Prostate Cancer

Prostate cancer is the most common cancer among American men and the second leading cause of cancer deaths (after lung cancer). This year, the American Cancer Society projects 184,500 new cases of prostate cancer in the United States and 39,200 deaths. For reasons that are not clearly understood, the disease is twice as common among African-American men than white men.

The risk of prostate cancer increases with age. More than 80 percent of all prostate tumors are diagnosed in men over age 65. In some men, prostate cancer is a slow-growing disease, and they may eventually die of other causes rather than from prostate cancer. For others, the disease can be very aggressive and requires treatment.

A family history of prostate cancer may increase an individual's risk of developing the disease, particularly if there are a number of close relatives who have been diagnosed with prostate tumors or if any relatives were younger than 60 at the time of diagnosis. Studies also suggest that a high-fat diet may increase the risk of prostate cancer.

The prostate is a walnut-sized gland located just below the bladder. Proper functioning of the prostate is important to bladder control and normal sexual functioning. Symptoms of prostate cancer can include frequent urination or an inability to urinate, trouble starting or holding back urine, and frequent pain or stiffness in the lower back, hips, or upper thighs. However, these symptoms are also seen with a common, non-cancerous condition called benign prostatic hyperplasia (BPH), which is an enlargement of the prostate gland. It is important to seek medical attention for any of these symptoms to ensure the proper diagnosis and treatment.

Many men learn they may have prostate cancer following a digital rectal examination, in which the doctor feels the prostate to check for abnormalities, or a blood test to detect the amount of prostate specific antigen (PSA) circulating in their blood. (High PSA levels -- greater than or equal to 4.0 ng/ml -- are a possible indicator of cancer.) If either test is abnormal, your physician may advise a biopsy, which involves inserting several needles into the prostate to withdraw cells. The cells are then examined under a microscope. Only a biopsy can confirm the diagnosis of prostate cancer.

All men 40 years of age and older should have an annual rectal exam. In addition, the American Cancer Society recommends that men receive an annual PSA test beginning at age 50. Men with a family history of prostate cancer as well as African-American men should receive an annual PSA test beginning at age 45.

The chance of recovery following prostate cancer and the choice of treatment for the disease depend on a patient's age, the stage of his cancer (whether it is just in the prostate or has spread to other places in the body), and his general health. Early-stage prostate cancer means that the disease is confined within the prostate gland. Treatment options for early-stage prostate cancer include surgery, radiation therapy, and watchful waiting (careful observation without further immediate treatment). In addition, a low-fat diet may also slow disease progression. Hormones and chemotherapy or combinations of these options may be considered for tumors that have spread beyond the prostate. Chemotherapy alone can be used in cases where the disease has spread and where hormonal treatments alone are no longer effective in preventing tumor growth. It also helps to relieve the symptoms of prostate cancer.

Nearly 60 percent of all prostate tumors are diagnosed while they are still confined to the prostate gland. For patients whose tumors are diagnosed at this stage, the five-year survival rate is 99 percent. According to the American Cancer Society, the survival rate for all stages of prostate cancer combined has increased from 50 percent to 87 percent over the past 30 years.

Since prostate cancer is generally a slow-growing disease, delaying the onset or progression of the disease could be tantamount to a cure. A recent study showed that a low-fat diet may slow the progression of prostate cancer. In animal studies, mice with induced human prostate cancer tumors had slower disease progression when fed a low-fat diet. A study is now under way at Memorial Sloan-Kettering Cancer Institute in the United States to determine if a low-fat diet with or without supplements of selenium, vitamin E, and soy protein can reduce PSA levels in prostate cancer patients who have had surgery or radiation therapy to remove their tumors but whose PSA levels have begun to rise -- an indicator that cancer is still present.

Questions and Answers About Prostate Cancer

How common is prostate cancer?

Prostate cancer is the most commonly diagnosed cancer among men in the United States and the second leading cause of cancer death (behind lung cancer). Prostate cancer is generally a slow-growing disease, so many men with the disease will die of other causes rather than from prostate cancer.

What are the symptoms of prostate cancer?

Symptoms of prostate cancer include frequent urination or an inability to urinate, trouble starting or holding back the flow of urine, and frequent pain or stiffness in the lower back, hips, or upper thighs. However, these symptoms are also seen with a common, non-cancerous condition called benign prostatic hyperplasia (BPH), which is an enlargement of the prostate gland. It is important to seek medical attention for any of these symptoms to ensure proper diagnosis and treatment.

What causes prostate cancer?

Certain factors have been linked to an increased risk of prostate cancer. The incidence of the disease increases with age; more than 80 percent of all prostate cancers are diagnosed in men over age 65. African-American men and men with a family history of the disease may also be at increased risk. Studies suggest that high dietary fat intake may also play a role in prostate cancer development. These risk factors are currently under study to determine their role in the disease.

How is prostate cancer treated?

There are different ways to treat the disease. The prostate gland may be removed through surgery. Some patients receive radiation therapy, chemotherapy, or hormone therapy. The patient's age, tumor type, and the extent of disease are taken into account when deciding which course of therapy will be most effective.

Is there any way I can prevent prostate cancer or detect it early?

There is no sure way to prevent prostate cancer, although studies are under way to see if a low-fat diet can reduce prostate-cancer risk. Due to new screening tests, more prostate tumors are being detected early, when they are most curable. Every man age 40 and over should a digital rectal examination as part of an annual physical checkup. Through this method, a doctor can feel the prostate gland for irregularities. In addition, men age 50 and over should have an annual blood test for prostate-specific antigen, or PSA. Elevated levels of PSA may indicate a need for additional follow-up. Men with a history of prostate cancer, well as African-American men, should have the PSA test starting at age 45.

HARRY KOCHAT
BioNumerik Pharmaceuticals Inc.
(An oncology based company based in San Antonio, Texas, USA)


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