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6 Common Cancers - Prostate Cancer

Singer Harry Belafonte

Singer Harry Belafonte has been vocal in his discussion of his prostate cancer and the need for early screening.
Photo: AP Photo/Danny Moloshok

Prostate Cancer

The prostate gland is a walnut-sized structure that makes up part of a man's reproductive system. The cause of prostate cancer is unknown, but it is the second most common cause of death from cancer in men of all ages and is the most common cause of death from cancer in men over 75. Prostate cancer is rarely found in men younger than 40.

Screening and Diagnosis

A yearly rectal exam by your doctor can often reveal an enlarged prostate. Symptoms of prostate cancer may include problems passing urine, such as pain, difficulty starting or stopping the stream, or dribbling; low back pain; and pain with ejaculation.

Since the development of the prostate-specific antigen (PSA) test, a prostate cancer screening method that measures the amount of PSA in a man's blood, it has become easier to spot prostate cancer early. A high PSA level has been linked to an increased chance of having prostate cancer, but does not mean that the person definitely has it. Several conditions besides cancer can cause the PSA level to rise. These include urinary tract infection, benign prostatic hypertrophy (BPH — an enlarged prostate), and prostatitis (inflammation of the prostate, often from a bacterial infection). Since the PSA test became common, most prostate cancers are found before they cause symptoms.

Physicians now use a prostate-cancer grading formula called the Gleason system that assigns prostate cancers a score from 2 to 10. The higher your Gleason score, the more likely it is that your cancer will grow and spread quickly.

Treatment

For prostate cancer that has not spread outside the prostate gland or nearby area, the most common treatment options are:

  • Watchful Waiting: For men over 70 with a low Gleason score, the most common recommendation is to defer treatment and watch closely for signs the disease is progressing.
  • Surgery (also known as prostatectomy): This is the surgical removal of part or all of the prostate, and other nearby areas if necessary.
  • Radiation therapy: This is aimed at killing cancer cells, either with an external beam of radiation or by implanting tiny radioactive "seeds" in the body.

For advanced prostate cancer that has spread to other parts of the body, the most common treatment options are hormone therapy, which starves prostate cancer cells of testosterone by using drugs that inhibit testosterone production or by removing the testicles, or chemotherapy and radiation therapy.

Research: What's New

  • Genetic markers: The NCI launched an initiative in 2006 to identify genetic alterations that make people susceptible to prostate and breast cancer. The Cancer Genetic Markers of Susceptibility (CGEMS) project is conducting scans of the entire human genome (genotyping) to identify common, inherited gene mutations that increase the risks for these cancers. In April 2007, researchers reported that a common variation in a DNA segment strongly influences prostate cancer risk, and that this variation may be responsible for up to 20 percent of prostate cancer cases in white men in the United States.

    "Discovery of this common variation is very exciting. Building on this finding we may be able to identify men at highest risk for prostate cancer, diagnose the disease earlier, and hopefully prevent it all together," says NCI's Dr. Niederhuber. "One of the next steps is to understand the mechanism by which this genetic variation exerts its effect on cancer risk."
  • Protein signatures: A recent NCI-funded study showed that testing blood samples for antibodies that men make against their own prostate cancer cells (called "autoantibodies") may help identify individuals with early stages of the disease. This might lead to a new test that could be used along with the PSA test to detect early-stage prostate cancer. This could potentially reduce the number of prostate biopsies that are done because of false–positive PSA tests.

Read More "6 Common Cancers" Articles
Lung Cancer / Breast Cancer / Prostate Cancer / Colorectal Cancer / Skin Cancer / Gynecologic Cancers

Spring 2007 Issue: Volume 2 Number 2 Page 10