About Prostate Cancer

Prostate cancer occurs when the cells of the prostate begin to grow uncontrollably. When caught and treated early, prostate cancer has a cure rate of over 90%.

Yet being diagnosed with prostate cancer can be a life-altering experience. It requires making some very difficult decisions about treatments that can affect not only the life of the man diagnosed, but also the lives of his family members in significant ways for many years to come.

More than 186,000 men in the United States will be diagnosed with prostate cancer this year, and each and every one of them will need to make very personal and individualized decisions about treatment options and diet and lifestyle changes. Most importantly, each and every one of them will have to find a strong, knowledgeable team of physicians, nurses, and other healthcare providers to help guide him through the process at each step of the way.

This section of our website is designed to help men and their families and friends understand how prostate cancer grows, the risk factors for prostate cancer, find out how prostate cancer is diagnosed, and look at the different treatment options for prostate cancer.

About the Prostate

Understanding what happens when prostate cancer begins to grow also helps explain how each of the different treatment options for prostate cancer is utilized.

Normal Anatomy
The prostate is a small, squishy gland about the size of a walnut that sits under the bladder and in front of the rectum. The urethra, the narrow tube that runs the length of the penis and that carries both urine and semen out of the body, runs directly through the prostate; the rectum, or the lower end of the bowel, sits just behind the prostate and the bladder.

Sitting just above the prostate are the seminal vesicles, two little glands that secrete about 60% of the substances that makes up semen; running alongside and attached to the sides of the prostate are the nerves that control erectile function.

Normal Physiology and Treatment-Related Changes

Despite the best efforts of physicians, treatment strategies for prostate cancer can disrupt normal urinary, bowel, and sexual functioning.

Under normal circumstances, the urinary sphincters, bands of muscle tissue at the base of the bladder and at the base of the prostate, remain tightly shut, thereby preventing urine that is stored in the bladder from leaking out. During urination, the sphincters are relaxed and the urine flows from the bladder through the urethra and out of the body.

During prostatectomy, after the prostate is removed, the bladder is pulled downward and is connected to the urethra at the point where the prostate had sat. If the sphincter at the base of the bladder is damaged during this process, or if it is damaged during radiation therapy, some measure of urinary incontinence or leakage will occur.

Solid waste that is filtered out of the body moves slowly down the intestines, and, under normal circumstances, the resultant stool is excreted through the anus following conscious relaxation of the anal sphincter. Damage to the rectum caused by radiation, or, more rarely, by surgery, can result in a number of bowel problems, including rectal bleeding, diarrhea, or urgency.

If the erectile nerves are damaged during prostatectomy, which was standard during this type of surgery up until the mid 1980s, the ability to achieve erection is lost. Sexual desire is not affected, but severing or otherwise damaging the nerves that stimulate the processes by which erection occurs leads to erectile dysfunction.

Finally, because about 10% of men have what is known as seminal vesicle invasion, meaning that the prostate cancer has either spread into the seminal vesicles or has spread around them, the seminal vesicles are typically removed during prostatectomy and are targeted during radiation therapy. The loss of the prostate and the seminal vesicles renders men infertile.

Risk Factors

Prostate cancer is the most common non-skin cancer in America, affecting 1 in 6 men. The older you are, the more likely you are to be diagnosed with prostate cancer. Although only 1 in 10,000 under age 40 will be diagnosed, the rate shoots up to 1 in 38 for ages 40 to 59, and 1 in 15 for ages 60 to 69. In fact, more than 65% of all prostate cancers are diagnosed in men over the age of 65.

But the roles of race and family history are important as well. African American men are 61% more likely to develop prostate cancer compared with Caucasian men and are nearly 2.5 times as likely to die from the disease. Men with a single first-degree relative—father, brother or son—with a history of prostate cancer are twice as likely to develop the disease, while those with two or more relatives are nearly four times as likely to be diagnosed. The risk is even higher if the affected family members were diagnosed at a young age, with the highest risk seen in men whose family members were diagnosed before age 60.

Although genetics might play a role in deciding why one man might be at higher risk than another, social and environmental factors, particularly diet and lifestyle, likely have an effect as well.

In fact, research in the past few years has shown that diet modification might decrease the chances of developing prostate cancer, reduce the likelihood of having a prostate cancer recurrence, or help slow the progression of the disease.

More information about how dietary and lifestyle changes can affect the risk of prostate cancer development and progression can be found in the Nutrition and Prostate Cancer guide.

When weighing risk factors for prostate cancer, it’s also important to recognize that there are non-risk factors, or factors that have not been linked to an increase in risk.

Non-Risk Factors

Equally important to knowing what has been linked to an increase in the risk of developing prostate cancer is knowing what has not been linked to an increase in risk.

The most common misperception about the risk of prostate cancer is that the presence of non-cancerous conditions of the prostate increase the risk of prostate cancer.

Although these conditions can cause symptoms similar to those of prostate cancer and should be evaluated by a physician, there is no evidence that having BPH (benign prostatic hyperplasia) or prostatitis increases the risk for developing prostate cancer.

BPH

BPH is a non-cancerous enlargement of the prostate. Because the urethra, the tube that carries urine from the bladder out of the body, runs directly through the prostate, enlargement of the prostate in BPH squeezes the urethra, making it difficult, and often painful, for men to urinate.

The growth of the prostate in men with BPH is unrelated to prostate cancer, and a number of research studies have shown that the presence of BPH does not make a man any more or less likely to develop prostate cancer.

Learn more about BPH

Prostatitis

Prostatitis is an infection in the prostate, and is the most common cause of urinary tract infection in men. Most treatment strategies are designed to relieve the symptoms of prostatitis, which include fever, chills, burning during urination, or difficulty urinating.

Research has shown that the presence of prostatitis does not make a man any more or less likely to develop prostate cancer.

Learn more about prostatitis

Sexual Activity

High levels of sexual activity or frequent ejaculation have been rumored to increase prostate cancer risk. This is untrue. In fact, studies show that men who reported more frequent ejaculations had a lower risk of developing prostate cancer.