What is the prostate gland?

The prostate gland is a part of the male reproductive system. It lies in front of and near the base of the rectum. The prostate makes a fluid that mixes with sperm and other fluids during ejaculation. A normal prostate is about the size of a walnut.

What is prostate cancer?

Who gets prostate cancer?

Prostate cancer is the second most common type of cancer in American men. Men of any age can get prostate cancer, but it is most common in men older than 50 years of age. Black men are more likely to get it than white men. Men with a father or brother who has had prostate cancer are also more likely to get it. Those with an abnormal rectal (prostate) exam may also be at a higher risk of prostate cancer.

How does my doctor check my prostate?

Your doctor may feel your prostate gland by putting a gloved lubricated finger a few inches into your rectum. This is called a digital rectal examination. A normal prostate feels firm but not hard. If there are hard spots or nodules, your doctor may suspect cancer. Your doctor can also draw a blood test called a PSA (prostate specific antigen). A referral to a urologist may be ordered.

Who should be screened?

Screening means looking for cancer before it causes symptoms. Some doctors recommend screening for men at high risk (such as black men and men with a family member who has had prostate cancer or those patients with abnormal prostate exams). 

Although screening finds many cases of cancer, it also finds less serious cancer or conditions that aren’t cancer at all. For example, as men age their prostates normally enlarge. This is called BPH (benign prostatic hypertioplay). The PSA rises also with this benign situation. This means that some men may have to go through unneeded tests and worry to make sure that they don’t have cancer. The prostate blood test can be positive or negative at times when there may not be or there may be cancer.  

How do I decide whether to be screened?

Talk to your doctor. Many times, prostate cancer doesn’t cause problems or shorten a man’s life. Some men would rather not know that they have cancer. Think about whether you would want to know. If you think you would want to know if you have prostate cancer, ask yourself if whether you would want treatment. Impotence and incontinence are not inconsequential potential complications of treatment. Up to this point, we really don’t know with certainty whether finding prostate cancer early makes a difference in the length of life one has thereafter. Perhaps other research will give us that answer in the future. We don’t know that answer today.

How is prostate cancer treated?

One option is “watchful waiting.” Watchful waiting means leaving the cancer alone, and seeing your doctor regularly, so that he or she can check up on it. This may be a good option especially for older men and those with a slow-growing cancer. At any time during watchful waiting, you can switch to a treatment option. 

Surgery, radiation, and medicines are other treatment options. Prostate cancer can be cured if it is caught early. However, these treatments can sometimes cause serious problems with sex and urination. Surgery or radiation or hormones may help treat more serious cancers. Serious cancers are more often found in middle age rather than older men.

Where can I get more information?

Talk to your primary care provider concerning prostate cancer. A very good website is produced by the Mayo Clinic at www.mayoclinic.com. A final website you might consider is produced by the National Cancer Institute telephone number 1-800-422-6237.  Their website can be found at www.cancer.gov.