10 Questions About Prostate Cancer Answered

Did you know that except for skin cancer, prostate cancer is the most common cancer found in men?

In 2017, the most recent year that data was available from the Centers for Disease Control and Prevention (CDC), approximately 207,000 new cases of prostate cancer were reported among men. In Missouri, there were about 3,400 cases reported in 2017.

So, what can men do to lower their risk for prostate cancer? Should all men be screened for prostate cancer?

Christopher Spencer, MD, MS, DABR, the medical director of the Phelps Health Delbert Day Cancer Institute (DDCI) and medical director of radiation oncology at Phelps Health, answers 10 common questions about prostate cancer.

1. What is the prostate?

The prostate is a gland found only in men that produces fluid that makes up semen.

2. What causes prostate cancer?

On a case-by-case basis, we can never tell what causes a specific type of cancer. However, men who eat many fats, especially animal fats, seem to be more likely to develop prostate cancer. Fats can lead to higher levels of testosterone and other hormones that can contribute to prostate cancer.

3. How common is prostate cancer?

In the US, prostate cancer is diagnosed in about 107 per every 100,000 men. In Missouri, the rate of prostate cancer is slightly lower, with about 90 per 100,000 men being diagnosed with the disease.

4. Who is most at risk to get prostate cancer?

Prostate cancer typically affects older men, usually those age 65 and older. Men who have a family history of prostate cancer also have a higher risk.

5. How can men lower their risk?

The best ways to reduce the risk of developing prostate cancer are to eat a balanced diet without excessive fat, exercise regularly and avoid tobacco.

6. What are the symptoms of prostate cancer?

Signs of prostate cancer and other prostate problems include the following:

• Difficulty urinating
• Frequent urination
• Decreased force of urination
• Difficulty starting or stopping urinating
• Blood in semen
• Pain or discomfort in the pelvic area

In addition, widespread bone pain can be a sign of advanced prostate cancer.

7. When should men be screened for prostate cancer and how often?

Men who have any symptoms of prostate cancer should talk to their doctor or urologist about being screened. The US Preventive Services Task Force recommends men ages 55-69 who are showing no symptoms discuss the benefits and risks of screening with their primary care provider. The task force does not recommend screening for men age 70 and older who show no symptoms.

8. What does screening for prostate cancer involve?

Screening for prostate cancer begins with a digital rectal exam and a test that measures the amount of prostate-specific antigen, or PSA protein, in the blood. An elevated PSA could mean that the person has prostate cancer or other problems related to the prostate.

9. Would patients diagnosed with prostate cancer see a cancer specialist or urologist?

Typically, if patients are diagnosed with an elevated PSA, they would be referred to a urologist. Patients who are diagnosed with prostate cancer would be treated by a team of healthcare workers, including a urologist, cancer specialist and other care staff.

10. How is prostate cancer treated?

Treatment of prostate cancer depends on several factors:

• Stage of cancer (I through IV)
• Gleason score of the prostate cancer (from normal cells to mutated cells)
• Overall PSA
• Amount of prostate cancer in the prostate
• Whether the cancer has spread to other areas of the body

Overall treatment can include one or more of the following:

• Surgery to remove the prostate
• Radiation to treat the prostate and/or lymph nodes
• Therapy to decrease the testosterone level in the patient, which in turn reduces the growth of the prostate cancer
• Chemotherapy, in advanced cases of prostate cancer