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PROSTATE: Overview


All men over the age of 50 are at a risk for prostate cancer. More than 70% of men over the age of 65 are annually diagnosed with prostate cancer. Prostate cancer is the most 

common cancer of men in the United States. Each year close to 200,000 new cases of prostate cancer are discovered and 30,000 men die from the cancer annually. 

Prostate cancer is generally a slow growing tumor and typically starts off in the periphery of the gland. In the early stages, prostate cancer causes no symptoms. However, if left untreated, it can grow, invade adjacent organs and spread to other parts of the body. It is not know what causes prostate cancer and why some subtypes behave differently. It is believed that a multitude of factors such as heredity, ethnicity, hormones, diet and environment may play a role in the cause of prostate cancer.

Knowing the risk factors may help to prevent or delay the onset of prostate cancer. The risk factors identified to cause prostate cancer include:
- Age. As men get older, the chances of having prostate cancer increase. It is recommended that after age 50, men should have regular prostate exams.
- Ethnicity. Of all ethnic groups, blacks have the highest risk of prostate cancer. 
- Hereditary. If anyone in the family has prostate cancer, the chance of a family member developing the cancer is greatly increased.
- Nutrition. A high-fat diet and obesity have been associated with an increase in prostate cancer. It is believed that fat stores are important for production of testosterone, and thus a low fat diet may reduce the risk of developing prostate cancer.
- Vasectomy. Although it has been suggested that vasectomy may be a risk factor for prostate cancer, there is no conclusive evidence to substantiate this fact.
- High levels of testosterone. Men who have high levels of testosterone are at a higher risk for prostate cancer. Long term testosterone treatments for other medical conditions have been linked to prostate cancer, so these individuals should undergo regular screening for prostate cancer.

In the early stage of prostate cancer, most individuals have no symptoms. However, when the cancer grows or spreads, the following symptoms may occur:
weak urine flow
frequent urination (especially at night)
difficulty starting urination
inability to urinate
pain or burning sensation when urinating
blood in the urine
persistent pain in lower back, hips, or thighs (bone pain)
painful ejaculation
difficulty having an erection

Unfortunately there are no early signs or symptoms of prostate cancer. The general advice is that if one is 50 or older, one should undergo prostate cancer screening. A blood test is also recommended to check for prostate-specific antigen (PSA) beginning at age 50, or earlier if one has risk factors for cancer. A digital rectal exam as early as age 40 is also advised in individuals with risk factors.

Since prostate cancer does not cause symptoms in the early stage, the following screening tests are recommended and include:

Digital rectal exam (DRE): A digital rectal exam is not fun but essential in examining the prostate. The digital exam can discover the presence of any abnormalities in the texture, shape or size of your gland.
Prostate-specific antigen (PSA) test: This blood test analyzes the levels of a chemical released from the prostate. Higher levels are not always specific for prostate cancer because infection, inflammation or prostate enlargement may also cause an increase in this chemical.
Transrectal ultrasound: If the above tests raise any suspicion of prostate cancer, a small probe is placed through the rectum and the gland is analyzed. The images can reveal the presence of any abnormal growth or deformity of the gland.

 

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Greg Cryns
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