Prostate Cancer: The Basic Facts

Paul Lange, MD
Professor
Department of Urology
University of Washington, Seattle WA


What is it?

Most men do not even know what a prostate is. Basically, the prostate gland sits between the bladder and penis, just in front of your rectum. The urethra, which is a tube that carries urine from your bladder through your penis to the outside, runs through your prostate. Normally the prostate adds fluid and nutrients to the sperm and seminal fluid which is the white stuff that’s ejaculated when a man has an orgasm. As men age, the prostate can enlarge (that is it can get benign prostatic hypertrophy or BPH for short) causing urine voiding problems. Dr. Pelman describes these problems in his article on Benign Prostatic Hyperplasia (BPH). The prostate also can develop cancer within it. This cancer may be a very slow growing kind that never bothers a man during his lifetime. However it often is a more serious type that grows more rapidly in the prostate and then spreads to other parts of the body, especially the bone, after which it is lethal. In fact in America, prostate cancer is the most frequently diagnosed male cancer and the second leading cause of cancer death in men.

How does one get prostate cancer?

Like most cancers, doctors do not exactly know what causes prostate cancer. However there are some clues. Doctors know that some men are more at risk for getting prostate cancer than others. For example there is a family tendency. If your brother or father had prostate cancer, then your chances are much greater of getting it too. Also African-Americans have over twice the chances of getting prostate cancer as other races. So if you are in one of these risk categories, you should check for prostate cancer early (probably at age 40) and often (probably yearly). Doctors also know that environment – especially diet, probably has something to do with getting prostate cancer.

Lifestyle and prostate cancer:

Once again the exact relationship between the cause of prostate cancer, diet and other lifestyle factors are still incompletely known. Evidence does show that people whose diets are heavy in red meat and other fatty foods have more prostate cancer. Generally diets containing plenty of fruits and vegetables are better. Some studies suggest that diets rich in tomatoes, selenium, or Vitamin E are beneficial. What can be said for sure right now is that a healthy life style with exercise, weight reduction toward an ideal weight, low fat diet, and avoidance of smoking and heavy drinking are good ways to reduce one’s chances of many diseases including prostate cancer.

How does one check for prostate cancer?

The best way to determine if you have prostate cancer is to get regular prostate cancer check-ups. This consists of a rectal examination and a blood test for something called PSA that stands for prostatic specific antigen. If either of these is abnormal, then your doctors need to send you to a urologist for a more thorough examination and possibly a prostate biopsy (these tests are described in more detail in the previous article by Dr. Brawer on PSA). If you are in the high-risk group, that is, you have a family history of prostate cancer or you are African-American, these tests should start at age 40 or 45. For most other people, the prostate cancer check-ups should begin at age 50. While I believe it is good to have these extensive prostate cancer check-ups regularly (usually every year), some doctors aren’t so sure, so you need to discuss these issues with your primary care doctor.

For more information, check out Dr. Lange’s book:

Prostate Cancer for Dummies 

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