There are no standard or routine screening tests for prostate cancer. Studies are being done to find ways to make prostate-specific antigen (PSA) testing more accurate for early cancer detection. A PSA test or digital rectal exam (DRE) may be able to detect prostate cancer at an early stage:
- DRE: It is an exam of the rectum (end part of the bowel). The doctor inserts a lubricated, gloved finger into the lower part of the rectum to feel the prostate for lumps or anything else that seems unusual.
- PSA test: It is a test that measures the level of PSA in the blood. PSA is a substance made mostly by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. The PSA level may also be high in men who have an infection or inflammation of the prostate or benign prostatic hyperplasia (an enlarged, but non-cancerous, prostate). A free PSA is a more precise marker for those who are at a high-risk case.
- Prostate cancer gene 3 (PCA3) RNA test: If a man has a high PSA level, a biopsy of the prostate does not show cancer, and the PSA level remains high after the biopsy, a PCA3 RNA test may be done. This test measures the amount of PCA3 RNA in the urine after a DRE. If the PCA3 RNA level is higher than normal, another biopsy may help diagnose prostate cancer.
- Prostate health index (PHI): This measures three different forms of the PSA protein to detect any prostate abnormalities including cancer.
- Magnetic resonance imaging (MRI) scan: An MRI scan uses a powerful magnet and radio waves to build up detailed pictures of the inside of the body. The doctor may suggest this scan to help work out if a biopsy is needed. An MRI can be used to show whether cancer has spread from the prostate to nearby areas. It can also help guide the biopsy needle. A specialized type of MRI called multi-parametric magnetic resonance imaging (mpMRI) is used for people suspected of having prostate cancer. This combines the results of three MRI images to provide a more detailed image.
What are the causes of prostate cancer?
The exact cause of prostate cancer is still unknown. Current risk factors for prostate cancer include:
- Age: The risk of prostate cancer increases with age.
- Race: African American men are more than twice as likely to be diagnosed with prostate cancer and to die from the disease.
- Family history: Men with a family history of prostate, breast, ovarian, colon, or pancreatic cancers may be at an increased risk of prostate cancer.
- Genetic mutations: Inherited mutations of BRCA1 or BRCA2 genes increase the risk of breast, ovarian, and prostate cancer in some families.
- Diet: Studies have indicated that there may be a link between a high-fat diet and the cause or prevention of prostate cancer.
- Chemical exposure: Exposure to certain chemicals such as pesticides and herbicides may have higher than average rates of prostate cancer. Veterans who were exposed to the defoliate Agent Orange are 49% more likely than non-exposed veterans to be diagnosed with prostate cancer.
- Firefighter: Recent studies have reported that firefighters are at a 28% higher risk to prostate cancer than the general population.
How is prostate cancer treated?
Not all prostate cancer requires treatment. Depending on the level of risk and stage of the disease, there are many different approaches to treating prostate cancer. Common approaches include:
- Active surveillance: This is often recommended for patients with low-grade prostate cancer. Prostate cancer can take a long time to grow. Active surveillance uses the latest imaging technologies to watch it and make sure it is not progressing.
- Surgical treatment options: Surgeons continually integrate innovative approaches into their practice to offer patients safer and more effective treatments. Minimally invasive surgical treatments include laparoscopic surgery and robotic-assisted surgery. Patients may also undergo removal of the prostate through more conventional surgery.
- Brachytherapy (radioactive seed implantation): In this treatment, radioactive seeds are implanted permanently in the prostate to give off radiation and provide localized treatment to the tumor.
- Intensity-modulated radiation therapy (IMRT): By targeting intense radiation on prostate tumors, urologists can minimize or even destroy them completely.
- Surgery, radiation, and hormonal therapy: These approaches can cause erectile dysfunction and other complications related to sexual health. However, within two years most men regain their potency and return to the sex life that they had before treatment.
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Marks LS, Bostwick DG. Prostate Cancer Specificity of PCA3 Gene Testing: Examples from Clinical Practice. Rev Urol. 2008;10(3):175-181. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556484/
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Enlarged Prostate (BPH, Benign Prostatic Hyperplasia)Benign prostatic hyperplasia (BPH or enlarged prostate) is very common in men over 50 years of age. Half of all men over the age of 50 develop symptoms of BPH, but few need medical treatment. This noncancerous enlargement of the prostate can impede urine flow, slow the flow of urine, create the urge to urinate frequently and cause other symptoms like complete blockage of urine and urinary tract infections. More serious symptoms are urinary tract infections (UTIs) and complete blockage of the urethra, which may be a medical emergency. BPH is not cancer. Not all men with the condition need treatment, and usually is closely monitored if no symptoms are present. Treatment measures usually are reserved for men with significant symptoms, and can include medications, surgery, microwave therapy, and laser procedures. Men can prevent prostate problems by having regular medical checkups that include a prostate exam.
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BPH SlideshowBenign Prostatic Hyperplasia (BPH) is a condition cause by an enlarged prostate. Get more information on how an enlarged prostate is diagnosed and available treatment for enlarged prostate glands.
How Does Prostate Cancer Kill You in the End?Prostate cancer is cancer of the prostate gland in men. Death from prostate cancer most often happens when cancer has spread (metastasized) to other organs in the body.
How Quickly Does Prostate Cancer Spread?Prostate cancer is a cancer that develops in the prostate gland in men and it is one of the most common types of cancer. In some cases, it can take up to eight years to spread from the prostate to other parts of the body (metastasis), typically the bones. In other cases, it may be more aggressive.
Prostate cancer is the most common cancer in men after skin cancer.
- Risk factors include age, family history, ethnicity, and diet.
- Prostate cancer is diagnosed by a digital rectal exam, prostate-specific antigen (PSA) test, and prostate biopsy.
- Symptoms may include
- frequent need to urinate,
- incontinence, pain,
- blood in the urine,
- fatigue, and more.
- Prognosis and treatment depend on cancer staging.
- Watchful waiting,
- cryotherapy, and
- other management strategies are available.
- Research and clinical trials strive to find new and better treatments for prostate cancer.
Prostate Cancer QuizIs prostate cancer the most common cancer in men? Take this prostate cancer quiz to find out and learn the causes, symptoms, and treatments of this disease.
Signs of Prostate Cancer: Symptoms, PSA Test, TreatmentsWhat is prostate cancer? Prostate cancer is the most common cancer in men. Learn the signs and symptoms of prostate cancer, along with causes and treatments. Know the stages, survival rates and how to lower your risk of prostate cancer.
Prostate Cancer Early Signs and Symptoms
Difficulty with urination – frequency, weak stream, trouble getting started, etc. – is usually the first sign of prostate cancer. But these and other early symptoms of prostatic cancer can also come from benign prostate conditions, so diagnostic testing is important, including PSA tests and digital rectal exam.
Illustrations of ProstateSide View of the Prostate. The prostate is a walnut-sized gland located between the bladder and the penis. See a picture of the Prostate and learn more about the health topic.
Prostate ProblemsThe prostate is a gland that is part of the male reproductive system and is located between the bladder and penis. Signs and symptoms of prostate problems include painful ejaculation, burning or pain while urinating, blood in the urine or semen, dribbling urine, frequent urination, urinary incontinence, and pain in the lower back, hips, upper thighs, or the pelvic or rectal area. Common causes of prostate problems in men are prostatitis, enlargement of the prostate gland (benign prostatic hyperplasia (BPH), and prostate cancer. Causes of prostate problems can assist in diagnosing prostate cancer. Treatments for prostate problems include medications, surgery, and hormone or radiation therapy.
Prostatitis (Inflammation of the Prostate Gland)Prostatitis is an inflammation of the prostate gland. Signs and symptoms of prostatitis include painful or difficulty urinating; fever; chills; body aches; blood in the urine; pain in the rectum, groin, abdomen, or low back; and painful ejaculation or sexual dysfunction. Causes of prostatitis include STDs, bacteria from urinary tract infections, or E. coli. Treatment for prostatitis depends on if it is a bacterial infection or chronic inflammation of the prostate gland.
Prostatitis vs. BPH (Enlarged Prostate): What Is the Difference?
Prostatitis and BPH (benign prostatic hyperplasia, enlarged prostate gland) are both conditions of the prostate gland.
There are four types of prostatitis that can be caused by infections (usually bacterial) or other health conditions or problems, acute bacterial prostatitis (type I), chronic bacterial prostatitis (type II), chronic prostatitis and chronic pelvic pain syndrome (type III), and asymptomatic inflammatory prostatitis (type IV).
BPH is inflammation of the prostate gland, and most men have the condition by age 50. Doctor's don't know what causes this inflammation, but they theorize that it may be related to hormones. Both of these conditions can cause similar symptoms like low back pain, pain during urination, or difficulty or the inability to urinate. However, prostatitis has many more symptoms and signs than BPH, and they based on the type of prostatitis. Examples include low back pain and/or abdominal pain, painful urination, fever, chills, feeling tired, recurrent urinary tract infections (UTIs), painful urination intermittently, intermittent obstruction urinary tract symptoms (frequent, painful, or incomplete urination), pelvic pain and/or discomfort, pain with ejaculation, and erectile dysfunction (ED).
If you think you have either of these conditions contact your doctor or other health care professional. Bacterial prostatitis can be cured with antibiotics; however, there is no cure for BPH.
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