Prostate Cancer FAQ

Here are some answers to frequently asked questions about prostate cancer.

Q: What is the prostate?

A: The prostate is a male sex gland that produces a thick fluid that forms part of the semen.

The prostate is about the size of a walnut. It's located below the bladder and in front of the rectum. It surrounds the upper part of the urethra, the tube that empties urine from the bladder. The prostate needs male hormones, including testosterone, to function.

Q: What causes prostate cancer?

A: The exact cause of prostate cancer is not known. Men whose close relatives have had prostate cancer are more likely to get it, suggesting that there are genetic factors. Studies are being done to see if exposure to certain materials, such as the metal cadmium, increases the risk of developing prostate cancer. The effect of a high-fat diet is also being studied for its impact on prostate cancer.

Q: What are the symptoms of prostate cancer?

A: Many men have no symptoms. The cancer is often found during a digital rectal examination (DRE) or a PSA blood test. These are the most common symptoms of prostate cancer (although prostate symptoms are more commonly caused by non-cancerous conditions, such as BPH):

  • A need to urinate often, especially at night

  • Weak or interrupted urine flow

  • Difficulty starting urination or holding back urine

  • Inability to urinate

  • Painful or burning urination

  • Painful ejaculation

  • Blood in urine or semen

  • Pain or stiffness in the lower back, hips, or upper thighs

Prostate cancer that has spread to the bones may show up as bone pain, usually in the hips or back.

Q: How is a digital rectal examination done?

A: For a digital rectal exam (DRE), you bend over and the doctor or nurse practitioner inserts a lubricated, gloved finger into your rectum. The examiner can feel your prostate through the rectal wall. He or she will check for hard or lumpy areas.

Q: What does PSA mean?

A: PSA stands for "prostate-specific antigen." The PSA test measures the levels of PSA in the blood.  PSA is produced by prostate tissue, whether it's normal or cancerous. The level of PSA in the blood may rise in men who have prostate cancer, BPH (an enlargement of the prostate), or an infection in the prostate. The function of PSA is not yet fully understood, but it doesn't seem to cause harm even when the blood level is very high. PSA does not cause the cancer to grow or spread. A doctor cannot diagnose prostate cancer with the PSA test alone, since elevated PSA level may also indicate other, noncancerous problems. However, the doctor will take the results of the PSA test into account when deciding whether to check further for signs of cancer.

Q: What are considered normal PSA levels?

A: A normal test range is from 0 to 4 ng/mL. This range changes slightly with age and race. When a man gets older, the normal range increases. A result of less than 4 is generally considered normal. Test results higher than 4 ng/mL are of concern, and suggest that further tests, such as a biopsy of the prostate, may be needed. Since PSA is a screening tool, it cannot tell the difference between cancer and other diseases of the prostate. However, a prostate biopsy can help tell the difference between cancer and other diseases of the prostate.

Q: What is a prostate biopsy?

A: A biopsy is a sample of tissue that is looked at under a microscope for cancer cells. Your urologist can take tissue samples from your prostate, often right in his or her office. Most of the time, the doctor performs the biopsy by inserting a needle through the perineum into the prostate. The perineum is the area between the anus and the testicles. The doctor usually uses a rectal ultrasound to help guide the needle into the prostate. To get a good tissue sampling, the doctor usually takes about 12 needle biopsies at the same time.

Q: What is staging?

A:

Staging is the process of finding out how far a cancer has spread in the body. Staging involves several types of tests to see if the cancer can be detected beyond the prostate gland. It can spread to tissue nearby or to other organs further away. A doctor may use blood tests, X-rays, CT scans, and nuclear medicine scans to help determine the cancer's stage.

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