is essential for a mans fertility. The gland surrounds the urethra at the neck of the bladder. The bladder neck is the area where the urethra joins the bladder. The bladder and urethra are parts of the lower urinary tract. The prostate has two or more lobes, or sections, enclosed by an outer layer of tissue, and it is in front of the rectum, just below the bladder. The urethra is the tube that carries urine from the bladder to the outside of the body. In men, the urethra also carries semen out through the penis.
Don’t Miss: Carboplatin Prostate Cancer
Personal And Family Medical History
Taking a personal and family medical history is one of the first things a health care provider may do to help diagnose benign prostatic hyperplasia. A health care provider may ask a man
- what symptoms are present
- when the symptoms began and how often they occur
- whether he has a history of recurrent UTIs
- what medications he takes, both prescription and over the counter
- how much liquid he typically drinks each day
- whether he consumes caffeine and alcohol
- about his general medical history, including any significant illnesses or surgeries
Deformation Of The Prostate Due To Bph
Our model predicted that BPH produces the volumetric expansion of the prostate in the perpendicular direction to the CG border, as depicted in . The PZ was pushed outward from the borders of the growing CG against the prostate external surface and experienced a very slight shrinkage, as the boundary conditions partially enabled outward displacement.
Deformation of the prostate caused by BPH over 1 y. Length of the displacement field vector over original anatomy at t y. Original and deformed geometries of the prostate at t 1 y.
The extremal values of the displacements were attained at the CG borders that are closer to the external surface of the prostate. The maximum total displacement was 0.74 mm. The urethra was displaced posteriorly and its diameter was virtually unaltered.
The hydrostatic stress was compressive within the CG and negligible within the PZ . Positive hydrostatic stress appeared in thin PZ regions between the CG border and the prostate boundary, where tension accumulated as the CG expanded. The Von Mises stress was negligible within the CG, except along the urethra . Within the PZ, the Von Mises stress peaked near the borders of the CG and decreased toward the external surface of the prostate , depending on the distance between them .
You May Like: Flomax Dosage For Bph
What Research Has Been Done To Study Prostate Cancer Screening
Several randomized clinical trials of prostate cancer screening have been carried out. One of the largest is the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which NCI conducted to determine whether certain screening tests can help reduce the numbers of deaths from several common cancers. In the prostate portion of the trial, the PSA test and DRE were evaluated for their ability to decrease a mans chances of dying from prostate cancer.
The PLCO investigators found that men who underwent annual prostate cancer screening had a higher incidence of prostate cancer than men in the control group but the same rate of deaths from the disease . Overall, the results suggest that many men were treated for prostate cancers that would not have been detected in their lifetime without screening. Consequently, these men were exposed unnecessarily to the potential harms of treatment.
A second large trial, the European Randomized Study of Screening for Prostate Cancer , compared prostate cancer deaths in men randomly assigned to PSA-based screening or no screening. As in the PLCO, men in ERSPC who were screened for prostate cancer had a higher incidence of the disease than control men. In contrast to the PLCO, however, men who were screened had a lower rate of death from prostate cancer .
Pathologic Features At Radical Prostatectomy
Of the 406 patients treated with RP, 98 men had EPE and 101 men had positive SM. Since RP specimens were not available for review we did not have information on the contemporary GS or grade group. All tumor volume parameters were strongly associated with EPE and SM status in univariate analysis . In multivariable analysis including all tumor volume parameters as covariates, calculated tumor length was the only significant predictive parameter for EPE , whereas none of the parameters were predictive for SM status . Multivariable analysis including age, PSA level, grade group, number of positive biopsies, and each of the tumor volume parameters separately revealed that none of the biopsy tumor volume parameters had independent predictive value for EPE or SM status . In contrast, PSA and grade group were independently associated with EPE .
Multivariable Analysis of All Tumor Volume Parameters on Outcome After Radical Prostatectomy, Including All Tumor Volume Parameters as Covariates
Also Check: How To Find The Prostate Gland Externally
How Is Benign Prostatic Hyperplasia Treated
Treatment options for benign prostatic hyperplasia may include
- lifestyle changes
- minimally invasive procedures
- surgery
A health care provider treats benign prostatic hyperplasia based on the severity of symptoms, how much the symptoms affect a mans daily life, and a mans preferences.
Men may not need treatment for a mildly enlarged prostate unless their symptoms are bothersome and affecting their quality of life. In these cases, instead of treatment, a urologist may recommend regular checkups. If benign prostatic hyperplasia symptoms become bothersome or present a health risk, a urologist most often recommends treatment.
Inclusion Criteria Of Patients
The study population consisted of 1040 consecutive patients that underwent radical prostatectomy between January 2006 and December 2013 at 2 Japanese academic institutions. We retrospectively reviewed the records for those pathologic findings of multiple core biopsy and clinical stages. Of those, 170 patients met our inclusion criteria of clinical stagecT2a, GS6 without Gleason pattern 4 or 5 as secondary scores, up to two biopsies with cancer, and no more than 50% of cancer involvement in any core no limitation was set on PSA value and PSA density . None of the patients had received hormonal treatments including antiandrogens, luteinizing hormone-releasing hormone analogues, or 5-alpha reductase inhibitors preoperatively.
Don’t Miss: Does Enlarged Prostate Affect Ejaculation
When To Contact A Medical Professional
- Less urine than usual
- Back, side, or abdominal pain
- Blood or pus in your urine
Also call if:
- Your bladder does not feel completely empty after you urinate.
- You take medicines that may cause urinary problems, such as diuretics, antihistamines, antidepressants, or sedatives. DO NOT stop or change your medicines without talking to your provider.
- You have tried self-care steps for 2 months and symptoms have not improved.
Deaths From Prostate Cancer
Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 41 will die of prostate cancer.
Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 3.1 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American Cancer Society. Facts & Figures 2021. American Cancer Society. Atlanta, Ga. 2021.
National Cancer Institute. SEER Cancer Stat Facts: Prostate Cancer. Accessed at https://seer.cancer.gov/statfacts/html/prost.html on March 15, 2019.
Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA . SEER Cancer Statistics Review, 1975-2015, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2015/, based on November 2017 SEER data submission, posted to the SEER web site, April 2018.
American Cancer Society. Facts & Figures 2021. American Cancer Society. Atlanta, Ga. 2021.
National Cancer Institute. SEER Cancer Stat Facts: Prostate Cancer. Accessed at https://seer.cancer.gov/statfacts/html/prost.html on March 15, 2019.
Last Revised: January 12, 2021
Don’t Miss: Does Enlarged Prostate Affect Ejaculation
How Is Prostate Cancer Treated
There are many treatment options for cancer limited to the prostate gland. You and your doctor should carefully consider each option. Weigh the benefits and risk as they relate to the aggressiveness and/or stage of the cancer as well as your age, overall health, and personal preferences. Standard treatments include:
- Surgery : The surgeon makes an incision in the lower abdomen or through the perineum and removes the prostate. If they cannot remove the entire tumor, you may need radiation therapy. You will need to keep a urinary catheter in place for several weeks after the procedure. Possible side effects can include incontinence and impotence. Some surgeons may use three small incisions to do robot-assisted prostatectomy. This may result in a shorter hospital stay and quicker recovery. This procedure may be preferable for some patients, but not for all.
- External beam therapy : a method for delivering a beam of high-energy x-rays or proton beams to the location of the tumor. The radiation beam is generated outside the patient and is targeted at the tumor site. These radiation beams can destroy the cancer cells, and conformal treatment plans allow the surrounding normal tissues to be spared. See the External Beam Therapy page for more information.
- Active surveillance: No treatment, with careful observation and medical monitoring.
Advanced treatment options may avoid or minimize some of the side effects associated with standard therapies. These options include:
What Is The Normal Prostate Size
A small prostate has a volume of 30 ml to 40 ml and a weight of 20 g to 70 g. A medium prostate has a volume of 40 ml to 80 ml and a weight of 20 g to 125g . A large prostate has a volume of 40ml to 100 ml and a weight of 40 g to 125 g.
Around age 40, prostate gland begins to grow. With a benign prostatic hyperplasia , glands size can increase by 4 to 5 times compared to its initial size.
Détection précoce du cancer de la prostate, Actualisation du référentiel de pratiques de lexamen périodique de santé , document PDF , HAS, mai 2013
Read Also: Prostate Cancer Osteoblastic