Prostate Cancer

What is prostate cancer?

Cancer begins in your body when normal cells start to grow out of control. In prostate cancer, the prostate cells grow out of control. They can spread and affect nearby organs. They can also spread to distant parts of the body and cause problems. How common is prostate cancer? Prostate cancer is the most common cancer in men (after skin cancer). The chance of having prostate cancer increases with age. Are all prostate cancers the same? No, they are not. Many prostate cancers grow slowly. These are not likely to cause any harm. Some prostate cancers grow fast. They spread to other parts of the body where they cause problems and can even cause death.

What causes prostate cancer?

 We don’t know what causes this cancer. We do know that certain things cause some men to have a higher chance of having prostate cancer than others. Some of these are age, family history, and race. We call these risk factors because they increase your risk of having prostate cancer.

  • Age: Your age is the strongest risk factor. The chance of having prostate cancer goes up quickly after age 50. About 2 out of 3 prostate cancers occur in men over the age of 65
  • Family history: Men with a father or brother who had prostate cancer are more likely to get prostate cancer, too. This is even more likely if the father or brother had the cancer before age 65
  • Race: We don’t know why, but prostate cancer is more common in African American men than in other races
What if I have prostate symptoms right now?

If you’re in pain when you pass urine, see blood in your urine, or have trouble passing urine, you should speak to your doctor at the earliest. These could be symptoms of other prostate problems, but can also be caused by prostate cancer. The only way to figure out the real issue is by visiting your doctor.

You can have prostate cancer and not have any symptoms. But if you have symptoms, please see a doctor immediately.
What are my chances of having prostate cancer?

 Based on the way prostate cancer testing is done today, about 14 out of 100 of men (14%) will be diagnosed with prostate cancer during their life. About 3 out of 100 men (3%) will someday die of prostate cancer.

As you get older, your chance of having prostate cancer increases.
Prostate cancer testing

A PSA blood test and rectal exam will give your doctor a better idea about the health of your prostate. Your doctor might do a PSA blood test alone, or he might do both tests.
What is a PSA test? This test measures how much PSA is in your blood. PSA stands for prostate-specific antigen, a protein made by the prostate gland.

What is a rectal exam?

During this test, your doctor puts a gloved, lubricated finger into your rectum to feel your prostate gland. A rectal exam can tell if the prostate size, shape, and texture are normal.

Can testing tell me for certain that I have prostate cancer?

No. There is no perfect test to look for prostate cancer.

  • PSA test: There is no PSA level that says for sure that a man has prostate cancer. Your chance of having prostate cancer goes up as your PSA level increases.

PSA levels can be high in prostate cancer, but they can also be high with prostate infections and other prostate problems. So, having a high PSA level does NOT always mean that you have prostate cancer.

  • Rectal exam: Most prostate cancers cannot be detected during a rectal exam. But sometimes rectal exams can detect cancer even when the PSA level may not suggest it.
If your PSA level is high or if your rectal exam is not normal, you will need other tests to find out the reason behind that.
Can testing tell me for certain that I do not have prostate cancer?

No. If your PSA level is low, you can still have prostate cancer. If your rectal exam does not suggest cancer, you can still have prostate cancer. The rectal exam is not as good as the PSA test for finding prostate cancer, but it might find cancers in some men with low PSA levels.

So, what happens if my PSA or rectal exam suggests prostate cancer?

 If your PSA level or your rectal exam suggests cancer, you may need a biopsy to know for sure if you have prostate cancer.

  • A biopsy is done with a needle. The needle is put into the prostate gland.
  • Tiny pieces of the prostate gland are removed with the needle.
  • These tiny pieces are looked at under a microscope to see if cancer cells are present.
  • The biopsy is done as an outpatient and takes only a few minutes.
If the biopsy shows cancer cells, you and your doctor will decide how to treat the cancer, or whether treatment is needed at this time.
QuestionsIf I get testedIf I do not get tested
What will happen?You go to your doctor and get a PSA test and maybe a rectal examYou have regular check-ups but no prostate cancer testing.
If your test results are cause for concern, you may have a biopsy.At any time, you can change your mind and be tested.
Possible benefits to youTesting may find an early prostate cancer – while it’s small and before it has spread.You avoid the worry that you might have from getting test results
If it’s found early, there may be a better chance of being treated and not dying from prostate cancer.You avoid being treated for a cancer that might never cause you any problems.
Getting tested may give you peace of mindYou avoid the side effects that may occur with treatment. These include problems passing urine, problems with your bowels, and/or problems having sex.
Risks to youTesting may lead to worry about the results.You may be worried that you have prostate cancer and have not been tested.
Testing may lead to more tests, such as a biopsy, even if you don’t have cancerYou may have an early prostate cancer, and you won’t know this.
Testing may find a cancer that might never have caused problems or caused death.You may have a prostate cancer that may later cause symptoms or death and not have the chance to find it early.
Testing may lead to treatment, and treatment can cause side effects. These include problems controlling your urine, problems with your bowels, and/or problems having sex.
Testing may not find anything even though cancer is there.
How do I decide if testing is the right choice for me?
Know the facts.
  • Know about prostate cancer and other prostate problems.
  • Know what the PSA test and rectal exam can and cannot tell you.
  • Know what other decisions you may need to make if you are tested.
Ask questions, and talk to others.
  • Write down your questions and discuss them with your doctor.
  • Talk about testing with your family and those who care about you.
Use the balance scale at the end of this booklet.
  • Weigh how you feel about testing.
  • Make your decision about testing.
So, what does the American Cancer Society recommend for me?

Starting at age 50, talk to your doctor about the pros and cons of testing. Then decide if testing is the right choice for you.

13 If you are African American or have a father or brother who had prostate cancer before age 65, have this talk with your doctor starting at age 45.

 This talk should take place at age 40 for men with 2 or more close relatives who had prostate cancer before age 65.

If you decide to be tested, you should have the PSA blood test with or without a rectal exam. How often you’re tested will depend on your PSA level.

The decision is yours.