Prostate Cancer

Early diagnosis greatly increases the chances of treating prostate cancer effectively.

Patricia Carruthers-Czyzewski, BScPhm, MSc

Prostate cancer has now surpassed lung cancer as the most frequently diagnosed cancer in Canadian men. A man born in 1993 has a 1-in-8 chance of being diagnosed with prostate cancer and a 1-in-26 chance of dying from the disease during his lifetime. Eighty nine % of men diagnosed with prostate cancer survive at least 5 years, and 63% survive at least 10 years.

Early diagnosis greatly increases the chances of treating prostate cancer effectively. Some prostate cancers may be found because of symptoms such as slowing or weakening of the urinary stream or the need to urinate more often. These symptoms are not specific and can also be caused by benign diseases of the prostate, such as benign prostatic hyperplasia (BPH). BPH does not seem to increase the chances of getting prostate cancer. Most cases of early prostate cancer cause no symptoms and are found by a prostate-specific antigen (PSA) blood test and/or digital rectal examination (DRE). A man with a healthy prostate typically has a PSA of 4.0 or less. The quantity of PSA generally rises when prostate cancer occurs. Men having the PSA blood test should tell their doctors about other drugs they are taking, such as finasteride or saw palmetto as they may interfere with the PSA level.

While the causes of prostate cancer are not yet completely understood, researchers have found several factors that are consistently associated with an increased risk:

  • The chance of having prostate cancer increases rapidly after age 50; more than 80% of cases are diagnosed in men over the age of 65.
  • It is more common among African-American men than among white American men.
  • It is more common in North America and northwestern Europe than in Asia, Africa, Central America, and South America.
  • Men who eat a lot of fat in their diet seem to have a great chance of developing prostate cancer. Men with diets low in fruits, vegetables, dairy products, calcium high foods and fructose (fruit sugar) may be at increased risk.
  • Regular physical activity and maintaining a healthy weight may help reduce prostate cancer risk.
  • It seems to run in some families
  • Men (especially men younger than 35) who have had a vasectomy may have a slightly increased risk fro prostate cancer.

Choosing a treatment for prostate cancer is not easy. The primary choices are surgery, radiation and hormone therapy, which are used alone or in combination. the treatments can have side effects. It is important to discuss the various options with your doctor and to weigh the benefits of each treatment against possible side effects or risks.

Hormone therapy is often used for patients whose prostate cancer has spread to other parts of the body or has come back after treatment. The goal of hormone therapy is to lower levels of testosterone, thereby shrinking the prostate cancer or making it grow more slowly.

Watching and waiting may be recommended if the cancer is not causing any symptoms, is expected to grow very slowly, and is small and contained with one area of the prostate. some men choose watching and waiting because, in their view, the side effects of aggressive treatment outweigh the benefits. If a man develops bothersome symptoms or his cancer begins to grow more quickly, decisions about active treatment can be considered.