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Prostate Cancer: early detection and prevention in men and young boys

What is prostate cancer?

Prostate cancer is a cancer that forms in the tissues of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum).

Treatment options and prognosis depend on the stage of the cancer and the patient’s age and general health. With greater public awareness, early detection is on the rise and mortality rates are declining. Additionally, new advances in medical technology are enabling cancer patients to return to active and productive lives after their treatment.

In the early stages, prostate cancer often causes no symptoms for many years. Prostate cancer usually is suspected initially because of an abnormality of one or both of the two screening tests that are used to detect prostate cancer. These screening tests are a digital rectal examination and a blood test called the prostate specific antigen (PSA).

Furthermore, in the later stages, prostate cancer can spread locally into the surrounding tissue or the nearby lymph nodes, called the pelvic nodes. The cancer can then spread even further (metastasize) to other areas of the body. Symptoms of metastatic disease include fatigue, malaise, and weight loss. During a rectal examination the doctor can sometimes detect local spread into the surrounding tissues.

To decide on treatment for an individual patient, doctors categorize prostate cancers. The treatment options for organ-confined prostate cancer or locally advanced prostate cancer usually includes surgery, radiation therapy, hormonal therapy, cryotherapy, combinations of some of these treatments, and watchful waiting.

Studies have found the following risk factors for prostate cancer:

Age over 65: Age is the main risk factor for prostate cancer.
Family history: Your risk is higher if your father, brother, or son had prostate cancer.
Race: Prostate cancer is more common among black men than white or Hispanic/Latino men. It's less common among Asian/Pacific Islander and American Indian/Alaska Native men.
Certain prostate changes: Men with cells called high-grade prostatic intraepithelial neoplasia (PIN) may be at increased risk of prostate cancer.
Certain genome changes: Researchers have found specific regions on certain chromosomes that are linked to the risk of prostate cancer. According to recent studies, if a man has a genetic change in one or more of these regions, the risk of prostate cancer may be increased.

Detection and Diagnosis

Ask your doctor when you should have your first exam and how often you should have checkups. If cancer cells are found, the pathologist studies tissue samples from the prostate under a microscope to report the grade of the tumor. Doctors use tumor grade along with your age and other factors to suggest treatment options.

Source: National Cancer Institute