Prostate Cancer

Overview

Prostate cancer is now the second most common, if not the most common, cancer in men in the U.S.  Overall, about 13% of men in the U.S. will be diagnosed with prostate cancer in their lifetime.  Every year 60,000 to 70,000 men find out they have prostate cancer and about 20,000  men die from prostate cancer.

Prostate cancer usually happens to men in their 50’s or later but it can occur in younger men as well.  Unlike most cancers, prostate cancer is very slow growing.  We know, in fact, that, because it is a very slow process and usually occurs in older men, most men with prostate cancer will not die from prostate cancer.  

Who Gets Prostate Cancer?

It’s a guy thing.  Obviously enough, all men are at risk to get prostate cancer.  There are, however, some things (risk factors) that make it more likely that a particular man might get prostate cancer.  Prostate cancer runs in families.  So, if your father or a brother has or had prostate cancer, you are more likely to get it.  African-American men seem to have a higher risk of prostate cancer.  Men who served in Vietnam get prostate cancer more often because of exposure to Agent Orange and other toxins.

How do I Know if I Have Prostate Cancer?

Unfortunately, there are no warning signs or symptoms of early prostate cancer.  Therefore, it is important that men get checked (screened) periodically for prostate cancer.  As with all forms of cancer, it is best to find out about it early on rather than late in the course of the disease.  The most widely accepted way to screen for prostate cancer is to do a prostate exam (called a digital rectal exam) and a PSA blood test.  For men who have an abnormal prostate exam or an elevated PSA, a urologist will usually recommend a prostate biopsy.

You may be aware that our approach to prostate cancer screening and use of PSA in the U.S. have been controversial for many years.  These topics are covered in greater detail on another page on this website.

How is Prostate Cancer Diagnosed?

The vast majority of prostate cancers are now diagnosed on the basis of an elevated PSA.  Prostate exams are still important, however, because there is a small number of men who will have significant prostate cancer but still have a normal PSA.  These cancers sometimes show up as a “lump”, nodule or irregularity on prostate exam.

In recent years, it has become more common to use MRI to diagnose prostate cancer.  There are special MRI techniques that provide excellent images of the prostate and can identify areas that are suspicious for prostate cancer.  MRI is not always necessary but is often helpful especially if there is continued concern about prostate cancer after a negative prostate biopsy.

If there is concern for prostate cancer because of an elevated PSA or an abnormal prostate exam or MRI, the only way to know for sure is to perform a prostate biopsy.  A biopsy involves taking tissues samples from the prostate which are examined by a pathologist under the microscope to determine whether or not prostate cancer is present.

More information regarding prostate biopsy can be found here.

What Should I Do if I Have Prostate Cancer?

First of all, don’t panic.  There are many options for dealing with prostate cancer and we are usually successful.

Because of the slow nature of prostate cancer, many men will never have problems from prostate cancer and will never need any treatment at all.  For some men, surgery to remove the prostate is the best option.  For others, radiation may be a better choice.  Hormonal therapy, chemotherapy, immunotherapy or combinations thereof may be necessary. More information on the treatment of prostate cancer can be found here.

We hope that this answers some of your questions about prostate cancer.  Call Gallatin Urology (406–551–2306) for an appointment if you would like more information or if you have concerns about prostate cancer.