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.
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.
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.
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.