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Prostate Cancer Early  Detection, Prevention, Treatment and Cures About Prostate Cancer
 

Prostate cancer is the most commonly diagnosed non-skin cancer in the United States. One in six American men will develop prostate cancer in the course of his lifetime. A little-known fact is that a man is 33% more likely to develop prostate cancer than an American woman is to get breast cancer.

These and other sobering facts are the driving forces of the Prostate Cancer Foundation, whose mission is to support research into better treatments and a cure for recurrent prostate cancer. The PCF is the world's largest source of philanthropic support for prostate cancer research. The PCF has raised more than $230 million to fund over 1,200 research projects, all with the goal of finding better treatments and a cure as soon as possible.

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 Page Title, Keywords  Description Metas, BB  

 This page is about: Prostate Cancer Early  Detection, Prevention, Treatment and Cures About Prostate Cancer

Prostate cancer is the most commonly diagnosed non-skin cancer in the United States. One in six American men will develop prostate cancer in the course of his lifetime. A little-known fact is that a man is 33% more likely to develop prostate cancer than an American woman is to get breast cancer.

These and other sobering facts are the driving forces of the Prostate Cancer Foundation, whose mission is to support research into better treatments and a cure for recurrent prostate cancer. The PCF is the world's largest source of philanthropic support for prostate cancer research. The PCF has raised more than $230 million to fund over 1,200 research projects, all with the goal of finding better treatments and a cure as soon as possible.

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PSA Test Might Not Save Lives
Study found screening for prostate cancer
 made no difference in survival rates

 

MONDAY, Jan. 9 (HealthDay News) -- Screening men for prostate cancer with the prostate-specific antigen (PSA) test may not reduce their risk of death from the disease, new research suggests.

The finding appears in the Jan. 9 issue of the Archives of Internal Medicine.

Researchers looked at 501 men aged 50 and older who were diagnosed with prostate cancer between 1991 and 1995, and who had died by the end of 1999. They compared those men to a control group of 501 men diagnosed with prostate cancer who were still alive.

The study found that 14 percent of the men who died of prostate cancer and 13 percent of the men in the  control group had been screened for prostate cancer with the prostate specific antigen (PSA) test. According to the researchers, if prostate cancer screening prevented death, fewer men who died would have received screening than those who were still alive.

The researchers, from the Veterans Affairs Connecticut Healthcare System and Yale University, also concluded  that screening did not reduce prostate cancer death risk among men who were younger or healthier, or when digital rectal exams were used with PSA testing.

While screening can increase detection of prostate cancer, even at earlier stages, it doesn't necessarily prolong survival, the study authors concluded.

"Optimal clinical strategies for diagnosing and treating prostate cancer remain uncertain, and in need of   additional investigation," the authors wrote. "Based on available evidence, including the present study, recommendations regarding screening for prostate cancer should not endorse routine testing of asymptomatic men to reduce mortality. Rather, the uncertainty of screening should be explained to patients in a process of 'verbal informed consent,' promoting informed decision-making."

 

The National Prostate Cancer Coalition called the study "invalid" because it didn't "take needed facts into consideration," such as the types of treatments offered the men.

"You need to look at what kind of treatments these men went through and change in PSA velocity over time," Dr. Richard N. Atkins, chief executive officer of the coalition, said in a prepared statement. "We're not examining genetically engineered mice where you have roughly the same DNA blueprint. These are men, and every man reacts differently to different treatments."

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

and 3.9 ng/mL    Results from an Austrian screening study raise questions about a PSA cut-off for disease detection

WEDNESDAY, Jan. 4 (CancerConsultants.com) -- In a population of men undergoing prostate cancer screening in Austria, prostate cancer was detected in 21% of men with a prostate-specific antigen (PSA) level between 2.0 and 3.9 ng/mL and 30% of men with PSA between 4.0 and 10.0 ng/mL. In men with PSA levels between 2.0 and 10.0 ng/mL, 37% of detected prostate cancers occurred in men with PSA less than 4.0 ng/mL. These results were published in the journal Urology.

Men with a PSA level greater than 4.0 ng/mL often undergo a prostate biopsy in order to determine whether prostate cancer is present; the optimal PSA cut-point, however, continues to be debated. Lowering the threshold for a prostate biopsy would detect more prostate cancers, but would also increase the number of cancer-free men who undergo prostate biopsies.

Because the frequency of prostate cancer in men with a PSA level of less than 4.0 ng/mL has not been well described, researchers evaluated information from a prostate cancer screening program in Austria. They collected information from about 3446 men with a PSA level between 2.0 and 10.0 ng/mL. All men had prostate biopsies after PSA testing. The cancer detection rate in men with PSA between 2.0 and 3.9 ng/mL was compared to the cancer detection rate in men with PSA between 4.0 and 10.0 ng/mL.

  • Prostate cancer was detected by biopsy in 21% of the men with PSA between 2.0 and 3.9 ng/mL and in 30% of men with PSA between 4.0 and 10.0 ng/mL.
  • 37% of the prostate cancers detected in this population occurred in men with PSA between 2.0 and 3.9 ng/mL.
  • A Gleason score of 7 or higher (indicating faster-growing cancer) was reported for 24% of the men with prostate cancer and low PSA and 33% of the men with prostate cancer and higher PSA.
  • Compared to men with prostate cancer and higher PSA, men with prostate cancer and lower PSA tended to be younger and to have smaller prostate volume.

The researchers conclude that prostate cancer is not uncommon in men with PSA values less than 4.0 ng/mL. Men with prostate cancer and low PSA tend to be younger and to have a smaller prostate volume. These men are likely to be good candidates for potentially curative treatments such as surgery or radiation therapy.

Reference: Pelzer AE, Tewari A, Bektic J et al. Detection Rates and Biologic Significance of Prostate Cancer with PSA less than 4.0 ng/mL: Observation and Clinical Implications from Tyrol Screening Project. Urology . 2005;66:1029-1033.

 

 

Asian Men More Likely to Survive Prostate Cancer
The reasons behind the better survival rates still unclear

By Anthony J. Brown, MD

TUESDAY, September 4 (Reuters Health) - In a study of prostate cancer patients living in California, most Asian men with the disease survived longer than their white counterparts. The exception was men from South Asia; their survival was worse than that of white men.

In an interview with Reuters Health, Dr. Anthony S. Robbins, from the California Cancer Registry in Sacramento, said that few studies have compared prostate cancer risk factors and survival between Asians and whites. He added that "there are zero that looked at Koreans, Vietnamese, and South Asians."

He said that his group was surprised at "how much better nearly all the Asian groups fared compared to whites."

The study involved an analysis of data for 108,076 whites and 8840 Asians who were diagnosed with prostate cancer from 1995 to 2004. The cohort included six of the largest ethnic subgroups of Asians: Chinese, Filipino, Japanese, Korean, South Asian, and Vietnamese. South Asians included men from southern India, Pakistan, Bangladesh, Sri Lanka, Nepal, Bhutan and Sikkim.

The overall 10-year prostate cancer-specific death rate was 11.9 percent, according to the report in the medical journal Cancer. The researchers were surprised by "how much variation there was across the Asian groups, all the way from an 8 percent risk of death over 10 years in Japanese men to a 16 percent risk in South Asian men."

All of the Asian groups had worse risk factor profiles than whites, yet only in South Asian men did the profile correspond with poorer survival. "For the groups with better survival, it was paradoxical," said Robbins, "because their risk factor profiles were all going in the wrong direction ... you would have thought they would do worse than whites."

Nonetheless, "The take-home message is that for five out of six Asian groups, 'being Asian' was a favorable prognostic factor for prostate cancer survival," Robbins noted.

"Obviously, the main question we are still trying to explain is why these five Asian groups had better survival. What is behind the 'Asian edge' in prostate cancer? Diet? Lower comorbidity? Less overweight/obesity?"

Study Adds to Debate Over Prostate Cancer Testing 
More frequent screening did not cut number of cases of aggressive tumors

By Will Dunham

THURSDAY, August 30 (Reuters) - More frequent screening for prostate cancer, as expected, found more tumors, but failed to cut the number of aggressive tumors detected in between scheduled screenings, European researchers said on Tuesday.

The findings, published in the Journal of the National Cancer Institute, added to the controversy over the value of screening tests for this common cancer among men and how frequently they should be performed.

Dutch and Swedish researchers tracked about 4,000 men who every two years were given a prostate-specific antigen, or PSA, blood test for prostate cancer in Gothenburg, Sweden, and another 13,000 men tested every four years in Rotterdam. They were 55 to 65 years old at the time of the first screening.

Over a 10-year period ending in December 2005, detection of any form of prostate cancer was higher among the Swedish men who were screened more frequently - 13 percent - compared to the Dutch men who were screened less often - 8 percent.

But there was no statistically significant difference in the two groups in the number of aggressive tumors that appeared between the times when the tests were conducted. This showed that more frequent screening did not cut the number of these cancer cases as one might have expected, the researchers said.

'TRICKY QUESTION'

Asked about the implications of the findings on how often men should be screened, study leader Monique Roobol of Erasmus Medical Centre in Rotterdam said, "That's a tricky question."

The researchers wrote that each PSA test may lead to prostate cancer diagnoses among some men who may have "clinically insignificant disease."

"We here in Europe feel that over-diagnosis and over-treatment is certainly something you should avoid," Roobol said in a telephone interview.

Diagnoses of prostate cancer have risen substantially since screening using PSA tests began in the late 1980s. While the death rate has dropped, it is unclear if this is a direct result of this screening, the American Cancer Society said.

The American Cancer Society recommends doctors offer the PSA test or another screening method called digital rectal exam, annually to men beginning at age 50.

The idea behind the screening is that the tests can detect tumors early on when they are easiest to treat. But, Roobol noted, screening also may detect minor tumors that may pose no threat but end up getting unnecessarily aggressive treatment.

Screening generally is less frequent in Europe. Most institutions taking part in a large European study assessing prostate cancer gave the tests to men every four years.

"Although many of us believe that early detection is saving lives, definitive evidence is lacking," Dr. David Crawford of the University of Colorado Health Sciences Center wrote in an editorial accompanying the study.

"Critics of the four-year screening interval have voiced concerns that clinically significant cancers could be missed by such an extended interval," Crawford added, saying he was not convinced that the new study has allayed these fears.

The World Health Organization said the results of studies already underway into the effectiveness of prostate cancer screening are needed before making any recommendation.

 
Red Wine Chemical Guards Mice From Prostate Tumors
Resveratrol-fed mice were nearly eight times less likely than the control mice to develop poorly differentiated prostatic tumors

By Anne Harding

TUESDAY, September 11 (Reuters Health) - Resveratrol, an antioxidant found in grapes and berries, can slow the growth of prostate tumors in mice, a new study shows.

"If we could do this in human beings, this would be a significant achievement," Dr. Coral A. Lamartiniere of the University of Alabama at Birmingham, the study's lead author, pointed out in an interview with Reuters Health. Slowing tumor growth so that a man developed prostate cancer in his 80s rather than in his 60s could mean he wouldn't wind up dying from the disease, Lamartiniere noted.

Red wine and grape juices also are rich sources of resveratrol, which plants produce to protect themselves from bacterial and fungal attacks. Studies in animals have found resveratrol may prevent cancer, protect the heart and even extend life.

To investigate whether resveratrol might be effective in slowing or preventing prostate tumor growth, the researchers fed mice bred to develop such tumors a diet containing the resveratrol equivalent of a bottle of red wine daily, or a control diet.

The resveratrol-fed mice were nearly eight times less likely than the control mice to develop poorly differentiated prostatic tumors, the researchers found. "That's the worst tumors that you can have -- those are the ones that are large, those are the ones that would more likely spread," Lamartiniere explained.

Resveratrol-fed mice also had slower cell growth and division in their prostate glands. Levels of several cellular messengers that inhibit cell growth were increased in the mice given resveratrol compared to the control mice, while levels of some tumor-linked chemicals such as insulin-like growth factor 1 were reduced.

Lamartiniere and his team are now investigating whether lower concentrations of resveratrol will have the same anti-tumor effects. "Maybe we could get this down to two glasses of wine a night rather than a bottle," he said.

Low-Fat, Vegetarian Diet May Stall Prostate Cancer 
Fiber and other nutrients found in plant-based diets may affect prostate cancer by altering levels of certain hormones that can feed tumor development

TUESDAY, September 11 (Reuters Health) - Low-fat, plant-based diets may help prevent or slow the progression of prostate cancer, according to a new research review.

A number of studies, though not all, have suggested that eating plenty of fruits and vegetables may help ward off prostate cancer, while "Western"-style diets heavy in animal fat and dairy products may increase a man's risk of developing the disease.

In the current study, researchers reviewed 25 previously published studies that examined the effects of plant-based diets on prostate cancer development or progression.

Overall, the evidence suggests that diets high in fiber, fruits and vegetables, and low in meat and dairy, can help battle the disease, they report in the journal Nutrition Reviews.

For example, several studies of men with prostate cancer have linked high saturated fat intake to faster disease progression and a higher risk of death. Saturated fat is found mainly in animal products.

In contrast, some small trials have found that a high-fiber, low-fat vegetarian diet may slow the growth and spread of early-stage prostate tumors. Some other studies have suggested that components of plant-based foods -- like certain antioxidants or soy isoflavones -- might be beneficial.

"For men diagnosed with prostate cancer, the key to improving the odds of survival is avoiding high-fat fare and instead choosing fruits, vegetables, beans and other cancer-fighting vegetarian foods," lead study author Dr. Susan Berkow said in a statement.

Berkow is with George Mason University in Alexandria, Virginia, and serves as a consultant to Physicians Committee for Responsible Medicine, a group that advocates vegetarian and vegan diets.

Berkow and her colleagues speculate that the fiber and other nutrients found in plant-based diets may affect prostate cancer by altering levels of certain hormones that can feed tumor development, including testosterone and insulin.

The balance of fats in a man's diet may also be key, the researchers point out. Some studies have found that omega-3 fatty acids may help stall prostate cancer progression. Omega-3 fats are found largely in oily fish, but also in some vegetable sources, like flaxseeds and canola oil.

Veggies May Lower Aggressive Prostate Cancer Risk
Broccoli and cauliflower appeared to have the biggest impact

FRIDAY, August 31 (Reuters Health) - Men may be able to halve their risk of aggressive prostate cancer by adding large amounts of broccoli and cauliflower to their menu. However, the overall risk of prostate cancer was not changed.

In a study of nearly 30,000 men, Dr. Richard B. Hayes of the National Cancer Institute in Bethesda, Maryland and colleagues found that men who ate more than a serving of either vegetable each week had roughly half the risk of developing advanced-stage prostate cancer -- that had spread beyond the prostate gland -- compared with their peers who ate these vegetables less than once a month.

A number of studies have linked high fruit and vegetable diets with lower prostate cancer risk, but these results have been mixed. Few investigators have looked at advanced disease, Hayes and his team note in the Journal of the National Cancer Institute. Hayes and his colleagues looked at 29,361 men who were being followed as part of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial.

During more than 4 years of follow-up, 1,338 of the men developed prostate cancer. While there was no overall link between fruit and vegetable intake and prostate cancer risk, men who ate the most veggies had a 49-percent lower risk of being diagnosed with prostate cancer that had advanced to stage III or IV (on a scale of I to IV), the researchers found.

Most of the effect appeared to be due to cruciferous vegetables, which include Brussels sprouts, cabbage, broccoli and cauliflower; larger amounts of any vegetables in this family cut risk by 40 percent.

Broccoli and cauliflower appeared to have the biggest impact. Men who ate broccoli more than once a week had a 45 percent lower risk of advanced prostate cancer than those who ate the vegetable less than once a month, while eating cauliflower this often cut risk by 52 percent.

There was also a tendency toward reduced risk of aggressive disease among men who ate raw or cooked spinach at least twice weekly, compared to those who ate the vegetable less than once a month.

Cruciferous vegetables are rich in glucosinolates, note Hayes and his team, which can produce other chemicals with anti-carcinogenic effects. The vegetables also are powerful antioxidants.

If it is ultimately found that these vegetables directly lower the risk of aggressive prostate cancer, "a possible means to reduce the burden of this disease may be primary prevention through increased consumption of broccoli, cauliflower, and possibly spinach," they conclude.

'Lumpectomy' Possible for Some Prostate Tumors
Focal ablative therapy may be an effective and less invasive approach for a considerable minority of men with early prostate cancer that is confined to the prostate

By David Douglas

THURSDAY, September 13 (Reuters Health) - Treating or removing just the part of the prostate that is cancerous may be an effective and less invasive approach for a considerable minority of men with early prostate cancer that is confined to the prostate, according to doctors in Durham, North Carolina.

Focal ablative therapy for prostate cancer "may become similar to breast-conserving lumpectomy in women for the treatment of breast cancer," senior investigator Dr. Thomas J. Polascik told Reuters Health.

Based on pathology findings of men who had surgery for prostate cancer at Duke University, perhaps 1 in 5 men have completely one-sided prostate cancers, Polascik said, "and as such could potentially be candidates for unilateral ablation of the cancerous side of the prostate rather than whole-gland radiation or surgical removal."

As they report in the medical journal Cancer, Polascik and colleagues examined tissue samples from the removed prostates of 1,184 men with prostate cancer that was confined to the prostate.

In all, 227 (19.2 percent) had completely one-sided cancers, and 164 of them (72.2 percent) had minimal tumor involvement of 5 percent or less. Only 14 (6.2 percent) had involvement beyond 15 percent.

In such patients, Polascik said, "the contralateral, non-cancerous side of the prostate would be spared, and therefore there exists the potential to better preserve quality of life, such as erectile and sexual function and urinary continence in men undergoing prostate cancer treatment."

Family Organizes Memorial Golf Tournaments to Raise Funds for the PCF    The Redmond family holds golf tournaments to raise funds in honor of a father who lost his battle with prostate cancer

With their 3rd annual tournament on September 8th, the Redmond Family has raised over $150,000 for the Prostate Cancer Foundation.

It's been over two years year since Kristie Redmond lost her father to prostate cancer, but she's still fighting hard for a cure.

Mark Redmond's prostate cancer came as a huge shock. At age 50, the devoted father, husband, and businessman had just been in for a check-up and received a clean bill of health.

Then the leg pains began, and an X-ray revealed what his PSA had not: a tumor. The cancer was advanced and aggressive, and none of the available treatments worked. A year later, Mark lost his battle with prostate cancer.

But even up to the end, he never lost hope.

"My dad was the most optimistic out of all of us," says Kristie, now 26. "He wasn't going to give up. I know he'd be really proud of our fundraising efforts if he were here."

The idea for a memorial golf tournament came from one of Mark's friends – and the family immediately jumped on board. So did the rest of the community.

"Hundreds of people show up," marvels Kristie’s mother, Kay. "And I got four phones calls from men who were tested after the golf outing and found out they had prostate cancer."

For the Redmonds, making that kind of difference for others is the best way to keep Mark's legacy alive. That's why Kristie’s brother, Ryan, has worked to oversee construction of a hospice in Peru in his father’s memory – and why the family plans to continue supporting the PCF in any way they can.

"People think 'I'm healthy, it can't happen to me,'" Kristie explains. "But as my dad proves, it can happen to anyone. The more money we have for research, the better chance we have of finding treatments and a cure."

 
 
 
 
Prostate Cancer Treatment Causes Bone Loss


Men treated with hormonal therapy may need bone-boosting meds, too

THURSDAY, Dec. 22 (HealthDay News) -- Many men diagnosed with advanced prostate cancer receive testosterone-reducing therapy, because the hormone is thought to spur tumor growth.

But a new study suggests this hormonal treatment may also have an unwelcome side effect: it triggers a decline in patients' bone mass.

Researchers at the University of Pittsburgh compared the bone health of 152 men with prostate cancer to that of healthy men, for one year. About half the cancer patients had not received hormonal therapy, 30 had received it for less than six months, while 50 had received it for six months or more.

Healthy men and cancer patients who had not undergone hormonal treatment showed no bone loss, the researchers report in the December issue of the Journal of Clinical Endocrinology and Metabolism.

But those who had recently started hormonal therapy showed a loss of bone mineral density ranging from 1 percent to 4 percent.

"Men with prostate cancer who are initiating androgen deprivation therapy have a 5- to 10-fold increased loss of bone density at multiple skeletal sites," compared to men not on this therapy, the researchers concluded.

Based on the findings, they suggested that patients receiving this type of hormonal therapy also receive concurrent treatment aimed at slowing or stopping bone loss, especially in the first year after such therapy begins. 

SOURCE: Journal of Clinical Endocrinology and Metabolism, abstract, December 2005

-- E.J. Mundell

Obesity Hinders Prostate Cancer Detection

Finding highlights need for rigorous screening in heavier patients
 
WEDNESDAY, Jan. 11 (HealthDay News) -- Doctors may have more difficulty in detecting prostate cancer in obese men, which could lead to delayed diagnosis and increased risk of death, researchers say.

A study led by experts at Duke University Medical Center found that doctors may be 20 percent to 25 percent less likely to identify prostate cancer in obese men. Doctors need to be aware of this and be especially thorough when examining obese men for prostate cancer, the study authors recommended
.
"Diagnosing prostate cancer is a bit like finding a needle in a haystack. The bigger the haystack you have, the harder it is to find the needle, and in this case, we may be missing cancers in obese men," principal investigator Dr. Stephen Freedland, an assistant professor in Duke's department of surgery-urology, said in a prepared statement.

 

He and his colleagues reviewed the medical records of 1,400 men who had their prostrates removed after being diagnosed with prostate cancer. The average weight of obese men's prostate glands was 40 grams, compared to a normal weight of 20 to 30 grams. An enlarged prostate increases the risk that a biopsy will fail to detect cancer, the experts say.

In addition, they note that it is more difficult to perform digital rectal exams on obese men compared with thinner men.

The study appears in the February issue of the Journal of Urology.

 

 

The prostate is made up of a number of small glands
 surrounded by a layer of tissue called the stroma.

The    small glands in the prostate produce the fluid secretions. The stroma contains some muscle cells which contract during ejaculation to help move fluid into the urethra.

The prostate gland produces a milky, slightly acidic fluid that is secreted through several openings into the urethra. Although the functions of the substances in prostatic fluid are not entirely known, they may help keep sperm alive and may also protect sperm when in the female reproductive tract. The prostate produces approximately 40% of the fluid that is ejaculated.

The prostate gland slowly increases in size from birth until puberty, and after that it grows more quickly.

The close location of the prostate around the urethra means that any enlargement of the gland can narrow the outflow from the bladder. If the prostate grows too large, it may slow or even stop the flow of urine.

The outflow of urine from the bladder is controlled by a ring of muscle called the internal sphincter which is located at the base of the bladder. When the internal sphincter is closed, it stops urine and semen leaving the body through the urethra at the same time. At orgasm, this muscle ring closes tightly to stop semen flowing 'backwards' into the bladder. This muscle ring cannot be consciously controlled and is referred to as an involuntary muscle.

The outflow of urine from the penis is controlled by a different muscle layer (external muscle sphincter) that sits underneath the prostate gland in the region referred to as the pelvic floor. Men can voluntarily control the flow of urine by the control of this muscle layer in the pelvic floor. This muscle layer is referred to as a voluntary muscle because it can be consciously controlled.
Growth of the prostate with age

 

The growth of the prostate gland is controlled by substances called androgens. Androgens are the sex steroids or hormones that are responsible for the development of male characteristics such as hair and beard growth.

The most important androgen in men is testosterone. Testosterone is produced mainly in the testes by Leydig cells which lie between the sperm producing tubes (seminiferous tubules). Small amounts of testosterone are also made by the adrenal glands which are walnut sized glands that sit on top of the kidneys. Testosterone is carried in the blood stream to other parts of the body to act on a number of other organs. Only those parts of the body which have sensors that detect androgens (androgen receptors) will respond to testosterone. Testosterone is changed to another androgen called dihydrotestosterone (DHT) which is the androgen that stimulates prostate growth.

Testosterone is not produced until puberty and therefore the prostate gland remains small before puberty. The rising levels of testosterone at puberty causes the prostate gland to increase in size and continues to grow during adult life and in ageing men. If testosterone levels are lowered by removal of the testes, the prostate shrinks in size. Without testosterone, the prostate will also stop producing fluid because the prostate cells depend on testosterone for this function.

Prostate Cancer Early  Detection, Prevention, Treatment and Cures

 About Prostate Cancer

Prostate cancer is the most commonly diagnosed non-skin cancer in the United States. One in six American men will develop prostate cancer in the course of his lifetime. A little-known fact is that a man is 33% more likely to develop prostate cancer than an American woman is to get breast cancer.

These and other sobering facts are the driving forces of the Prostate Cancer Foundation, whose mission is to support research into better treatments and a cure for recurrent prostate cancer. The PCF is the world's largest source of philanthropic support for prostate cancer research. The PCF has raised more than $230 million to fund over 1,200 research projects, all with the goal of finding better treatments and a cure as soon as possible.

Prostate Cancer And You
Every man diagnosed with prostate cancer begins a deeply personal journey for himself and his loved ones in determining the appropriate therapy for the disease. Receiving a diagnosis of cancer is always very difficult. Prostate cancer is particularly complicated due to the variety of treatment options and the lack of knowledge, in certain cases, as to the most appropriate treatment. However, learning more about the disease, understanding the treatment options and their risks and benefits, and discovering the diet and lifestyle changes that may improve the prognosis all can help empower patients. It lets them participate more actively in their care and helps in making informed choices about treatment options.

This website presents information about prostate cancer that anyone concerned about or diagnosed with prostate cancer should know. It is impossible, however, to present all the information that might be relevant to a particular diagnosis. Therefore, in the "Prostate Cancer Useful Resources" section, there are links to additional sources of information and support.  And, of course, patients should consult with their health care provider regarding their individual situation.

 

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What Is The Prostate?

The prostate is a walnut-sized gland located between the bladder and the penis and in front of the rectum. The urethra, the tube which carries urine from the bladder and out of the body through the penis, passes through the center of the prostate. The microscopic nerves that control erection are attached to both sides of the prostate as they extend to the penis.  The prostate is not a vital organ; however, it is surrounded with lots of small and sensitive nerves and blood vessels that can be damaged as a result of the disease and its treatment. In some ways, it functions as "Grand Central Station" for the male reproductive and urinary systems where urine and semen must pass through the prostate to leave the body. Its importance is less related to what it does than to the problems that it creates when something goes awry.

The Prostate's Role In Reproduction

 

The primary function of the prostate is the production of seminal fluid, a milky substance that nourishes sperm (seminal vesicles, attached to the prostate, contribute nutrients as well). Sperm passes to the prostate by traveling through the vas deferens, tubes originating from the testes. The semen, a mixture of seminal fluid and sperm, is ejaculated during orgasm through a connection to the urethra called the ejaculatory ducts.

Anatomy Of The Prostate
The prostate is divided into five zones: (1) the peripheral zone, which is located in the rear part of the prostate near the rectum and which contains three-fourths of the glands in the prostate and is where most prostate cancer occurs; (2)  the central zone, which is involved in the connection of the seminal vesicles to the prostate, and which contains most of the rest of the organ's glands; (3) the anterior zone, which is primarily smooth muscle tissue, is located in the front part of the prostate; (4) the transition zone, the zone that enlarges with "benign prostatic hyperplasia" (BPH), a noncancerous enlargement of the prostate; and (5), the pre-prostatic tissue, which contains muscles that help prevent semen from flowing backward into the bladder during ejaculation.

What Is Prostate Cancer?

Prostate cancer occurs when cells within the prostate grow uncontrollably, creating small tumors.  The term “cancer” refers to a condition in which the regulation of cell growth is lost and cells grow uncontrollably.  Most cells in the body are constantly dividing, maturing and then dying in a tightly controlled process.  Unlike normal cells, the growth of cancer cells is no longer well-regulated.  Instead of dying as they should, cancer cells outlive normal cells and continue to form new, abnormal cells.

Abnormal cell growths are called tumors.  The term “primary tumor” refers to the original tumor; secondary tumors are caused when the original cancer spreads to other locations in the body.  Prostate cancer typically is comprised of multiple very small, primary tumors within the prostate.  At this stage, the disease is often curable (rates of 90% or better) with standard interventions such as surgery or radiation that aim to remove or kill all cancerous cells in the prostate.  Unfortunately, at this stage the cancer produces few or no symptoms and can be difficult to detect.

About Metastatic Prostate Cancer
If untreated and allowed to grow, the cells from these tumors can spread in a process called metastasis.  In this process, prostate cancer cells are transported through the lymphatic system and the bloodstream to other parts of the body, where they lodge and grow secondary tumors.  Once the cancer has spread beyond the prostate, cure rates drop dramatically.

In most cases, prostate cancer is a relatively slow-growing cancer, which means that it typically takes a number of years for the disease to become large enough to be detectable, and even longer to spread beyond the prostate.  This is good news. However, a small percentage of patients experience more rapidly growing, aggressive forms of prostate cancer.  Unfortunately, it is difficult to know for sure which prostate cancers will grow slowly and which will grow aggressively – complicating treatment decisions.

The spread of cancer outside the prostate can be detected by the presence of prostate cancer cells in areas surrounding the prostate such as the seminal vesicle, lymph nodes in the groin area, the rectum and bones.  When prostate cancer spreads to another site, such as bone, the new tumor is still considered to be prostate cancer, not bone cancer.

Screening & Diagnosis

Screening for prostate cancer can be performed quickly and easily in a physician’s office using two simple tests: the prostate specific antigen (PSA) blood test, and the digital rectal exam (DRE).

About The PSA Test
PSA is an enzyme produced in the prostate that is found in the seminal fluid and the bloodstream.  An elevated PSA level in the bloodstream does not necessarily indicate prostate cancer, since PSA can also be raised by infection or other prostate conditions such as BPH.  Many men with an elevated PSA do not have prostate cancer.

Nonetheless, a PSA level greater than 4.0 nanograms per milliliter of serum was established initially as the cutoff where the sensitivity for detecting prostate cancer was the highest and the specificity for detecting non-cancerous conditions was the lowest. A PSA level above 4.0 ng per milliliter of serum may trigger a prostate biopsy to search for cancer.  Recently, experts have argued that men with a PSA level greater than 2.5 should obtain biopsies to increase the likelihood that prostate cancer might be detected earlier in a more curable form of the disease.  This issue is not yet scientifically resolved, and the topic remains controversial.

It is important to note that the PSA test is an imperfect screening tool.  A man can have prostate cancer and still have a PSA level in the “normal” range.  Approximately 25% of men who are diagnosed with prostate cancer have a PSA level below 4.0.  In addition, only 25% of men with a PSA level of 4–10 are found to have prostate cancer.  With a PSA level exceeding 10, this rate jumps to approximately 65%.

More sophisticated forms of the PSA blood test can be used to further improve the precision of the test. It should be noted that the standard PSA test remains the most widely used screening assay for prostate cancer and that the newer methods are just starting to be adopted by the medical community. Learn more about additional diagnostic tests.

About The Digital Rectal Exam
The digital rectal exam should be performed along with the PSA test.  The DRE is performed by a physician who will insert a gloved finger into the rectum to feel the peripheral zone of the prostate where most prostate cancers occur.  The physician will be checking for hardness of the prostate or for irregular shapes or bumps extending from the prostate – all of which may indicate a problem.  The DRE is particularly useful because the PSA test may miss up to 25% of cancers, and the DRE may catch some of these.

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