Studies have shown that advancing age, race, hormonal influences, and environment all play a role in its development. There is also a strong family history variable, individuals who have a immediate family member with Prostatic cancer are two times as likely to develop the disease. If two family members are affected then the risk of a third member of the family can be as high as five times that of the general population.

The Prostate is a small walnut size gland that surrounds the urethra near the base of the bladder. Normalejaculation produces about 3cc of semen.  The sperm makes up less than one percent of the volume, with the seminal vesicles and the prostate producing about ninety-five percent of the total volume.

Symptoms

Many men as they get older will develop benign prostate hyperplasia. This is a non- cancerous enlargement of the prostate gland.  As the gland enlarges it can impede the flow of urine causing symptoms that are very similar to those found in individuals with prostate cancer. Therefore men who experience any of the following symptoms should seek immediate medical advice:

• Difficulty in urinating resulting in increase in frequency and/or interrupted flow of urine
• Pain or a burning sensation when urinating
• Pain in the lower back, upper thighs or pelvis region

Many times the above symptoms will not be present until the prostate cancer is in the advance stages. Therefore all men over the age of forty should have a complete physical including a rectal exam.  The rectal exam can readily detect an enlarged prostate and in some cases prostate cancer. 

If your physician suspects you are at risk he/she may order some diagnostic tests. The tests may include a Prostate Specific Antigen, which detects an abnormal substance released by cancer cells. Transrectal ultrasound is another diagnostic test that uses a probe that is inserted into the rectum and can identify identify abnormalities within the prostate.

Theses initial test may warrant a biopsy of the tissue. The physician will then obtain a biopsy of the tissue by inserting a small needle through the rectum to remove some prostate cells. A pathologist who grades the cancer subsequently examines these cells.  The grade of the cancer can determine the method of treatment. Generally, a lower grade tumor is easily managed as compared to a high-grade tumor that is more aggressive and likely to spread to other regions. The Gleason system provides a good correlation between the histologic appearance of a carcinoma and the clinical stage (how far the tumor as spread) and the prognosis of the neoplasm.

Treatment Options

Depending on the diagnosis your physician will determine your treatment options. Radiation and surgery are generally used when the cancer is confined to the prostate, while hormonal treatment is used when the cancer has spread to other regions.

Radiation  - this form of treatment is usually indicated when the cancer is confined to the prostate or if the cancer as spread to other regions but surgery is not an option. Radiation therapy is usually performed on an outpatient basis and involves high doses of radiation directed at the prostate. Treatment may last for several weeks depending on the grade and/or the size of the tumor. Side effects include burning while urinating, headaches, nausea and vomiting, etc.

Surgery - involves the excision of the prostate gland by an urologist.  The procedure

involves excising the prostate while avoiding the surrounding urethra and nerves. Side effects from surgery can include incontinence and/or impotence.

Hormonal - treatment is generally used when the prostate cancer has spread to other regions of the body and/or when surgery is not an option. Hormonal therapy works by depriving the tumor cells of testosterone a hormone that promotes growth of the malignant cells.  By limiting the amount of Testosterone the tumor will generally reduce in size. Hormonal therapy can be provided by surgical excision of the testes or by taking prescription medications such LH-HR analogs, which prevent the body from producing Testosterone. Side effects of the LH-HR analogs include impotence and possibly hot flashes.

The prognosis of individuals with prostate cancer is primarily related to the stage of the disease. Localized disease treated with surgery and/or radiotherapy can expect a 10-year survival rate of 50 to 80%. Individuals with advanced disease treated with orchiectomy, or the administration of LH-HR analogs can expect 10-year survival rates 10-40%.

Although treatment methods have improved in recent years early detection is still the mainstay to treating the disease. Males over the age of 40 years of age should have a complete physical exam on a yearly basis.