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Prostate Cancer

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Medically reviewed by
Interprofessional Advanced Clinical Simulation Fellow. Durham, NC
Last updated September 22, 2022

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Care Plan

1

First steps to consider

  • Prostate cancer should be diagnosed and treated by a team of urologists and radiation and medical oncologists (cancer specialists).
  • See a healthcare provider if you have any of these symptoms or history:
    • Unexplained weight loss or fatigue
    • Excruciating back or bone-related pain
    • Difficulties urinating
    • Blood in your urine

Emergency Care

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Go to the ER if you have any of the following symptoms:

  • Unable to urinate
  • Blood and clots in your urine
  • Sudden muscle weakness

What is prostate cancer?

The prostate is the walnut-sized organ in males that sits beneath the bladder and penis. It makes fluid that is secreted with sperm in the ejaculate. Prostate cancer occurs when the prostate cells turn cancerous.

Prostate cancer can sometimes be deadly, but in the U.S., the survival rates are excellent. Both the 5- and 10-year survival rate for prostate cancer is 98%.

Detecting the disease early is important. It is more likely to be deadly if it spreads to other organs. Prostate cancer doesn’t always cause symptoms in the early stages, so you should be screened for it at your yearly physical.

Symptoms

Early-stage prostate cancer usually doesn’t cause any symptoms. In the later stages of the disease, you may experience:

  • Difficulty when starting to urinate
  • Decreased force in the stream of urine
  • Feeling like you have to urinate constantly or urgently
  • Dribbling after urination
  • Trouble getting an erection
  • Unexplained weight loss
  • Fatigue
  • Bone pain and fractures (in later stages if the cancer spreads to the bones)

How is prostate cancer detected early?

Prostate cancer screening is recommended in men from 55–79 years old, sometimes earlier depending on risk factors. It consists of a digital rectal exam or DRE and a blood test known as a prostate specific antigen (PSA).

  • Your provider should perform a DRE as part of your yearly physical exam. During this exam, the provider gently places their finger in the rectum and feels the back side of the prostate (where the cancer generally occurs). If they feel an irregularity or hard nodule, they will want to run other tests to confirm if it is prostate cancer.
  • While PSA is made by all prostate cells, it is higher in men with prostate cancer. If the PSA is high or suddenly increases from normal levels, it may be an early sign of prostate cancer. But there can be other reasons for its increase. Your provider will interpret your PSA results.

Causes of prostate cancer

It’s not known what causes prostate cancer. It develops when normal prostate cells have changes in their DNA, which controls how the cells function. These changes, or mutations, can be inherited from a parent or happen during a person’s lifetime.

Risk factors

  • Older age. Most prostate cancers (60%)  occur in men ages 65 and older.
  • Race. In the U.S., African-American men and Caribbean men of African ancestry have the highest risk of prostate cancer than any other race. In these men, the disease tends to start at a younger age. They’re also more likely to die from prostate cancer.
  • Family history. Having a father or brother with prostate cancer more than doubles a man’s risk of developing the disease.
  • Chemical exposure. Prostate cancer has been linked to exposure to Agent Orange, a chemical spray used during the Vietnam War.

Preventative tips

There are no proven ways to completely prevent prostate cancer. The best form of prevention is early detection. Be sure to get a yearly physical, which includes screening tests for prostate cancer.

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Interprofessional Advanced Clinical Simulation Fellow. Durham, NC
Dr. Chandrapal is the current Interprofessional Advanced Clinical Simulation Fellow at the VA medical center in Durham, NC. Prior to his current position he was a urology resident at Duke University. Originally from Houston, TX he went to undergrad at the University of Texas in Austin, followed by a masters degree from the University of Texas Health Science Center in San Antonio, and medical schoo...
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