General Medical Advices

The size of a walnut, the prostate is a gland in the male reproductive system located below the bladder, in front of the rectum. The prostate secretes nutrients and semen thinners.

As it surrounds the urethra (the canal from the bladder), a tumor in the prostate can interfere with urination. To function, prostate needs of sex hormones, androgens, which are produced in the testes, especially, and by the adrenal glands. Some prostate cancers are stimulated by these hormones.

In North America, cancer of the prostate is the most common cancer in men. According to autopsy studies, one third of men aged under 80 had traces of cancer prostate39. In the 80 years or more, this proportion rises to two thirds. However, most men in whom it detects prostate cancer die of other causes.

Prognosis

Compared to other cancers, the prognosis of prostate cancer is quite good. Today, only one third of men with prostate cancer will die. Often, the cancer remains localized in the prostate and has little or no effect on the overall health or longevity of the person. Its growth is relatively slow in most cases, after diagnosis, the disease progresses in ten years or more. Thus, many men die with prostate cancer without it is not the case.

The severity of cancer depends on the extent of the tumor (local, metastatic or adjacent to distance) and the type of cancer cells, that is to say, their degree of malignancy.

Diagnosis and Screening

* Digital rectal exam. The doctor inserts a gloved finger into the rectum to feel the prostate and check for irregularities. This method allows only a partial assessment, only half of cancers can be detected as well. This method is inadequate.
* Blood test to measure PSA. The prostate cancer can be detected by determining the increase of a protein, PSA (prostate specific antigen) blood. PSA is a substance produced by the prostate. A high quantity (more than 4 nanograms / ml) of this protein in blood is associated with prostate cancer in approximately 25% of cases and other disorders of the prostate in 75% of cases (benign prostatic , inflammation or infection of the prostate). Thus, a high score on this test does not necessarily mean it is cancer. In addition, the PSA test does not detect all cases of clinically significant cancers. In a study evaluating the effectiveness of PSA testing, 15% of men who tested negative in this test (of a cohort of 2 950 men aged 62 to 91 years) actually had cancer the prostate1. The PSA test is also used to track the evolution of prostate cancer.
* Transrectal ultrasound. With echoes produced by an ultrasound beam and interpreted by a computer, the physician may obtain a representation (ultrasound image) of the prostate. There are also other modes of imaging. This technique is used for diagnostic, not screening.
* Biopsy. Only a biopsy can diagnose for sure cancer of the prostate. The biopsy is usually performed using a needle inserted into the prostate. It is reserved for men with elevated PSA or abnormal DRE. The biopsy is not devoid of side effects. It can cause pain in the prostate.
* Cystoscopy. Examination of the bladder that practice after the introduction of a cystoscope into the urethra.

Symptoms of Prostate Cancer

Initially, prostate cancer causes no symptoms. Moreover, the symptoms described below may be related to another disease of the prostate as the more common of the benign prostate (or benign prostate).

* The need to urinate frequently, especially at night.
* Difficulty starting urination or urine retention.
* The inability to urinate.
* Difficulty obtaining an erection.
* From the pain during ejaculation.
* The frequent pain or stiffness in lower back, hips or upper thighs.

People at Risk

* Age. In North America, the prostate cancer mainly affects men over 55 years. The average age at diagnosis is 70 years.
* Family history. The risks are higher when the father or brother has suffered from this disease. It is unclear whether genetic modification may be responsible for some prostate cancers. It is also possible (but not yet demonstrated) that a high testosterone levels may play a role in triggering the disease.
* Race. The men of African descent are more at risk than Caucasians, who are more likely than Asians.

Risk Factors

It is estimated that over 80% of cases of cancer of the prostate, breast, and colon cancer are related to factors alimentaires2.

* Fat. The scientific literature indicates that a diet richer in lipid (fat) is associated with an increased risk of prostate cancer. However, it is not clear yet what kind of fat or fat source which is particularly responsible for this association3, 4. The animal fat content in red meat have been cited in some studies épidémiologiques5, 6. For example, according to data from the Health Professionals Follow-Up Study, in which 51 529 men participated, consumption of red meat (sausage, bacon, beef, pork or lamb) was associated with an increased risk of cancer metastasis the prostate5.
* Dairy products. Some research supports the hypothesis that a high intake of dairy products (because they contain calcium, and possibly fat) slightly increase the risk of cancer prostate7, 8.

The research discussed several other factors, but for now, the medical community does not consider these data conclusive.
- Obesity
- Lack of exercise
- Smoking
- Vasectomy
- Benign prostatic
- Sexually Transmitted Diseases

Preventing Prostate Cancer. Can we prevent it?

We still know little about the prevention of prostate cancer. You can put all the odds in his favor by adopting preventive measures described below and those contained in the sheet Cancer.

Screening Measures

Two tests can be used in combination by doctors in order to detect early cancer of the prostate in men who have no symptoms: testing for prostate specific antigen (PSA) and DRE. However, their ability to improve survival and extend life is not demonstrated. For this reason, medical authorities do not recommend physicians to perform routine screening for prostate cancer using these tests10, 38. The Canadian Cancer Society invites men aged over 50 years to discuss with their doctor whether the dépistage11.

Basic Preventive Measures

Consult Cancer sheet to learn about ways to reduce your risk of one day suffering from cancer, including prostate cancer.

Other measures to prevent the onset of the disease

Finasteride. Finasteride (Propecia ®, Proscar ®) is used to treat benign prostate and baldness in men. This medicine reduces the production of testosterone. In June 2003, the results of a double-blind study of high envergure9 (PCPT for Prostate Cancer Prevention Trial) showed that taking finasteride reduces the risk of prostate cancer. Paradoxically, this drug would increase slightly the risk of suffering from prostate cancer serious. These results have sparked controversy and a series of questions, so far unanswered. Experts are still questioning about the relevance of using finasteride to prevent cancer prostate23. The approach in each case is unique.

Medical Treatment of Prostate Cancer

Because prostate cancer usually develops slowly, there are several ways to treat it.
Watchful waiting!

It may be that we choose watchful waiting as a treatment option when the tumor is well circumscribed (cancer cells are confined to the prostate). It does so no medicine and we do not practice surgery, but it is closely monitoring the evolution of the tumor.

Moreover, if the tumor grows very slowly, and that the person affected is elderly, the tumor will not have time to grow before other health problems arise. Indeed, as the more invasive treatments often cause complications (pain, inability to have an erection, urinary incontinence, infection), it is sometimes better to watch without intervening.

Surgery

When cancer cells do not migrate, they can be eliminated from the body by removing the prostate, in whole or in part. The absence of prostate causes some problems, such as temporary or permanent impotence. If the tumor is very large and affects the nerves, it may be that we decide not to proceed with the surgery does not jeopardize the nervous system.

Another type of surgery, orchiectomy (or orchiectomy), involves removing the testicles in order to deprive cancer cells of the testosterone.

Cryosurgery

For some cancers very small size or precancerous lesions, it sometimes uses intense cold (created by liquid nitrogen) to freeze and kill the tissues involved.

Chemotherapy

Chemotherapy is administered by injection or tablet form, toxic chemical agents to eliminate cancer cells. There are many who have different mechanisms of action and different side effects.

Radiotherapy

It is to destroy cancer cells using external electromagnetic radiation (emitted by a radiation therapy machine), trying to spare the surrounding healthy tissue.

Brachytherapy is another form of radiation therapy sometimes used. Radioactive substances, including radiation kill cancer cells are introduced into the patient’s body near the tumor. To do this, we can proceed in various ways (for example, an implant can be inserted into the prostate).

Hormone Therapy

This approach, long term, to administer drugs that will act to deprive cancer cells of male hormones they need to grow.

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