Prostate cancer is cancer that occurs in the prostate. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of cancer.
In the UK, about 1 in 8 men will be diagnosed with prostate cancer in their lifetime. We don’t know exactly what causes prostate cancer but there are some things that may mean you are more likely to get it – these are called risk factors.
There are three main risk factors for getting prostate cancer, which are things you can’t change. These are:
Testing healthy men with no symptoms for prostate cancer is controversial. There is some disagreement among medical organizations whether the benefits of testing outweigh the potential risks.
Most medical organizations encourage men in their 50s to discuss the pros and cons of prostate cancer screening with their doctors. The discussion should include a review of your risk factors and your preferences about screening.
Prostate screening tests might include:
If prostate cancer screening detects an abnormality, your doctor may recommend further tests to determine whether you have prostate cancer, such as:
When a biopsy confirms the presence of cancer, the next step is to determine the level of aggressiveness (grade) of the cancer cells. A doctor in a lab examines a sample of your cancer cells to determine how much cancer cells differ from the healthy cells. A higher grade indicates a more aggressive cancer that is more likely to spread quickly.
Techniques used to determine the aggressiveness of the cancer include:
Once a prostate cancer diagnosis has been made, your doctor works to determine the extent (stage) of the cancer. If your doctor suspects your cancer may have spread beyond your prostate, one or more of the following imaging tests may be recommended:
Not every person should have every test. Your doctor will help determine which tests are best for your individual situation.
Low-grade prostate cancer may not need treatment right away. For some, treatment may never be needed. Instead, doctors sometimes recommend active surveillance.
In active surveillance, regular follow-up blood tests, rectal exams and prostate biopsies may be performed to monitor progression of your cancer. If tests show your cancer is progressing, you may opt for a prostate cancer treatment such as surgery or radiation.
Active surveillance may be an option for cancer that isn’t causing symptoms, is expected to grow very slowly and is confined to a small area of the prostate. Active surveillance may also be considered for someone who has another serious health condition or who is of an advanced age that makes cancer treatment more difficult.
Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes.
Surgery is an option for treating cancer that’s confined to the prostate. It’s sometimes used to treat advanced prostate cancer in combination with other treatments.
Making several small incisions in your abdomen. During robot-assisted laparoscopic prostatectomy, surgical instruments are attached to a mechanical device (robot) and inserted through several small incisions in your abdomen. The surgeon sits at a console and uses hand controls to guide the robot to move the instruments. Most prostate cancer operations are done using this technique.
Making one long incision in your abdomen. During retropubic surgery, the surgeon makes one long incision in your lower abdomen to access and remove the prostate gland. This approach is much less common, but may be necessary in certain situations.
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Radiation placed inside your body (brachytherapy). Brachytherapy involves placing radioactive sources in your prostate tissue. Most often, the radiation is contained in rice-sized radioactive seeds that are inserted into your prostate tissue. The seeds deliver a low dose of radiation over a long period of time. Brachytherapy is one option for treating cancer that hasn’t spread beyond the prostate.
In some situations, doctors may recommend both types of radiation therapy.
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