Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.
Prostate cancer is a slow-growing cancer of the prostate gland. Prostate cancer actually refers to a wide spectrum of diseases, with some tumors being aggressive and others that act more benign.
Prostate cancer is the third most common cancer in the United States and the second leading cause of cancer-related deaths in men.
Urination issues are the most common symptoms of the disease, though most cases are first detected by screening tests, such as a prostate-specific antigen (PSA) test. A formal diagnosis can only be made with tests such as an ultrasound-guided or MRI-targeted biopsy. Treatment options range from active surveillance (careful monitoring) to surgery and radiation and depend on your case.
What causes prostate cancer is uncertain, but there are known risk factors, such as age or inherited genetic mutations. Roughly 80% of men are diagnosed after the age of 65. It develops more frequently in African Americans and Caribbean men of African ancestry. Having high levels of androgens (hormones) or being exposed to Agent Orange or occupational pesticides may also increase risk.
It’s unknown what may help prevent prostate cancer, but lifestyle factors that may be helpful include eating a diet that’s high in fruits and vegetables and low in red meat and dairy and exercising regularly. Discuss screenings with a physician if you are over age 45, or after age 40 if you have a family history of prostate cancer or gene mutations linked to prostate cancer.
When prostate cancer is caught early, treatments can cure the disease. Also, many prostate cancers are considered non-aggressive and may never progress or cause symptoms. In these cases, careful monitoring of the tumor (active surveillance) for signs of progression may be recommended before considering surgery, radiation, and other therapies.
About 5% to 10% of prostate cancers are hereditary, including inherited gene mutations such as BRCA1 and BRCA2, that are linked to other cancers. The chance that a prostate cancer is hereditary is increased if first-degree relatives have had prostate cancer.
Carefully monitoring a cancer (often every six months) and only treating it with surgery or therapies if it begins to progress. Active surveillance is a common option for low-risk prostate cancers that are small and considered non-aggressive.
Inflammation of the prostate caused by a bacterial infection. Prostatitis can cause pain and urinary symptoms, such as increased frequency and/or urgency and difficulty urinating. These urinary symptoms overlap with symptoms of prostate cancer, but they are separate conditions. Tests, including urinalysis to check for bacteria, can help determine if prostatitis is causing the symptoms.
A walnut-size gland that is part of the male reproductive system and secretes a seminal fluid that’s a major part of semen. The prostate is located just below the bladder and surrounds the urethra, the tube from the bladder to the urethral opening in the penis. When cancer begins in the prostate, it is called prostate cancer.
A prostate-specific antigen (PSA) test is a blood test that measures a protein made by the prostate. Increased levels may indicate prostate cancer. Although, an abnormal PSA is just as likely to be due to a benign cause (such as prostatitis) as it is to be due to cancer. Similarly, men with prostate cancer can have a normal PSA. To make a prostate diagnosis, a biopsy needs to be done.
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