Prostate Cancer By: Kurt Rishel

The Prostate The prostate is a walnut sized gland found in front of the rectum and underneath the urinary bladder. Almost 100% of prostate cancer will develop in the glands cells that make the prostate fluid which is added to the semen (adenocarcinoma). Other forms of prostate cancer can be small cell or transitional cell sarcomas, but these types are extremely rare.

The Prostate’s Function Prostate cancer affects the prostate gland, the normal function of the prostate gland is to make some of the fluid that protects and nourishes sperm cells in semen.

Risk Factors A key risk factor for contracting prostate cancer is age, more than 70% of cases occur in males after the age of 65. It also is more likely to develop in African-Americans and Hispanics as opposed to Caucasians. The risk of developing prostate cancer also rises with people who have close relatives with the disease. Also men who have had a vasectomy under the age of 35 have a higher chance of contracting prostate cancer.

Signs and Symptoms Prostate cancer can show no signs or symptoms for many years. Signs include abnormality in a blood test or a hard nodule on the prostate. When the cancer enlarges it will press against the urethra and make urinating more difficult. It can also cause blood to appear in your urine. If the cancer metasisizes the doctor may be able to detect the tumor in different areas of the body (most commonly the lower spine or the pelvic bones). If the cancer metastase to the liver it can cause chest pain or jaundice, or frequent coughing if it moves to the lungs.

Detection and Diagnosis Prostate cancer usually is suspected initially because of an abnormality of one or both of the two screening tests that are used to detect prostate cancer. These screening tests are a digital rectal examination and a blood test called the prostate specific antigen (PSA). In the digital rectal examination, the doctor feels (palpates) the prostate gland with his gloved index finger in the rectum to detect abnormalities of the gland. Thus, a lump, irregularity, or hardness felt on the surface of the gland is a finding that is suspicious for prostate cancer. Accordingly, doctors usually recommend doing a digital rectal examination annually in men age 40 and over.

Staging Process Two main systems are used to stage prostate cancer. In the American urologic staging system, stage A describes a minimal cancer that can neither be palpated (felt) on physical examination nor seen by imaging techniques. Such a tumor is so small that it can be detected only by viewing it under a microscope. Stage B refers to a larger cancer that may be palpated, but that still is confined (localized) to the prostate gland. Stage C indicates local spread beyond the prostate into the surrounding tissues. Stage D1 signifies a spread to the nearby (pelvic) lymph nodes and D2 is for distant spread (metastasis), for example, to the bones, liver, or lungs.

Survival Rates 5-year relative survival by stage at the time the cancer is found * local 100% * regional 100% * distant 31%

Available Treatments surgical treatment for prostate cancer is commonly referred to as a radical or total prostatectomy, which is the removal of the entire prostate gland: 90% survival rate goal of radiation therapy is to damage the cancer cells and stop their growth or kill them: used in 30% of patients Hormonal treatment: the production of testosterone is the primary fuel for the spread of prostate cancer so the main goal of hormonal treatment is to stop the production of the testosterone: used in less than 10% of cases Cryotherapy: This treatment kills the cancer cells by freezing them: used in patients with localized prostate cancer Chemotherapy: They are used (for hormone resistant prostate cancer) as a palliative treatment (palliation to relieve symptoms) in patients with advanced cancer for whom a cure is unattainable

Common Side Effects Surgical: side effects include local bleeding, impotence, and incontinence Radiation therapy: impotence and incontinence Hormonal Treatment: enlarged breasts (gynecomastia) that often are tender, flushing (like hot flashes), and impotence. Cryotherapy: damage to the urethra and bladder Chemotherapy: weakness, nausea, hair loss, and suppression of the bone marrow. The suppression of marrow, in turn, can decrease the red blood cells (causing anemia), the white blood cells (leading to infections), and the platelets (resulting in bleeding).

Types of Doctors Oncologist: doctor who deals with cancer Urologist: focuses on urinary tract and male reproductive system General Practioner: performs annual rectal exams

Key Statistics About 1 in 6 men will be diagnosed with prostate cancer during their lifetime Prostate cancer accounts for about 10% of cancer related deaths in males New cases in 2009: 192,280 Cases resulting in death: 27,360

Video Link to cryotherapy video: http://www.sunkavallymd.com/cryosurgery-prostate-procedure-uologist-san-jose-ca.htm#procedure

Works cited http://www.cancer.org/docroot/CRI/content/CRI_2_2_4X_Prostate_cancer_survival_rates_36.asp?sitearea= http://www.cancer.net/portal/site/patient http://www.medicinenet.com/prostate_cancer/page11.htm#_Toc498458224 http://www.sunkavallymd.com/cryosurgery-prostate-procedure-uologist-san-jose-ca.htm#procedure