Men's Health

Prostate Cancer

In the US, one in six men will be diagnosed with prostate cancer in their lifetime making it the most frequently diagnosed cancer in men after skin cancer. In 2013, over 238,000 new cases of the disease will be diagnosed and almost 30,000 men will die of prostate cancer in the US alone. 

Despite these figures, the level of awareness, understanding and support for prostate cancer lags significantly behind that of women’s health causes. 
  • A man is 35% more likely to be diagnosed with prostate cancer than a woman is to be diagnosed with breast cancer.
  • One new case of prostate cancer occurs every 2.2 minutes and a man dies from the disease every 17.5 minutes.
  • The incidence rates are double for African American men.
  • If detected and treated early, prostate cancer has a 97 percent success rate.

OVERVIEW             TESTING             NAVIGATING PROSTATE CANCER             RESOURCES



OVERVIEW

What is the prostate?
The prostate is a gland forming part of the male reproductive system. In younger men the prostate is about the size of a walnut. It is located immediately below the bladder and just in front of the bowel. Its main function is to produce fluid that protects and enriches sperm. It is doughnut shaped as it surrounds the beginning of the urethra, the tube that carries urine and semen out through the penis. The nerves that control erections surround the prostate.

What is prostate cancer?
Prostate cancer occurs when some of the cells of the prostate reproduce much more rapidly than in a normal prostate, causing a tumor. If left untreated prostate cancer cells may eventually break out of the prostate and invade distant parts of the body, particularly the bones and lymph nodes, producing secondary tumors, a process known as metastasis. Once the cancer escapes from the prostate, treatment is still possible but is more intensive and difficult.

If appropriate treatment begins while the cancer is still confined to the prostate gland, it is possible to prevent the progression of the disease.

One of the most worrying aspects of the disease is that most prostate cancers develop without men experiencing any symptoms.

What are the risk factors?
  • Gender: Prostate cancer only affects men as women do not have a prostate gland.
  • Age: The older a man, the more likely he is to be diagnosed with prostate cancer, about 97% of all prostate cancers are diagnosed in men 50 and older.
  • Family History: A man with a father or brother who developed prostate cancer before age 60 is twice as likely to develop the disease.
  • Ethnicity: African American men are more likely to develop prostate cancer and are nearly 2.5 times as likely to die from the disease.
  • Lifestyle: Poor diet and lack of exercise.
What are possible symptoms?
While the majority of prostate cancers have no symptoms, advanced disease that has spread throughout the prostate (and beyond) can cause urinary symptoms such as:
  • Slow Flow: Urine flow is slow and difficult to stop
  • Hesitancy: Difficulty starting flow of urine
  • Frequency: Need to urinate more frequently
  • Nocturia: Need to urinate during the night
  • Urgency: Urgent need to urinate
  • Blood in the urine or semen
  • Reduced ability to get an erection
  • Painful ejaculation
It’s important to note that these symptoms are common to many different conditions, not just prostate cancer.
 
Talk to your doctor about prostate cancer testing, as there are advantages and disadvantages of testing.



TESTING

Talking to your doctor about prostate cancer testing
Men should talk to their doctor about prostate cancer testing. There are advantages and disadvantages to PSA testing. Understand the prostate cancer risk factors, discuss these with your doctor and decide if prostate cancer testing is right for you. 

What tests are available?
The purpose of testing is to detect prostate cancer at its earliest stages, before any symptoms have developed. 
There are two tests:
  • Physical Examination (DRE: Digital Rectal Exam)
  • Blood Test (PSA: Prostate Specific Antigen)


The PSA blood test (PSA)

The PSA blood test looks for the presence in the blood of a protein that is produced specifically by prostate cells called Prostate Specific Antigen (PSA). The presence of an elevated PSA does not necessarily mean prostate cancer is present as there are other medical conditions that can lead to a PSA result outside the normal range.  These include enlargement of the prostate (Benign Prostatic Hyperplasia or BPH) and inflammation of the prostate (prostatitis).

The Digital Rectal Exam (DRE)

The DRE involves the doctor inserting a gloved finger in the anus, where it is possible to feel part of the surface of the prostate. Irregularities include swelling or hardening of the prostate, or lumps on the surface that may indicate development of a tumor or other problems. The drawback to this test is that the doctor can feel only part of the prostate, so some irregularities may be beyond reach.

If the results of a test are abnormal your doctor would refer you to a specialist (i.e. Urologist) to take a tissue sample in the form of a biopsy. A biopsy is the only way to determine if cancer is present. A doctor typically diagnoses prostate cancer after closely examining biopsy cells through a microscope. There are several types of cells in the prostate and each contributes in its own way to the prostate’s development, architecture and function. Cancer cells look different than normal prostate cells. Pathologists look for these differences first to detect the presence of cancer and then to determine the cancer grade. Doctors will perform various tests to stage the cancer, determine its risk and develop a treatment plan.

To test or not to test?
The question of testing is a personal and complex one. It’s important for every man to talk with his doctor about whether prostate cancer testing is right for him.

There is no unanimous opinion in the medical community regarding the benefits of prostate cancer testing. Those who advocate regular testing believe that finding and treating prostate cancer early offers men more treatment options with potentially fewer side effects.

Ultimately, decisions about testing should be individualized based on a man’s level of risk, overall health, and life expectancy, as well as his desire for eventual treatment if he is diagnosed with prostate cancer.

Movember recommends that men discuss their health with their doctor to decide if testing is the right choice for them.

Download the PSA overview here.














NAVIGATING PROSTATE CANCER

Newly Diagnosed
If you or someone you know has just been diagnosed with prostate cancer you may be experiencing a number of feelings; disbelief, fear, anger, anxiety and depression. There are many treatment options and support resources that can help you and your family through this difficult time and on toward a normal, healthy life.

Dealing with a new prostate cancer diagnosis
  1. Educate yourself about prostate cancer and the available treatments to improve your outlook and relieve some of the anxiety and stress caused by diagnosis.
  2. Be an empowered patient and feel comfortable getting a second opinion.
  3. Be prepared with a list of questions for your doctor.
  4. Bring along your partner, a family member or friend for support and an objective observer who can help translate what occurred and what information has been offered in the doctor’s office.
Visit the Prostate Cancer Foundation website for extensive information on a new diagnosis.
Download the LIVESTRONG Foundation's guide on what to do after a cancer diagnosis.

Treatment Decision
If you have been diagnosed with prostate cancer, have hope, most prostate cancers are slow growing and may not need surgery or other radical treatment. Active surveillance – regular monitoring – is now a common treatment option for men with low risk, low grade prostate cancer. Educate yourself about the various treatment options and to make an informed decision about what to do. Men diagnosed with localized prostate cancer today may live for many years, so decisions made now may reverberate long into your future. Take action and seek advice from medical professionals and reputable sources such as the Prostate Cancer Foundation.

As the side effects of treatment can include erectile dysfunction, prostate cancer can have a serious impact on intimate relationships. As many people who have been through the journey will tell you, prostate cancer isn’t just a man’s disease, it’s a couple’s disease. Make sure you involve your partner as you think through the various treatment options. The LIVESTRONG Foundation has information on the practical and emotional implications of fighting a cancer diagnosis.

Your decision-making process will likely include a combination of clinical and psychological factors, including: 
  • The need for therapy
  • Your level of risk
  • Your personal circumstances
  • Your preference for a certain therapy based on the risks and benefits
     
Treatment Options

Active Surveillance
Many prostate cancers are slow growing and may not need surgery or other radical treatment. Active surveillance (which is regular monitoring) is now a common treatment option for men with low risk, low grade prostate cancer.

 
During active surveillance, prostate cancer is carefully monitored for signs of progression. These tumors can be safely watched, using regular PSA tests and biopsies to ensure that they do not progress. If symptoms develop, or if tests indicate the cancer is growing, treatment might be warranted.


Click here for more information on active surveillance.

Prostatectomy
A surgical approach to treating prostate cancer will remove all or part of the prostate gland. Typically, men with early-stage disease or cancer that’s confined to the prostate will undergo radical prostatectomy – removal of the entire prostate gland, plus some surrounding tissue. Advances in surgical technique allow men to stay in the hospital one to two nights on average. Other surgical procedures may be performed on men with advanced or recurrent disease.

Click here for more information on prostatectomy.

Radiation Therapy
Radiation therapy involves the use of various directed types of X-rays (radiation) to kill cancer cells and surrounding tissues.

External beam radiation therapy is the most common type of radiation therapy. Short pulses of tightly focused beams of X-rays are delivered from outside the body into the prostate for a few minutes each day. Regardless of the form of external radiation therapy, treatment courses usually run five days a week for about seven or eight weeks, and are done on an outpatient basis.
 
Proton treatment can hit a targeted prostate cancer tumor with energetic particles without affecting surrounding tissue. It is notably valuable for treating localized, isolated, solid tumors before they spread to other tissues and the rest of the body. 
 
Brachytherapy is a more recent development in which radiation is delivered from inside the prostate. Tiny metal pellets containing radioactive iodine or palladium are inserted into the prostate via needles that enter through the skin behind the testicles. Over the course of several months, the seeds give off radiation to the immediate surrounding area, killing the prostate cancer cells. By the end of the year, the radioactive material degrades, and the seeds that remain are harmless.
 

Click here for more information on radiation therapy.

Hormone Therapy
Prostate cancer cells are like other living organisms, meaning they need fuel to grow and survive. Because the hormone testosterone serves as the main fuel for prostate cancer cell growth, it’s a common target for therapeutic intervention in men with the disease.

Hormone therapy, also known as androgen-deprivation therapy or ADT, is designed to stop testosterone from being released or to prevent it from acting on the prostate cells. Although hormone therapy plays an important role in men with advancing prostate cancer, it is increasingly being used before, during, or after local treatment as well.

The majority of cells in prostate cancer tumors respond to the removal of testosterone. But some cells grow independent of testosterone and remain unaffected by hormone therapy. As these hormone-independent cells continue to grow unchecked, hormone therapies have less and less of an effect on the growth of the tumor over time.

For this reason, hormone therapy is not a perfect strategy in the fight against prostate cancer, and it does not cure the disease. It also carries some unwanted side effects. However, it remains an important step in the process of managing advancing disease, and it will likely be a part of every man’s therapeutic regimen at some point during his fight against recurrent or advanced prostate cancer.

Click here for more information on hormone therapy.

Chemotherapy
The term "chemotherapy" refers to any type of therapy that uses chemicals to kill or halt the growth of cancer cells. The drugs work in a variety of ways, but are all based on the same simple principle: stop the cells from dividing and you stop the growth and spread of the tumor. Chemotherapy, like all powerful drugs, can take a toll on the body. Paramount in all researchers’ minds is a way to maximize benefit while minimizing side effects. 

Click here for more information on chemotherapy.
 


Side Effects
It is important to understand that it is possible to deal with the two most common side effects of treatment for prostate cancer – incontinence (involuntary leakage of urine) and erectile dysfunction (difficulty achieving or maintaining an erection). The prostate is situated just under the bladder and is surrounded by the nerves that control erections, which is why surgery, radiotherapy and other treatments commonly cause these side effects at least temporarily. If the problems don’t go away there are now many medical and surgical treatments available to cure incontinence and erectile dysfunction.

Click here for more information on the side effects of prostate cancer treatment.


RESOURCES
Our health partners publish a series of helpful guides and additional resources to help connect men and their loved ones to the latest prostate cancer research and survivorship information
Visit Men’s Health Resources for Movember’s sources, or email: info.us@movember.com