Learn more about prostate cancer from Mayo Clinic urologist Mitchell Humphreys, M.D.
Hi. I'm Dr. Humphreys, a urologist at Mayo Clinic. In this video, we'll cover the basics of prostate cancer: What is it? Who gets it? The symptoms, diagnosis, and treatment. Whether you're looking for answers about your own health or that of someone you love, we're here to provide you with the best information available. Prostate cancer, unfortunately, is common. It affects one in seven men, making it the second most common cancer among men worldwide. The good news is, is that prostate cancer can be curable, especially when identified and treated early. That is why I and most urologists and medical professionals you talk to encourage men over a certain age to get regular prostate screenings. First, let's talk about what the prostate is and how it functions. The prostate is a small gland that is involved in reproduction and makes some of the essential components in semen. While it is small, it has an important role in reproductive health and can cause voiding or urinary symptoms as men age, as well becoming a source of cancer. Like other kinds of cancer, prostate cancer starts when cells mutate. These small changes in DNA cause the cells to grow faster and live longer than they normally would. As these abnormal cells accumulate, they monopolize resources from normal cells, which can damage surrounding tissue. These cancerous cells can then spread to other parts of the body.
Who gets it?
By definition, prostate cancer only affects bodies with male reproductive organs. But in addition, there are some other risk factors that we can monitor. Age is a big one, as prostate cancer is more prevalent in older men, which is why testing is encouraged as men age. For reasons that are unclear, Black men also have a greater risk compared to other races or ethnicities. Being at a higher weight as another possible risk factor. Genetics can also play a role in prostate cancer. A family history of prostate cancer or certain kinds of breast cancer increases the likelihood of being diagnosed with prostate cancer. Well, it's not a guarantee, there are plenty of steps you can take to reduce your risk. A healthy diet and exercise helps your body's overall well-being and can lower your chances of getting prostate cancer.
What are the symptoms?
A big reason to get regular testing is that prostate cancer usually has no presenting symptoms. And when they do show up, it generally indicates a worse stage of cancer. When symptoms do occur, they can include: trouble urinating or decreased force of stream, blood in the urine or semen, bone pain, unexpected weight loss, and unexplained fevers. If you consistently notice any of these symptoms, you should see your doctor right away. How is it diagnosed? There are a variety of ways to detect prostate cancer in both physical exam and from the blood. For starters, there's the DRE, the digital rectal exam. Just like the name suggests, the doctor inserts their finger and your rectum to feel the prostate to detect any abnormalities. You can also get a blood test to look for prostate-specific antigen, or PSA. It is recommended that you have this as well as the physical exam. And if there are any abnormalities, there are additional tests that can be used. If prostate cancer is detected, the next step is figuring out how fast it grows. Fortunately, prostate cancer often doesn't grow very fast. Prostate cancer is graded by a Gleason score, which measures how abnormal or different from normal cells are. There are also other tests to see if the cancer has spread: bone scan, CT scan, MRI, and even specific PET scans. Your doctor will be able to determine which, if any, is appropriate for you.
How is it treated?
Treatments are most effective when the cancer is caught early. In fact, immediate treatment isn't always necessary. Keeping an eye on the cancer until it grows bigger is sometimes enough. When cancer is localized only to the prostate, surgery to remove the prostate, or a radical prostatectomy, could be your best option. Radiation is another possibility. With external beam radiation, high-energy beams that deliver photons, target and kill the abnormal cells of the prostate from outside your body. Another treatment is chemotherapy, which uses powerful chemicals, destroy the cancer cells. Cryotherapy, which freezes the cancer cells, or heat, can be used to kill the cancer cells with high-intensity focused ultrasound. Consider that prostate cancer uses male hormone or testosterone as an important factor for growth. In some prostate cancers, it may be beneficial to block that hormone with androgen deprivation therapy, or ADT, which can slow the cancer or even put it in remission. It is generally not curative and usually the cancer will find a way to grow even with the lack of testosterone. Sometimes ADT is used in combination to enhance the treatment success of other therapies, such as with radiation. All of these treatments have side effects of various degrees and have different success rates of treating prostate cancer. It's important that you have a candid discussion with your family and your care team and weigh all that information to make the best choice for you. Support groups for cancer survivors can be helpful in dealing with the stress of the diagnosis and treatments.
As we've seen here, research and scientific advancement has provided us with a host of options for this extremely treatable form of cancer. And with early detection, your chances are even better. While it may not be a thing people want to think about, it's an important part of your health and an expert medical care team can guide you to the solutions that are most tailored for you, your wishes and your body. If you'd like to learn even more about prostate cancer, watch our other related videos or visit mayoclinic.org. We wish you well.