What is Prostate Cancer?
Prostate cancer is the most prevalent cancer among men, with approximately 12.6% of men receiving a diagnosis at some point in their lives. Fortunately, the survival rate remains high, with a 5-year survival rate of 96.8%. The decline in prostate cancer-related deaths in the U.S. is due to advancements in screening and treatment options. In this article, we will discuss prostate cancer, its risk factors, symptoms, and the importance of early detection.
Causes and Risk Factors for Prostate Cancer
The exact cause of prostate cancer is not yet clear, but it is believed to involve a complex interplay of factors. At the molecular level, prostate cancer occurs when DNA changes in cells lead to abnormal growth and cell proliferation in the prostate. Several known risk factors for prostate cancer include:
- Age: Prostate cancer is more common in men over 50 years old.
- Race: Black patients have a higher risk for prostate cancer compared to non-Black patients, with more advanced and aggressive forms often observed.
- Family history: A family history of prostate cancer increases the risk. Certain gene mutations like BRCA1 or BRCA2, also associated with breast cancer, increase the likelihood of developing prostate cancer.
- Obesity: A correlation exists between obesity and the incidence of prostate cancer.
Signs and Symptoms of Prostate Cancer
There is a range of signs and symptoms for prostate cancer. Not all patients will experience these symptoms. It is important to note that a lot of cases of prostate cancer are also localized and asymptomatic when initially discovered.
- Difficulty initiating urination: A mass within the prostate may press on the urethra, disrupting the urination process.
- Weak or dribbling urine stream: Prostate cancer may impinge on the urethra, causing a weak or dribbling stream.
- Nocturia: Pressure on the bladder from prostate cancer can increase the sensation of needing to void, even with an empty bladder.
- Incomplete bladder emptying: Prostate cancer may obstruct the urethra, leading to difficulty emptying the bladder completely.
- Hematuria: Blood in the urine may indicate malignancy, urinary infection, or bladder irritation.
- Pain in the abdomen or pelvis: Persistent dull pain in the abdomen or pelvic area may be caused by malignancy.
- Painful ejaculation: Prostate cancer can disrupt nerves, resulting in painful ejaculation.
Early Detection of Prostate Cancer is Key
Early detection is important as this can guide treatment options. Screening for prostate cancer is commonplace. Screening for prostate cancer is a commonly practiced regimen and should generally begin when a man becomes 40 years old. Screening can help detect early-stage disease which may not be readily apparent. Additionally, screening and treatments can lead to more personalized surveillance plans.
Your primary provider will often obtain a prostate-specific antigen (PSA) test, which measures the level of prostate-specific antigens within your blood. Some providers will also conduct digital rectal exams, whereby your provider will use a gloved, lubricated finger to assess the prostate gland via the rectum. It has been suggested that for some types of prostate cancer, earlier detection is associated with better prognosis. Screening itself has led to a recent decrease in prostate cancer-related deaths [2].
Screening for prostate cancer in Houston, TX
Blood tests
PSA blood test is a very common test used for assessment for prostate cancer. This is a blood test that can be done every one to two years for men about the age of 40 years old. higher levels of PSA correlate with increased chance of prostate cancer. However, it is important to note that there is no set cutoff point. Some providers will use a PSA cutoff point of 4 ng/mL to guide further assessment and management, but this will vary between patients and providers. It is generally accepted that men with PSA levels between 4 and 10 have about a 25% chance of having prostate cancer, and those with PSA levels above 10 have about a 50% chance of having prostate cancer [3]. It is important to note that other factors may affect PSA level. These include:
- Larger prostate gland sizes
- Older age
- Prostatitis
- Ejaculation
- Mechanical trauma
- Medications
Exams
The digital rectal exam (DRE) is another way to assess the prostate. In this case, your doctor will insert a gloved, lubricated finger into the rectum to assess the prostate gland. During this exam, the physician will assess for any anatomic irregularities, such as bumps or hard areas, within the prostate. While this exam may be uncomfortable, it is generally very fast.
Biopsy
In the event of a suspicious PSA or DRE, you may be referred for a prostate biopsy. A biopsy allows a physician to take a sample of the prostatic tissue for microscopic assessment. In this case, a thin needle is used to take a sample of tissue from the prostate.
Ultrasound/MRI/CTA
If PAE becomes an option for your treatment plan additional imaging may offer valuable information about the anatomy of your prostate. This allows your physician, an interventional radiologist, to assess the anatomy of your prostate, including the vasculature and volume. This allows for improved intraprocedural guidance.
Prostate cancer screening is common among primary care providers. Reach out to Dr. Maneevese today for help scheduling an appointment.
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