The prostate is a gland of the male reproductive system. The prostate produces some of the fluid for semen, which transports sperm during the male orgasm.

 

Normally, the prostate is quite small—it is nearly the same size and shape as a chestnut. It is located in front of the rectum, just below the bladder, and wraps around the urethra, the tube that carries urine from the bladder out through the tip of the penis. The prostate is made up of approximately 30% muscular tissue, and the rest is glandular tissue.

 

 

While researchers still do not know the exact answer to this question, they have identified some risk factors. These include environment, genetics and family history.

 

 

 

As the tumor grows, it may spread from one part of the prostate to surrounding areas. Symptoms of prostate cancer may include:

Stopping testicular production of testosterone may relieve many of these symptoms.

 

 

Determining whether you have prostate cancer generally involves a series of tests and exams. Before starting the testing process, your physician may ask you questions about your medical history, your family history of cancer and any symptoms you may be having, particularly problems with urination. Then, your doctor will most likely proceed to one or more of the tests described below.

 

Because the prostate lies in front of the rectum, your physician can feel the prostate by inserting a gloved, lubricated finger into the rectum. This simple procedure is called a digital rectal examination (DRE). It allows your physician to determine whether the prostate is enlarged or has lumps or other types of abnormal texture.

 

Used in addition to the DRE, a PSA test increases the likelihood of prostate cancer detection. PSA is the abbreviation for prostate-specific antigen, a substance produced by the prostate cells. A PSA test measures the level of PSA in the bloodstream and is reported as nanograms per milliliter, or ng/mL. Very little PSA escapes from a healthy prostate into the bloodstream, but certain prostate conditions can cause larger amounts of PSA to leak into the blood.

 

 

A benign noncancerous enlargement of the prostate called benign prostatic hyperplasia (BPH)

prostate cancer

 

A high level of PSA in the bloodstream is a warning sign that prostate cancer may be present. But since other kinds of prostate disease can also cause high PSA levels, PSA testing by itself cannot confirm the presence of prostate cancer. A high PSA level only indicates the possibility of prostate cancer and the need for additional evaluation by your physician. Conversely, a low PSA level does not always mean that prostate cancer is not present.

 

According to the American Cancer Society, men aged 50 and older, and those over the age of 45 who are in high-risk groups, such as African-American men and men with a family history of prostate cancer, should have a prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) once every year. Any man who develops persistent urinary symptoms should contact his physician.

 

Transrectal Ultrasound (TRUS) is the use of soundwaves to create an image of the prostate. As the waves bounce off the prostate, they create a pattern that is converted into a picture by a computer. TRUS is used to detect abnormal prostate growth and to guide a biopsy of the abnormal prostate area.

 

A biopsy is the removal of a sample of tissue, which is then examined under a microscope to check for cancerous changes. Only a biopsy can definitely confirm prostate cancer.

 

Typically, the physician takes multiple tissue samples for biopsy. Keep in mind that it is still possible to have cancer, even if the biopsy is negative. This is because, even though multiple samples are taken during a biopsy, it can still miss some cancers.

 

If the biopsy is taken and prostate cancer is found, the tumor is graded in the medical lab. The grade estimates how aggressive a prostate cancer is; that is, how fast it is growing and the likelihood of its spreading. Sometimes you will hear the grade referred to as the Gleason grade.

 

Once diagnosis is made, prostate cancer is categorized into stages based on the size and spread of the disease. Learn more about grading and staging of prostate cancer.

 

 

Once prostate cancer is discovered, the tumor is graded and staged. The grade estimates how aggressive a prostate cancer is; that is, how fast it is growing and the likelihood of its spreading.

 

The staging estimates the size and location of the cancer (including how far it has spread). Grading and staging will help determine what type of treatment, if any, is most appropriate.

 

The grade indicates how different the cancer cells appear from normal cells, when seen through a microscope. Sometimes you will hear the grade referred to as the Gleason grade. A Gleason grade ranges from 1 through 5.

 

Prostate cancers often have areas with different grades. Therefore, a grade is assigned to each of the two areas that make up most of the cancer. These two grades are added together to yield a Gleason score of between 2 and 10. Low Gleason grades and scores indicate slow-growing cancer. High grades and scores indicate a cancer likely to grow aggressively.

 

Staging is the assessment of the size and location of prostate cancer (that is, how far the cancer has already spread). Staging is necessary for the patient and physician to decide what type of treatment is most appropriate.

 

Currently there are two different systems used to stage prostate cancer. The traditional method classifies the disease into four clinical categories rated A through D. The second system is called TNM, which stands for Tumor-Nodes-Metastases.

 

 

 

Stage A is early cancer. The tumor is located within the prostate gland and cannot be felt during a DRE (Digital Rectal Examination).

 

 

In Stage B, the tumor is considered to be within the prostate and can be felt during a DRE (Digital Rectal Examination).

 

 

In Stage C, prostate cancer is more advanced. Stage C indicates that the tumor has spread outside the prostate to some surrounding areas, but not to other organs. This stage of cancer can usually be detected by a DRE (Digital Rectal Examination).

 

 

In Stage D, the cancer has spread to the nearby organs and usually to distant sites, such as the bones or lymph nodes.

 

 

TNM staging takes into consideration tumor size (T) and whether the cancer has spread to lymph nodes (N) or metastasized (M) to distant sites in the body.

 

Tumor size is assessed on a scale of 1 to 4. Generally, tumors graded T1 are confined to the prostate gland but are so small that they cannot be felt during a DRE or detected during ultrasound. T2 prostate cancer is confined to the prostate, but it is large enough to be detected during a DRE. T3 and T4 prostate cancers have expanded beyond the prostate into surrounding tissues.

 

Lymph node involvement is graded on a scale of 0 to 3. N0 means that the cancer has not spread into the lymph nodes. The number and size of lymph nodes involved dictates whether the cancer is N1, N2 or N3.

 

Metastasis is rated 0 or 1. M0 means no metastasis has occurred; M1 indicates metastasis to a distant location.

 

Earlier diagnosis of prostate cancer has increased since the introduction of the PSA blood test. As a result, the overall prognosis for prostate cancer patients has dramatically improved compared with years ago. Over the past 20 years, the overall survival rates for all stages of prostate cancer combined have increased from 67% to 97%. According to the American Cancer Society, the five-year relative survival rate for patients whose cancers are detected while still in the local and regional stages is 100%.

 

The major treatment options for prostate cancer include:

These options are not listed in any particular order. The options selected for your treatment will depend on several factors, including your age, the stage of your disease and the advice of your physician.