What is cancer of the prostate? Cancer of the prostate, a common form of cancer,
is a disease in which cancer (malignant) cells are found in the prostate. The
prostate is one of the male sex glands and is located just below the bladder and
in front of the rectum. The prostate is about the size of a walnut. It surrounds
part of the urethra, the tube that carries urine from the bladder to the outside
of the body. The prostate makes fluid that becomes part of the semen, the white
fluid that contains sperm. Cancer of the prostate is found mainly in older men.
As you get older, your prostate may get bigger and block the urethra or bladder,
which can cause you to have difficulty urinating or may interfere with sexual
functions. This condition is called benign prostatic hyperplasia (BPH), and
although it is not cancer, you may need surgery to correct it. The symptoms of
BPH or of other problems in the prostate may be similar to symptoms for prostate
cancer. Following are common symptoms of prostate cancer: weak or interrupted
flow of urine, urinating often (especially at night), difficulty urinating, pain
or burning when you urinate, blood in the urine, or nagging pain in the back,
hips, or pelvis. Often there are no symptoms of early cancer of the prostate.
{Samuel R. Denmeade, American Association for Cancer Research} Stage
Explanation: {Judd W. Moul, Monographs in Urology 1995} - Stages of cancer of
the prostate: Once cancer of the prostate has been found (diagnosed), tests can
be done to find out if cancer cells have spread from the prostate to tissues
around it or to other parts of the body. This is called "staging." It
is very important to know the stage of the disease to plan treatment. The
following stages are used for cancer of the prostate:- Stage I (A) Prostate
cancer at this stage cannot be felt and causes no symptoms. The cancer is only
in the prostate and usually is found accidentally when surgery is done for other
reasons, such as for BPH. Cancer cells may be found in only one area of the
prostate or they may be found in many areas of the prostate. Stage II (B) The
tumor may be shown by a blood test or felt in the prostate during a rectalexam,
but the cancer cells are found only in the prostate gland. Stage III (C) Cancer
cells have spread outside the covering (capsule) of the prostate to tissues
around the prostate. The glands that produce semen (the seminal vesicles) may
have cancer in them. Stage IV (D) Cancer cells have spread (metastasized) to
lymph nodes (near or far from the prostate) or to organs and tissues far away
from the prostate such as the bone, liver, or lungs. Recurrent Recurrent disease
means that the cancer has come back (recurred) after it has been treated. It may
come back in the prostate or in another part of the body. Prostate staging can
also be described by using T (tumor size), N (extent of spread to lymph nodes),
and M (extent of spread to other parts of the body). Treatment options for
Prostate Cancer How cancer of the prostate is treated- Three kinds of treatment
are commonly used: - Surgery (taking out the cancer) - Radiation therapy (using
high-dose x-rays or other high-energy rays to kill cancer cells) - Hormone
therapy (using hormones to stop cancer cells from growing). Surgery is a common
treatment for cancer of the prostate. The cancer may taken out using one of the
following operations: Radical prostatectomy removes the prostate and some of the
tissue around it. The may be done surgery by cutting into the space between the
scrotum and the anus (the perineum) in an operation called a perineal
prostatectomy or by cutting into the lower abdomen in an operation called a
retropubic prostatectomy. Radical prostatectomy is done only if the cancer has
not spread outside the prostate. Often before the prostatectomy is done, a
surgery to take out lymph nodes in the pelvis to see if they contain cancer is
done. This is called a pelvic lymph node dissection. If the lymph nodes contain
cancer, usually a prostatectomy will not be done. Impotence and leakage of urine
from the bladder can occur in men treated with surgery. Transurethral resection
cuts cancer from the prostate using a tool with a small wire loop on the end
that is put into the prostate through the urethra. This operation is sometimes
done to relieve symptoms caused by the tumor before other treatment or in men
who cannot have a radical prostatectomy because of age or other illness.
Cryosurgery is a type of surgery that kills the cancer by freezing it. {David C.
Smith, Rodney L. Dunn, Myla S. Strawderman, and Kenneth J. Pienta, Journal of
Clinical Oncology, May 1998} Radiation therapy uses high-energy x-rays to kill
cancer cells and shrink tumors. Radiation may come from a machine outside the
body (external radiationtherapy) or from putting materials that produce
radiation (radioisotopes) through thin plastic tubes in the area where the
cancer cells are found (internal radiation therapy). Impotence may occur in men
treated with radiation therapy. {Jeffrey M. Kamradt- Advances in Oncology, Jun
1998} Hormone therapy uses hormones to stop cancer cells from growing. Hormone
therapy for prostate cancer can take several forms. Male hormones (especiallytestosterone)
can help prostate cancer grow. To stop the cancer from growing, female hormones
or drugs that decrease the amount of male hormones made may be given. Sometimes
an operation to remove the testicles (orchiectomy) is done to stop the testicles
from making testosterone. This treatment is usually used in men with advanced
prostate cancer. Growth of breast tissue is a common side effect of therapy with
female hormones (estrogens); hot flashes can occur after orchiectomy and other
hormone therapies. {Mark A. Moyad, Cancer Communication Newsletter, Jun 1998}