Patient Information

Facts About Prostate Cancer

Facts about the Prostate

The prostate is a combination of glands encased in an outer shell. It is approximately the size of a golf ball. It resembles an orange with a spongy inner section and a firmer outer surface. The purpose of the prostate is to produce a cloudy white fluid known as semen. This transports the sperm cells out of the body. The prostate surrounds the urethra and is located immediately below the bladder. This portion is referred to as the base, and the other end is the apex. Approximately one third of the prostate is muscle and as it contracts, the glandular secretions are forced into the urethra.

During childhood, the prostate remains about the size of a marble. At onset of puberty, the prostate begins to grow. It reaches adult size in the mid to late teens. Nothing much happens to the prostate until about the early fifties. At this time, it begins to show some signs of age and loses tone and vigor. With the stimulation of the hormone, testosterone, the prostate may grow. It can grow to as large as a baseball or even more. It is during this time that urinary symptoms caused by impingement on the urethra and bladder may occur.

Symptoms of Prostate Cancer

Unfortunately, early stage prostate cancer does not have any noticeable symptoms. By the time any symptoms become bothersome, the disease could be in advanced stages. Many times these same symptoms present and there is no cancer. The best way to ensure you’ve done everything to detect prostate cancer is to have a yearly check up. Unfortunately, it is impossible for men to check their own prostate. They must rely on a doctor to do this for them. The exam takes a few seconds by a doctor and can detect a tumor years before it would present any symptoms. This is done by the doctor inserting a gloved finger into the rectum to feel the prostate.

Prostate-Specific Antigen Test

PSA is a blood test which is drawn to determine the level of an enzyme called prostatic specific antigen. The PSA is not found anywhere else in the body. A small amount of PSA leaks in the blood and binds onto certain proteins in the blood. When there is any type of irritation to the prostate, more PSA is detected in the blood. This test was developed in 1980 and has been one of the greatest impacts on the diagnosis and treatment of prostate cancer. The PSA should never be used alone as a screening tool. Some men with low PSA levels have prostate cancer, while some men with high elevations do not. The PSA level rises with age, so therefore, the acceptable level is different for each age group. Many additional factors enter into evaluation of the PSA level. Some factors to be considered are: body size, race, testosterone level, prostatitis, urinary retention, and medications.

There is no agreement among specialists as to when the PSA testing should begin. The time to start screening is generally based on individual risk, with age 40 being a reasonable time to start screening for those at highest risk (genetic predispositions or strong family histories of prostate cancer at a young age).

For otherwise healthy men at high risk (positive family history or African American men), starting at age 40-45 is reasonable.

Guidelines differ for men at average risk. Some recommend an initial PSA and digital rectal exam at age 40, and others recommend starting at age 50. In general, all men should develop a prostate health plan that is right for them based on their lifestyle and family history.