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Know Your Prostate Booklet
This booklet is a guide to the prostate what it is, what it does, and what can go wrong with it.
The following people have a prostate:
- non-binary people who were assigned male at birth**
- some intersex people.***
* A trans woman is someone who was assigned male at birth but identifies as a woman. Trans women can develop prostate problems, even if they have taken hormones. The prostate is not removed during genital reconstructive surgery.** A non-binary person may not identify as a man or a woman.*** An intersex person may have both male and female sexual characteristics and so might have a prostate.
Trans, non-binary or intersex?
The information on this website has been developed based on guidance and evidence in men. If you are a trans woman, male-assigned non-binary or intersex, some of this information is still relevant to you but your experience may be slightly different. Find out more about trans women and prostate cancer.
Veterans & Chemical Exposure
Exposure to chemicals and defoliants can add to prostate cancer risk and severity. Studies have shown Vietnam and Korean War Veterans with exposure to defoliants like Agent Orange have a higher occurrence of prostate cancer. In fact, Veterans are about twice as likely to be diagnosed with prostate cancer than men who have never served in the military. Read more about Veterans and prostate cancer here.
Farmers and other men who work with large amounts of pesticides can be at increased risk and those who are frequently exposed to metal cadmium like welders, battery manufacturers, and rubber workers are abnormally vulnerable to prostate cancer. There is some evidence that firefighters are also at higher risk.
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What Causes Prostate Cancer
Researchers do not know exactly what causes prostate cancer. But they have found some risk factors and are trying to learn just how these factors might cause prostate cells to become cancer cells.
On a basic level, prostate cancer is caused by changes in the DNA of a normal prostate cell. DNA is the chemical in our cells that makes up our genes, which control how our cells function. We usually look like our parents because they are the source of our DNA. But DNA affects more than just how we look.
Some genes control when our cells grow, divide into new cells, and die:
- Certain genes that help cells grow, divide, and stay alive are called oncogenes.
- Genes that normally keep cell growth under control, repair mistakes in DNA, or cause cells to die at the right time are called tumor suppressor genes.
Cancer can be caused by DNA mutations that keep oncogenes turned on, or that turn off tumor suppressor genes. These types of gene changes can lead to cells growing out of control.
DNA changes can either be inherited from a parent or can be acquired during a persons lifetime.
Five Things Every Man Should Know About Prostate Cancer
Its only about the size of a walnut, but the prostate takes on an oversized place in mens health as they age. In support of National Prostate Cancer Awareness Month, we talked to MultiCare Urologist Douglas Sutherland, MD, to learn the five things every man should know about prostate cancer and why an annual physical is so important for mens health.
Prostate cancer is the second most common cancer in American men, behind skin cancer, according to the American Cancer Society. In fact, one in eight men will be diagnosed with prostate cancer in his lifetime. Its also the second-leading cause of cancer death in American men .
But the statistics arent all grim. If caught and treated early, prostate cancer is very survivable. Localized prostate cancer is nearly 100 percent curable. But its also not likely to cause any symptoms. A simple blood test to measure prostate-specific antigens has been shown to reduce the death rate of prostate cancer.
Older men and non-Hispanic Black men are at higher risk for prostate cancer. Family history also plays a part. If your father or brother had prostate cancer, your risk of developing the disease is double what it would be otherwise.
In a twist, obesity seems to reduce the risk of developing prostate cancer overall. But thats not a license to ignore the scale because when an obese man does develop prostate cancer, its usually more aggressive.
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Are There Side Effects Of The Combination Approach To Prostate Cancer Radiation Therapy
When it comes to early stages of disease, patients very frequently do well with either brachytherapy or external beam radiation. Success rates of around 90% or higher can be achieved with either approach. When the disease is somewhat more advanced based on the PSA level, Gleason score, extent of visible disease on magnetic resonance imaging we have learned over the years that higher doses of radiation are critical to achieving better results. Some evidence, including a large trial, suggests that for patients with intermediate- or high-risk prostate cancer, a combined approach using brachytherapy along with external beam radiation may be best compared to standard dose external beam radiation therapy alone.
Are There Side Effects Of The Combination Approach
There is a slightly higher chance that patients who receive the combined therapy will have rectal irritation or urinary side effects. This is common with prostate cancer radiation therapy because the radiation can damage cells in the tissues surrounding the prostate. But at MSK, we routinely use sophisticated computer-based planning techniques that help us reduce the dose given to normal tissues such as the rectum, bladder, and urethra, lessening the chances of side effects and complications. We have also found that, when treating with the combined approach, using the high-dose-rate brachytherapy compared to low-dose-rate brachytherapy may have less in the way of side effects.
In addition, at MSK, we routinely use a rectal spacer gel, which we inject between the prostate and the rectum while the patient is under mild anesthesia, to create a buffer between these two tissues. By creating this space, we can further reduce the dose of radiation the rectum is exposed to. This leads to fewer side effects for the patient. The rectal spacer gel is biodegradable and dissolves on its own within the body after a few months.
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Inherited Risk Of Prostate Cancer
Over past decades, scientists have learned that some prostate cancer that runs in families is hereditary. In these cases, mutations in genes that raise the risk of prostate cancer occur in every cell of the body and are passed on from either a mother or father to a child, said Elias Obeid, MD, MPH, medical oncologist and director of the Prostate Risk Assessment Program at Fox Chase Cancer Center.
These inherited alterations in genes may be responsible for up to 10 percent of all prostate cancers, according to the American Cancer Society, and often occur in genes that repair damage to DNA, including BRCA1 and BRCA2 genes.
Mutations in these two genes are best known for causing breast and ovarian cancer in women. But they also raise prostate cancer risk in men who inherit them, especially faulty BRCA2 genes, which are tied to aggressive prostate cancer, Obeid said.
Other genes that can cause prostate cancer through mutations include those related to DNA repair, such as CHEK2 and ATMHOXB13, which is related to the development of the prostate gland and the genes tied to a disease called Lynch syndrome.
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What Is Prostate Cancer
Cancer can start any place in the body. Prostate cancer starts in the prostate gland. It starts when cells in the prostate grow out of control.
Cancer cells can spread to other parts of the body. Cancer cells in the prostate can sometimes travel to the bones or other organs and grow there. When cancer cells do this, its called metastasis. To doctors, the cancer cells in the new place look just like the ones from the prostate.
Cancer is always named for the place where it starts. So when prostate cancer spreads to the bones , its still called prostate cancer. Its not called bone cancer unless it starts from cells in the bone.
Ask your doctor to use this picture to show you where your cancer is.
The prostate
The prostate is a gland found only in men, so only men can get prostate cancer.
The prostate is just below the bladder and in front of the rectum . The tube that carries pee goes through the prostate. The prostate makes some of the fluid that helps keep the sperm alive and healthy.
There are a few types of prostate cancer. Some are very rare. Most prostate cancers are a type called adenocarcinoma. This cancer starts from gland cells. Your doctor can tell you more about the type you have.
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Causes Of Prostate Cancer
The causes of prostate cancer are largely unknown. But certain things can increase your risk of developing the condition.
The chances of developing prostate cancer increase as you get older. Most cases develop in men aged 50 or older.
For reasons not yet understood, prostate cancer is more common in black men and less common in Asian men.
Men whose father or brother were affected by prostate cancer are at slightly increased risk themselves.
Recent research also suggests that obesity increases the risk of prostate cancer.
Is Early Onset Prostate Cancer Common
The average age for a first prostate cancer diagnosis is 68. In the U.S., about 10% of men newly diagnosed with prostate cancer are under 55. You may also develop prostate cancer when youâre much younger, in your teens or as a young adult, though this is extremely rare.
Around the world, thereâs been an increase in early onset prostate cancer in men between 15 and 40 years old.
Experts arenât sure why thereâs an increase. It may be related to certain risk factors. It may also be because of changes in how itâs diagnosed. Screenings are more frequent, and thereâs more awareness that prostate cancer can happen in younger men.
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Everyone Older Than 60 Has Cancer
Doctors are finally realizing that most people have cancer in their body. But its latent or hidden cancer. Latent cancers are so well contained by the immune system that they never get large enough to cause problems. As a result, doctors rarely discover them, unless they discover them by accident. Most of the cancers they discovered in this autopsy study were latent cancers. And, as you can see, they are very common.
Autopsy studies on women, for example, show that by the time a woman is 40 years old, the chance of her having a latent breast cancer is 40 percent.
That sounds terrible, doesnt it? Its really not terrible. In fact, the existence of latent cancers is very reassuring. They clearly demonstrate how effective a healthy immune system can be in stopping cancer.
Its so effective that the great majority of latent cancers never go on to become full-blown cancers. Thats good news. When you start to add up all of the various autopsy studies that are published, you soon realize that every single one of us over the age of 60 has cancer. Actually, we have at least two of these cancers already living in our bodies. But the really important thing about latent cancers is that they can teach us a lot.
The first thing they teach us is that by maintaining a healthy immune system, we can dramatically decrease our chances of dying from cancer.
Whats the best way to do this?
Prostate Cancer What Is It
To get checked for prostate cancer please consult with your GP.
The human body is made up of billions of tiny building blocks called cells. Sometimes, cells reproduce in an uncontrolled way and grow into a lump, or tumour. There are two kinds of tumours: noncancerous and cancerous . Benign tumours do not spread to other parts of the body and are not life threatening .
Prostate cancer occurs when abnormal cells develop in the prostate. These cells have the potential to continue to multiply, and possibly spread beyond the prostate. Doctors do not know what causes prostate cancer. What they do know however, is that the growth of cancer cells in the prostate is stimulated by male hormones, especially testosterone. Most prostate cancer growth is influenced by testosterone but the speed at which prostate cancer grows varies from man to man. In some men the cancer grows very slowly , in others growth is more rapid .
Men are more likely to develop prostate cancer as they get older. It is also more common in men who have a father or brother with prostate cancer, and in families who carry certain genes such as the BRCA1 or BRCA2 genes.
Anyone with a prostate can get prostate cancer including transgender women, male-assigned non-binary people or intersex people.
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What Kind Of Treatment Will I Need
There are many ways to treat prostate cancer. The main kinds of treatment are observation, active surveillance, surgery, radiation, hormone therapy, and chemo. Sometimes more than one kind of treatment is used.
The treatment thats best for you will depend on:
- Any other health problems you might have
- The stage and grade of the cancer
- Your feelings about the need to treat the cancer
- The chance that treatment will cure the cancer or help in some way
- Your feelings about the side effects that might come with treatment
Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
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How Common Is Prostate Cancer And Who Is At Risk
Prostate cancer most often affects men between ages 55 and 69. There is a huge gap between the proportion of men diagnosed with prostate cancer and those whose health and lifespan are affected by the disease. American men have a 16 percent lifetime risk of developing prostate cancer, but only 2.9 percent of men die from it.
In fact, many prostate cancers are believed to be slow growing, with men dying from causes other than prostate cancer. Autopsy studies support this, finding that 30 percent of 55-year-old men and 60 percent of men reaching age 80 on whom an autopsy is performed have autopsy-discovered prostate cancer.
There are some factors that increase risk for prostate cancer, including:
Race Race seems to play a role in the frequency and severity of the disease. African-American men are far more likely to develop prostate cancer than white men 203.5 vs. 121.9 cases per 100,000 men. They are also more than twice as likely as white men to die of prostate cancer 44.1 vs. 19.1 deaths per 100,000 men.
Family History Positive family history of prostate cancer is another risk factor.
Elevated Body Mass Index Elevated BMI is another risk factor, linked to an increased risk of prostate-cancer-specific mortality and biochemical recurrence in men with prostate cancer.
Do We Know Which Treatment Is Best For Prostate Cancer Brachytherapy Or External Beam Radiation
Its not a question of which type of radiation therapy is best in general, but rather which therapy is best for the patients specific disease and quality-of-life concerns. We want to use the most tailored, pinpointed radiation to treat the prostate tumor effectively while minimizing side effects. This can depend on the tumors size and stage as well as other patient characteristics and even a patients individual preferences.
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Does Undergoing A Vasectomy Cause Prostate Cancer
The link between prostate cancer and vasectomy is controversial. A 2020 study in the Journal of the National Cancer Institute suggests that undergoing a vasectomy may result in a small increased risk of prostate cancer that persists for at least three decades, regardless of the age at vasectomy. However, other studies have not found this to be true and more research is needed, according to the American Cancer Society.
Should I Get Prostate Cancer Screening
You may have wondered why there is no nationwide prostate cancer screening program in Australia . Thats because experts do not recommend routine prostate cancer screening if youre aged between 50 and 69, healthy, and dont have a family history of prostate cancer.
There are several reasons for this:
- A high PSA level can be a result of something other than cancer.
- Experts dont fully agree on what is a normal or abnormal PSA level.
- Most men with a slightly raised PSA level have a biopsy that confirms no cancer.
- Many prostate cancers are low risk, slow growing, and are unlikely to cause harm if left untreated.
- Testing and treating low risk, slow growing cancers may cause more harm than good.
You should speak to your doctor if you have a family history or ongoing symptoms of prostate cancer, such as difficulty passing urine. Your doctor can help you make an informed decision about whether prostate cancer screening is suitable for you.
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