Men's Health Tips

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Mo Your Body!
Get Educated about Prostate Cancer

THE STATS

• 1 in 6 men will be diagnosed with prostate cancer in their lifetime - a new case is diagnosed every 2.1 minutes.A man dies from prostate cancer every 18 minutes.
• In 2012, 242,000 new cases of the disease will be diagnosed and 28,000 men will die of prostate cancer.
• Prostate cancer is the most frequently diagnosed cancer in men after skin cancer.
• A man is 35% more likely to be diagnosed with prostate cancer than a woman is to be diagnosed with breast cancer.
• The incidence rates are nearly double for African American men.
• If detected and treated early, prostate cancer has a 95 percent success rate.
• While there are cases of prostate cancer showing up in younger men, it is recommended that men begin an annual screening at age 50 and at age 40 if there is a family history.

WHAT IS PROSTATE CANCER?

The normal prostate is a small, squishy gland about the size of a walnut. It sits under the bladder and in front of the rectum. The urethra-the narrow tube that runs the length of the penis and carries both urine and semen out of the body-runs directly through the prostate. The rectum, or lower end of the bowel, sits just behind the prostate and the bladder. Sitting just above the prostate are the seminal vesicles-two little glands that secrete about 60% of the substances that make up semen. Running alongside and attached to the sides of the prostate are the nerves that control erectile function.

The prostate is not essential for life, but it's important for reproduction. The prostate typically grows during adolescence under the control of the male hormone testosterone and its byproduct DHT, or dihydrotestosterone. Prostate cancer occurs when cells within the prostate grow uncontrollably, creating small tumors.  The term "cancer" refers to a condition in which the regulation of cell growth is lost and cells grow uncontrollably.  Most cells in the body are constantly dividing, maturing and then dying in a tightly controlled process.  Unlike normal cells, instead of dying, as they should, cancer cells outlive normal cells and continue to form new, abnormal cells. Prostate cancer typically is comprised of multiple very small, primary tumors within the prostate.  At this stage, the disease is often curable (rates of 90% or better) with standard interventions such as surgery or radiation that aim to remove or kill all cancerous cells in the prostate. Unfortunately, at this stage the cancer produces few or no symptoms and can be difficult to detect.

HOW CURABLE IS PROSTATE CANCER?

As with all cancers, "cure" rates for prostate cancer describe the percentage of patients likely remaining disease-free for a specific time. In general, the earlier the cancer is caught, the more likely it is for the patient to remain disease-free.

Because approximately 90% of all prostate cancers are detected in the local and regional stages, the cure rate for prostate cancer is very high-nearly 100% of men diagnosed and treated at this stage will be disease-free after five years. By contrast, in the 1970s, only 67% of men diagnosed with local or regional prostate cancer were disease-free after five years. However, being diagnosed with prostate cancer can still be a life-altering experience. It requires making some very difficult decisions about treatments that can affect not only the life of the man diagnosed, but also the lives of his family members in significant ways for many years to come. Prostate cancer can be slow to grow following initial therapy, and it has been estimated that about 20-30% of men will relapse after the five-year mark and begin to show signs of disease recurrence.

RISK FACTORS

Prostate cancer is the most common non-skin cancer in America, affecting 1 in 6 men. The older you are, the more likely you are to be diagnosed with prostate cancer. Although only 1 in 10,000 under age 40 will be diagnosed, the rate shoots up to 1 in 38 for ages 40 to 59, and 1 in 15 for ages 60 to 69. In fact, about 97% of all prostate cancers are diagnosed in men 50 and older.

The roles of race and family history are important as well. African American men are 60% more likely to develop prostate cancer compared with Caucasian men and are nearly 2.5 times as likely to die from the disease.

Genetic studies suggest that strong familial predisposition may be responsible for 5%-10% of prostate cancers.

Men with a first-degree relative-father, brother or son-with a history of prostate cancer are twice as likely to develop the disease, while those with two or more relatives are nearly four times as likely to be diagnosed. The risk is even higher if the affected family members were diagnosed at a young age, with the highest risk seen in men whose family members were diagnosed before age 60.

Although genetics might play a role in deciding why one man might be at higher risk than another, social and environmental factors, particularly diet and lifestyle are likely to have an effect as well. In recent years, research has shown that diet modification might decrease the chances of developing prostate cancer, reduce the likelihood of having a prostate cancer recurrence, or help slow the progression of the disease. When weighing risk factors for prostate cancer, it's also important to recognize that there are non-risk factors, or factors that have not been linked to an increase in risk.

SCREENING

The purpose of screening is to detect prostate cancer at its earliest stages, before any symptoms have developed. Typically, prostate cancer that's detected by screening is in the very early-stages and can be treated most effectively. Physicians can screen for prostate cancer quickly and easily in their office using two tests: the PSA (prostate-specific antigen) blood test and the digital rectal exam (DRE).

Ultimately, decisions about screening should be individualized based on a man's level of risk, overall health, and life expectancy, as well as his desire for eventual treatment if he is diagnosed with prostate cancer. When to start screening is generally based on individual risk, with age 40 being a reasonable time to start screening for those at highest risk (genetic predispositions or strong family histories of prostate cancer at a young age). For otherwise healthy men at high risk (positive family history or African American men), starting at age 40-45 is reasonable.

It's important for men to create a proactive prostate health plan based on your lifestyle and family history, as well as to discuss these tests with your doctor to make the screening decisions that are best for you.

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PROSTATE CANCER RESOURCES

Prostate Cancer Foundation website

American Cancer Society website

CDC - Prostate Cancer