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Prostate cancer: Early detection saves lives

» What is the prostate gland?

» Diagnosing prostate cancer

» Treatment options

Watch for these symptoms

  • a weak or interrupted stream of urine
  • a frequent urge to urinate, especially at night
  • difficulty in starting to urinate
  • blood or pus in the urine
  • pain or burning upon urination
  • continuing pain in the lower back, pelvis or upper thighs

Guidelines for early detection: What the experts say

The American Cancer Society recommends a digital rectal exam (DRE) and a prostate-specific antigen (PSA) test yearly, starting at age 50 for men who have at least a 10-year life expectancy. Men at high risk, such as African Americans and men who have one or more first-degree relatives—a father or a brother—diagnosed with prostate cancer at an early age (younger than 65) should begin testing at 45. Talk to your doctor about the benefits and limitations of testing and subsequent treatment so you can make an informed decision about testing.

Prostate cancer is the most common cancer in men. It’s also the second most deadly (after lung cancer). The good news is that prostate cancer can be detected earlier than ever, when treatment is most likely to be effective.

What is the prostate gland?

The prostate gland is located under a man’s bladder. The urethra (the duct that carries urine out of the body) passes through the prostate gland. That’s why disorders of the prostate—from benign enlargement to cancer—cause urinary symptoms such as decreased strength of urine stream, difficulty starting to urinate and painful urination.

The prostate gland plays an important role in reproduction, adding fluids to semen that, among other things, appear to increase the ability of sperm to survive the journey toward the egg.

Diagnosing prostate cancer

Experts agree that the best way to find prostate cancer early is a combination of two tests. Used together, these tests can pick up most prostate cancers at a curable stage. The first test is the digital rectal exam, or DRE. In DRE, a doctor feels the prostate through the wall of the rectum to check for abnormalities. The second test is the prostate-specific antigen (PSA) test. This blood test, which measures a protein made only by the prostate, can detect cancers at an earlier stage than ever before.

Unfortunately, the PSA test has a fairly high false-positive rate because conditions other than cancer, such as benign prostatic hypertrophy (enlarged prostate) or prostatitis (a prostate infection), can cause the prostate to secrete increased amounts of the PSA protein. This means that the PSA test sometimes suggests cancer, which further testing shows to be a false alarm.

Treatment options

Once prostate cancer has been diagnosed, treatment depends on a number of factors—not only whether the cancer has spread, but also the man’s age, health, expected life span and level of concern about possible side effects.

Hormonal therapy, radiation therapy and/or surgical removal of the prostate gland (and, if the cancer has spread, the testicles) may be recommended. Brachytherapy, a relatively new treatment, involves placing radioactive “seeds” into or near the cancer to shrink tumors while minimizing exposure to surrounding healthy tissues. Older men with small, slow-growing cancers may be monitored to determine if treatment might be needed later.

© 2014 Dowden Health Media