1 Prostate Cancer

2 Prostate Gland Muscular Walnut-sized gland Makes seminal fluid Muscles contract to push semen through the urethra Located directly beneath the bladder and in front of the rectum

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4 Prostate Cancer Most common cancer in American men Grows very slowly More common in African American men & men with family history

5 Statistics About one man in 6 will be diagnosed Only one man in 34 will die About 80% of men who reach 80 have prostate cancer

6 Outlook Nearly 100% survive 5 years 93% survive at least 10 years 67% survive longer than 15 years

7 BPH Enlargement which is not cancer 50% of men between 51 and 60 90% of men older than 80

8 Prostatitis Inflammation of the prostate Can be caused by bacterial infection Men of all ages

9 Prostate Cancer In early stages, may not cause any symptoms As it progresses, symptoms appear

10 Risk Factors Age Family history –Father or brother with it more than doubles the risk –Risk even higher if multiple family members affected

11 Risk Factors Race –Occurs about 60% more often in African American men than in white American men –Cancer is more likely to be advanced Diet –High dietary fat may contribute

12 Prevention Cannot prevent, but may be able to lower risk Diet –Low-fat diet –Antioxidants especially lycopenes Vitamin supplements –Vitamin E –Selenium

13 Screening Guidelines Annual digital rectal exam beginning at age 45 PSA testing beginning at age 50 Both of these tests beginning at age 40 for African American men & those with family history

14 Digital Rectal Exam Goal: detect cancer early when treatment is most successful Done during standard physical exam Feels for hard, lumpy, or abnormal areas

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16 PSA Blood Test PSA is produced by prostate gland PSA level under 4 ng/ml Trend is important Early prostate cancer found by PSA

17 Elevated PSA Prostate cancer Prostatitis BPH Other factors –Age –Medications

18 Staging Find out size and location of cancer –And whether it has metastasized (spread) ABCD is simplest method T = tumor N = nodes (lymph nodes) M = metastasis

19 Grading Grade refers to the cancer’s appearance and indicates how quickly a cancer is growing Gleason score assigns a grade (1 to 5) based on how the cancer cells look compared to normal

20 Gleason Score The higher the number, the more likely the cancer will grow and spread (number is between 2 & 10) Less than 6 indicates a less aggressive cancer Grade of 7 and up – more aggressive

21 Specialists Urologist Radiation oncologist Medical oncologist Oncology nurses Dietitians Physical & occupational therapists Psychologists or counselors

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23 Side Effects of Surgery Impotence –Unable to achieve an erection Incontinence –Stress incontinence: leaking of urine while coughing, sneezing, laughing

24 Radiation Therapy External radiation –Machine is outside the body Internal radiation –Brachytherapy –Radioactive implants placed directly into tumor

25 New Procedure Focal cryosurgery –Focused freezing of only the portion affected with cancer “Male lumpectomy” Cancer needs to be confined to one prostate lobe