What is a prostate cancer?

The prostate gland is usually about the size of a walnut and is located just under the bladder. It surrounds the top part of the urethra (the tube that carries urine from the bladder to the end of the penis). Because the prostate gland is located in front of the rectum (lower part of the large bowel), the prostate gland can be felt by your doctor during a digital rectal exam (checking the prostate by inserting a gloved finger into the rectum).

The prostate gland is responsible for producing part of the liquid that is ejaculated through the urethra during sexual activity (semen). The other part of the liquid contains sperm and comes from the testicles to the prostate gland through a tube, called the vas deferens. As with many other tissues and organs in the body, uncontrolled growth of cells (cancer) can occur in the prostate gland. According to the National Cancer Institute of Canada (1996), prostate cancer is the most frequent cancer and the second leading cause of death from cancer in men. However, most men will die with, rather than from, prostate cancer. Autopsy studies report that more than 30% of all men over the age of 50 have evidence of prostate cancer, but only 3% die from it.

What are the risk factors for developing prostate cancer?

• being over 50 years of age – the risk for developing prostate cancer in men 75 years of age is 30 times greater than in men 50 years of age
• a high intake of dietary fat is associated with higher risk
• race- African-American men have a 30% greater incidence of prostate cancer compared to Caucasian (white) men
• family history – there is an increased risk the development of prostate cancer in men who have first degree relative with the disease (e.g. father, brother)

What are the symptoms of prostate cancer?

NOTE: Prostate cancer can cause enlargement of the prostate gland. As a result, the symptoms of prostate cancer can be very similar to the symptoms of benign (non-cancerous) prostate enlargement:

• trouble starting the flow of urine
• a weaker than normal stream of urine
• the urge to pass urine often
• dribbling when passing urine (especially at the end of the stream)
• inability to pass urine
• incontinence (failure to prevent the passage of urine)

These symptoms should be reported to your doctor as soon as possible.

While most symptoms of prostate enlargement are NOT due to cancer, this possibility needs to be ruled out.

In some men, the above symptoms will not be present or they will be mild. Instead pelvic pain or pain in the bones (from prostate cancer that has spread to the bones) will be the first symptoms noticed.

How can I be diagnosed?

The first step toward a diagnosis of prostate cancer usually involves a rectal exam (a cancerous prostate gland will usually feel lumpy and harder than normal). If your doctor thinks that there may be cancer of the prostate present, other tests will be done. For example, an ultrasound and, perhaps, a needle biopsy of the prostate to collect a sample of prostate tissue for testing in the lab. A bone scan may also be done to see if there has been any spread of the prostate cancer to the bones.

Prostate Specific Antigen (PSA) Testing

Along with the other tests your doctor may do, there is now a blood test available in Canada that can be helpful in the diagnosis and ongoing monitoring of prostate cancer. The blood test is called a prostate-specific antigen (PSA) test. PSA is a protein that is produced by both normal and cancerous prostate tissue. Increased levels of PSA in the blood may be an indicator of both cancerous and non-cancerous abnormalities of the prostate gland.

Talk to your doctor about PSA testing.

What are some treatment options?

If prostate cancer is found, your doctor will recommend treatment options depending on a number of factors such as:

• how large the prostate tumor is
• whether the tumor has spread to the bones or other places in your body
• your age
• your general state of health

You will need to discuss your treatment options with your doctor(s) carefully. A combination of options may be recommended.

What are some resources and services available?

• Visit the Canadian Cancer Society’s ^[1] website
• Call the Canadian Cancer Society’s toll free Cancer Information Service at 1-888-939-3333. This bilingual service is available Mon. to Fri., 9 a.m. to 6 p.m. ET (7 a.m. to 4 p.m. Mountain Time)
• You can also e-mail the Cancer Information Service at: [email protected] ^[2]

To speak to a health professional, contact your family doctor or speak to a registered nurse 24 hours a day, seven days a week by calling: Calgary Health Link at 403-943-LINK (5465) or toll free at 1-866-408-LINK (5465).  Mandarin Health Link 403-943-1554, Cantonese Health Link 403-943-1556.

Source: “Prostate Cancer”, HealthLink Alberta, www.healthlinkalberta.ca ^[3]

If you want to read any of the previous ‘Road to Healthy Living’ series articles, please go to

http://www.albertahealthservices.ca/4248.asp ^[4] and get health information in your own language