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Types of Cancer - Prostate Cancer

The prostate is a gland found only in men, located just below the bladder, in front of the rectum. There are several cell types in the prostate, but nearly all prostate cancers start in the gland cells.

Types of Cancer

What is Prostate Cancer?

The prostate is a gland in a man's reproductive system that makes and stores seminal fluid, a milky fluid that nourishes sperm. This fluid is released to form part of semen. Prostate cancer develops when cells in the prostate begin to divide at an uncontrolled, abnormal rate. Although prostate cancer in its earliest stages often does not cause noticeable problems, prostate cancer can cause any number of the following problems: a need to urinate frequently, especially at night; difficulty starting urination or holding back urine; inability to urinate; weak or interrupted flow of urine; painful or burning urination; difficulty in having an erection; painful ejaculation; blood in urine or semen; or frequent pain or stiffness in the lower back, hips, or upper thighs.

Stages of Prostate Cancer

Prostate cancer is categorized into various stages according to the tumor growth and spread. There are four stages of prostate cancer:

Stage 1 (Stage A)

This is the earliest stage of prostate cancer; at this point the cancer cannot be felt during a rectal exam. It is usually found by accident during surgery for some other reason, usually for BPH, and has not yet metastized (spread) beyond the prostate.

Stage 2 (Stage B)

At this stage, the tumor can be felt during a rectal exam, or it may be found with a biopsy investigating a high PSA level. The cancer, however, is still confined to the prostate tissues.

Stage 3 (Stage C)

At the stage, the prostate has spread to nearby tissues.

Stage 4 (Stage D)

The cancer has spread to lymph nodes or to other parts of the body.

Treatment

A wide variety of treatment options exists for prostate cancer: watchful waiting, surgery, radiation therapy, or hormonal therapy. For some patients, doctors may suggest a combination of treatments.

Watchful waiting is most often suggested for men who have slow-growing cancer at an early stage; these men are usually older or have other serious medical problems. Surgery is a commonly advised treatment for early stage prostate cancer. The surgeon may either remove all of the prostate (radical prostatectomy) or only part of it. Surgery for prostate cancer can result in sexual impairment; however, in some cases a new technique known as nerve-sparing surgery may save the nerves that control erection. Other surgical procedures include radiacal retropubic prostectomy (involves the removal of the entire prostate and nearby lymph nodes), radical perineal prostatectomy (removal of prostate through an incision between the scrotum and anus), and transurethral resection of the prostate (TURP: part of the prostate is removed through the urethra using electricity and wire).

If the cancer has spread beyond the prostate, other treatments such as chemotherapy and radiation therapy may be considered. Radiation therapy may be external (directed at the body by a machine) or internal (brachytherapy). Hormonal therapy is another technique for treatment; it works by preventing cancer cells from getting the male hormones they need to grow. Hormonal therapy is often used in conjunction with surgery to prevent the cancer from recurring, or to kill any cancer that was not removed during the operation.

Many patients and their families want to learn all they can about prostate cancer and the treatment choices so they can take an active part in decisions about medical care. The doctor is the best person to answer these questions. When discussing treatment, the patient, or in the case of a child, the patient's family, may want to talk with the doctor about research studies of new treatment methods. Such studies, called clinical trials, are designed to improve cancer treatment. More information about clinical trials is in the Clinical Trials section.

Researchers are finding better ways to treat prostate cancer, and the chances of recovery keep improving. Still, it is natural for patients and their families to be concerned about the future. There are many resources available both on and off the web for patients and their families. Links to some good web sites can be found on our web resources page, or check out our recommended reading list for patients and their families.

Source: NCI Cancernet