Prostate cancer is a form of cancer thatdevelops in the prostate,a gland in the male reproductive system. The cancer cells may metastasize(spread) from the prostate to other parts of the body, particularly the bones and lymph nodes.Prostate cancer may cause pain, difficulty in urinating,problems during sexual intercourse, or erectile dysfunction. Other symptoms canpotentially develop during later stages of the disease.
Rates of detection of prostate cancers vary widely across the world, withSouth and East Asia detecting less frequently than in Europe, and especiallythe United States.Prostate cancer tends to develop in men over the age of fifty and although itis one of the most prevalent types of cancer in men, many never have symptoms,undergo no therapy, and eventually die of other causes. This is because cancerof the prostate is, in most cases, slow-growing, symptom-free, and since menwith the condition are older they often die of causes unrelated to the prostatecancer, such as heart/circulatory disease, pneumonia, other unconnectedcancers, or old age. Many factors, including genetics and diet,have been implicated in the development of prostate cancer. The presence ofprostate cancer may be indicated by symptoms, physical examination, prostate specific antigen (PSA), or biopsy. There iscontroversy about the accuracy of the PSA test and the value of screening.Suspected prostate cancer is typically confirmed by taking a biopsy of theprostate and examining it under a microscope.Further tests, such as CT scans and bone scans,may be performed to determine whether prostate cancer has spread.
Treatment options for prostate cancer with intent to cure are primarily surgery, radiationtherapy, and proton therapy. Other treatments, such as hormonal therapy, chemotherapy,cryosurgery, and high intensity focused ultrasound(HIFU) also exist, depending on the clinical scenario and desired outcome.
The age and underlying health of the man, the extent of metastasis,appearance under the microscope, and response of the cancer to initialtreatment are important in determining the outcome ofthe disease. The decision whether or not to treat localized prostate cancer (atumor that is contained within the prostate) with curative intent is a patienttrade-off between the expected beneficial and harmful effects in terms ofpatient survival and quality of life.
Signs and symptoms
Early prostate cancer usually causes no symptoms. Often it is diagnosedduring the workup for an elevated PSA noticed during a routine checkup.It's highly advised to avoid sexual intercourse for 3 days prior to a PSA testbecause that affects the outcome of the test. Sometimes, however, prostatecancer does cause symptoms, often similar to those of diseases such as benign prostatic hyperplasia. Theseinclude frequent urination, increased urinationat night, difficulty starting and maintaining a steady stream of urine, blood in theurine, and painfulurination. Prostate cancer is associated with urinary dysfunction as theprostate gland surrounds the prostatic urethra. Changes within the gland,therefore, directly affect urinary function. Because the vasdeferens deposits seminal fluid into the prostatic urethra, and secretionsfrom the prostate gland itself are included in semen content, prostate cancermay also cause problems with sexual function and performance, such asdifficulty achieving erection or painful ejaculation.
Advanced prostate cancer can spread to other parts of the body, possiblycausing additional symptoms. The most common symptom is bone pain,often in the vertebrae(bones of the spine), pelvis, or ribs. Spread of cancer into other bones such as the femur is usually tothe proximal part of the bone. Prostate cancer in the spinecan also compress the spinal cord, causing leg weakness and urinary and fecal incontinence.