What You Need to Know About Prostate Cancer
"
Many people with cancer want to learn
all they can about their disease, their treatment choices, and
possible side effects of treatment, so they can take an active
part in decisions about their medical care.
"
Introduction
Prostate cancer is the most common type of cancer in men in
the United States (other than skin cancer). The National Cancer
Institute (NCI) has written this booklet to help patients with
prostate cancer and their families and friends better understand
this disease. We hope others will read it as well to learn more
about prostate cancer.
This booklet discusses symptoms, diagnosis, and treatment. It
also has information to help patients cope with prostate cancer.
Our knowledge about prostate cancer keeps increasing. For up-to-date
information or to order this publication, call the National Cancer
Institute's Cancer Information Service (CIS). The toll-free number
is 1-800-4-CANCER (1-800-422-6237).
The CIS staff use a National Cancer Institute cancer information
database called PDQ and other NCI resources to answer callers'
questions. Cancer Information Specialists can send callers information
from PDQ and other NCI materials about cancer, its treatment,
and living with the disease.
Words that may be new to readers appear in italics. Definition
of these and other terms related to prostate cancer can be found
in the Glossary. For some words, a "sounds-like" spelling is also
given.
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The Prostate
The prostate is a male sex gland. It produces a thick fluid
that forms part of the semen. The prostate is about the size of
a walnut. It is located below the bladder and in front of the
rectum. The prostate surrounds the upper part of the urethra,
the tube that empties urine from the bladder.
The prostate needs male hormones to function. The main male
hormone is testosterone, which is made mainly by the testicles.
Some male hormones are produced in small amounts by the adrenal
glands.
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What Is Cancer?
Cancer is a group of many different diseases that have some
important things in common. They all affect cells, the body's
basic unit of life. To understand cancer, it is helpful to know
about normal cells and what happens when cells become cancerous.
The body is made up of many types of cells. Normally, cells
grow and divide to produce more cells only when the body needs
them. This orderly process helps keep the body healthy.
If the cells keep dividing when new cells are not needed, they
form too much tissue. Excess tissue can form a mass, called a
tumor. Excess tissue can be benign or malignant.
Benign tissue is not cancer. The cells do not invade nearby
tissue or spread to other parts of the body.
Malignant tissue is cancer. The cancer cells divide out of control.
They can invade and destroy nearby healthy tissue. Also, cancer
cells can break away from the tumor they form and enter the bloodstream
and lymphatic system, This is how cancer spreads from the original
(primary) tumor to form new tumors in other parts of the body.
The spread of cancer is called metastasis.
Benign prostatic hyperplasia (BPH) is the abnormal growth of
benign prostate cells. In BPH, the prostate grows larger and pushes
against the urethra and bladder, blocking the normal flow of urine.
More than half of the men in the United States between the ages
of 60 and 70 and as many as 90 percent between the ages of 70
and 90 have symptoms of BPH. Although this condition is seldom
a threat to life, it may require treatment to relieve symptoms.
Most cancers are named for the type of cell or organ in which
they begin. Cancer that begins in the prostate is called primary
prostate cancer (or prostatic cancer). Prostate cancer may remain
in the prostate gland, or it may spread to nearby lymph nodes.
Prostate cancer may also spread to the bones, bladder, rectum,
and other organs.
When cancer spreads to other parts of the body, the new tumor
has the same malignant cells and the same name as the primary
tumor. For example, if prostate cancer spreads to the bones, the
cancer cells in the new tumor are prostate cancer cells. The disease
is metastatic prostate cancer; it is not bone cancer.
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Symptoms
Early prostate cancer often does not cause symptoms. When symptoms
of prostate cancer do occur, they may include some of the following
problems:
A need to urinate frequently, especially at night;
Difficulty starting urination or holding back urine;
Inability to urinate;
Weak or interrupted flow of urine;
Painful or burning urination;
Painful ejaculation;
Blood in urine or semen; and/or
Frequent pain or stiffness in the lower back, hips, or upper
thighs.
Any of these symptoms may be caused by cancer or by other, less
serious health problems, such as BPH or an infection. Only a doctor
can tell the cause. A man who has symptoms like these should see
his family doctor or a urologist (a doctor who specializes in
treating diseases of the genitourinary system). Do not wait to
feel pain; early prostate cancer does not cause pain.
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Diagnosis
If symptoms occur, the doctor asks about the patient's medical
history, performs a physical exam, and may order laboratory tests.
The exams and tests may include the following:
Digital rectal exam -- the doctor inserts a gloved, lubricated
finger into the rectum and feels the prostate through the rectal
wall to check for hard or lumpy areas.
Blood tests -- a lab measures the levels of prostate-specific
antigen (PSA) and prostatic acid phosphatase (PAP) in the blood.
The level of PSA in the blood may rise in men who have prostate
cancer, BPH, or an infection in the prostate. The level of PAP
rises above normal in many prostate cancer patients, especially
if the cancer has spread beyond the prostate. The doctor cannot
diagnose prostate cancer with these tests alone because elevated
PSA or PAP levels may also indicate other, noncancerous problems.
However, the doctor will take the results of these tests into
account in deciding whether to check the patient further for signs
of cancer.
Urine test -- a lab checks the urine for blood or infection.
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The doctor may order other tests to learn more about the
cause of the symptoms and to help determine whether conditions
of the prostate are benign or malignant, such as:
Transrectal ultrasonography -- sound waves that cannot
be heard by humans (ultrasound) are sent out by a probe inserted
into the rectum. The waves bounce off the prostate, and a computer
uses the echoes to create a picture called a sonogram.
Intravenous pyelogram -- a series of x-rays of the organs
of the urinary tract.
Cystoscopy -- a procedure in which a doctor looks into
the urethra and bladder through a thin, lighted tube.
If test results suggest that cancer may be present, the patient
will need to have a biopsy. A biopsy is the only sure way to know
whether a problem is cancer. During a biopsy, the doctor removes
a small amount of prostate tissue, usually with a needle. A pathologist
looks at the tissue under a microscope to check for cancer cells.
If cancer is present, the pathologist usually reports the grade
of the tumor. The grade tells how closely the tumor resembles
normal prostate tissue and suggests how fast the tumor is likely
to grow. One way of grading prostate cancer, called the Gleason
system, uses scores of 2 to 10. Another system uses G1 through
G4. Tumors with lower scores are less likely to grow or spread
than tumors with higher scores.
A man who needs a biopsy may want to ask the doctor some of
the following questions:
How long will the procedure take? Will I be awake? Will it hurt?
How soon will I know the results?
If I do have cancer, who will talk to me about treatment? When?
If the physical exam and test results do not suggest cancer,
the doctor may recommend medicine to reduce the symptoms caused
by an enlarged prostate. Surgery is another way to relieve these
symptoms. The surgery used in such cases is transurethral resection
of the prostate (TURP or TUR). In TURP, an instrument is inserted
through the penis to remove prostate tissue that is pressing against
the upper part of the urethra.
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Staging
If cancer is found in the prostate, the doctor needs to know
the stage, or extent, of the disease. Staging is a careful attempt
to find out whether the cancer has spread and, if so, what parts
of the body are affected. The doctor may use various blood and
imaging tests to learn the stage of the disease. Treatment decisions
depend on these findings.
The results of staging tests help the doctor decide which stage
best describes a patient's disease:
Stage I (A) -- The cancer cannot be detected by rectal
exam and causes no symptoms. The cancer is usually found during
surgery to relieve problems with urination. State I tumors may
be in more than one area of the prostate, but there is no evidence
of spread outside the prostate.
Stage II (B) -- The tumor is felt in a rectal exam or
detected by a blood test, but there is no evidence that the cancer
has spread outside the prostate.
Stage III (C) -- The cancer has spread outside the prostate
to nearby tissues.
Stage IV (D) -- Cancer cells have spread to lymph nodes
or to other parts of the body.
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Treating Prostate Cancer
Getting a Second Opinion
Decisions about prostate cancer treatment are complex. It may
be helpful to have the opinion of more than one doctor. Before
starting treatment, men may want to have a second doctor review
their diagnosis and treatment options. A short delay will not
reduce the chance that treatment will be successful. Some health
insurance companies require a second opinion; many others will
cover a second opinion if the patient requests it. There are a
number of ways to find a doctor who can give a second opinion:
The doctor may be able to recommend a specialist. Doctors who
specialize in treating prostate cancer are urologists, radiation
oncologists, and medical oncologists.
The Cancer Information Service, at 1-800-4-CANCER, can tell
callers about treatment facilities, including cancer centers and
other programs supported by the National Cancer Institute.
People can get the names of doctors from their local medical
society, a nearby hospital, or a medical school.
The Directory of Medical Specialists lists doctors by state
and specialty and gives information about their background. This
resource is in most public libraries.
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Preparing for Treatment
The doctor develops a treatment plan to fit each patient's needs.
Treatment for prostate cancer depends on the stage of the disease
and the grade of the tumor (how fast the cells are likely to grow
or spread to other organs). Other important factors in planning
treatment are the man's age and general health and his feelings
about the treatments and their possible side effects.
Many people with cancer want to learn all they can about their
disease, their treatment choices, and possible side effects of
treatment, so they can take an active part in decisions about
their medical care. There are a number of available treatments
for men with prostate cancer (surgery, radiation therapy, and
hormone therapy). Not all men require treatment. The patient and
his doctor may want to consider both the benefits and possible
side effects of each option, especially the effects on sexual
activity and urination, and other concerns about quality of life.
Patients may find helpful information in Methods of Treatment,
Side Effects of Treatment, and Support for Cancer Patients. Also,
the patient may want to talk with his doctor about taking part
in a research study to help determine the best approach or to
study new kinds of treatment. To find more information about such
studies, see the Clinical Trials section.
When a person is diagnosed with cancer, shock and stress are
natural reactions. These feelings may make it difficult for patients
to think of everything they want to ask the doctor. Often it helps
to make a list of questions. Also, to help remember what the doctor
says, patients may take notes or ask the doctor whether they may
use a tape recorder. Some patients also may want to have a family
member or friend with them when they talk to the doctor--to take
part in the discussion, to take notes, or just to listen.
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Questions may arise throughout the treatment process. From
time to time, patients may wish to ask members of their health
care team to explain things further.
These are some questions a patient may want to ask the doctor
before treatment begins:
- What is the stage of the disease?
- What is the grade of the disease?
- Do I need to be treated? What are the treatment choices? What
do you recommend for me?
- What are the expected benefits of each kind of treatment?
- What are the risks and possible side effects of each treatment?
- Is treatment likely to affect my sex life?
- Am I likely to have urinary problems?
- Are new treatments being studied in clinical trials? Would
a trial be appropriate for me?
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Methods of Treatment
Many men whose prostate cancer is slow growing and found at
an early stage may not need treatment. Also, treatment may not
be advised for older men or men with other serious medical problems.
For these men, the possible side effects and the risks of treatment
may outweigh the possible benefits of treatment; instead, the
doctor may suggest "watchful waiting"--following the patient closely
and treating the patient later for symptoms that may arise. Researchers
are studying men with early stage prostate cancer to determine
when and in whom treatment may be necessary and effective.
Treatment for prostate cancer may involve surgery, radiation
therapy, or hormone therapy. Sometimes, patients receive a combination
of these treatments. In addition, doctors are studying other methods
of treatment to find out whether they are effective against this
disease.
Surgery is a common treatment for the early stages of prostate
cancer. Surgery to remove the entire prostate is called radical
prostatectomy. It is done in one of two ways. In retropubic prostatectomy,
the prostate and nearby lymph nodes are removed through an incision
in the abdomen. In perineal prostatectomy, the prostate is removed
through an incision between the scrotum and the anus. Nearby lymph
nodes are sometimes removed through a separate incision in the
abdomen. If the pathologist finds cancer cells in the lymph nodes,
it may mean that the disease has spread to other parts of the
body.
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These are some questions a patient may want to ask the doctor
before having surgery:
- What kind of operation will it be?
- How will I feel after the operation?
- If I have pain, how will you help?
- Will I have any lasting side effects?
Radiation therapy is another way to treat prostate cancer. In
radiation therapy (also called radiotherapy), high-energy rays
are used to damage cancer cells and stop them from growing and
dividing. Like surgery, radiation therapy is local therapy; it
can affect cancer cells only in the treated area. In early stage
prostate cancer, radiation can be used instead of surgery, or
it may be used after surgery to destroy any cancer cells that
may remain in the area. In advanced stages, it may be given to
relieve pain or other problems.
Radiation may be directed at the body by a machine (external
radiation), or it may come from a small container of radioactive
material placed directly into or near the tumor (internal radiation).
Some patients receive both kinds of radiation therapy.
For external radiation therapy for prostate cancer, the patient
is treated in an outpatient department of a hospital or clinic.
Treatment generally is given 5 days a week for about 6 weeks.
This schedule helps protect healthy tissues by spreading out the
total dose of radiation. The rays are aimed at the pelvic area.
At the end of treatment, an extra "boost" of radiation is often
directed at a smaller area, where the tumor developed.
For internal (or implant) radiation therapy, a brief stay in
the hospital may be needed when the radioactive material is implanted.
The implant may be temporary or permanent. When a temporary implant
is removed, there is no radioactivity in the body. The amount
of radiation in a permanent implant is not generally dangerous
to other people, but patients may be advised to avoid prolonged
close contact with others for a period of time.
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These are some questions a patient may want to ask the doctor
before having radiation therapy:
- What is the goal of this treatment?
- How will the radiation be given?
- When will the treatment begin? When will it end?
- How will I feel during therapy?
- What can I do to take care of myself during therapy?
- How will we know if the radiation therapy is working?
- Will I be able to continue my normal activities during treatment?
Hormone therapy prevents the prostate cancer cells from getting
the male hormones they need to grow. When a man undergoes hormone
therapy, the level of male hormones is decreased. This drop in
hormone level can affect all prostate cancer cells, even if they
have spread to other parts of the body. For this reason, hormone
therapy is called systemic therapy.
There are several forms of hormone therapy. One is surgery to
remove the testicles. This operation, called orchiectomy, eliminates
the main source of male hormones.
The use of luteinizing hormone-releasing hormone (LHRH) agonist
is another type of hormone therapy. LHRH agonists prevent the
testicles from producing testosterone.
In another form of hormone therapy, patients take the female
hormone estrogen to stop the testicles from producing testosterone.
After orchiectomy or treatment with an LHRH agonist or estrogen,
the body no longer gets testosterone from the testicles. However,
the adrenal glands still produce small amounts of male hormones.
Sometimes, the patient is also given an antiandrogen, a drug that
blocks the effect of any remaining male hormones. This combination
of treatment is known as a total androgen blockade.
Prostate cancer that has spread to other parts of the body usually
can be controlled with hormone therapy for a period of time, often
several years. Eventually, however, most prostate cancers are
able to grow with very little or no male hormones. When this happens,
hormone therapy is no longer effective, and the doctor may suggest
other forms of treatment that are under study.
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Clinical Trials
Many men with prostate cancer take part in clinical trials (treatment
studies). Doctors conduct clinical trials to learn about the effectiveness
and side effects of new treatments. In some clinical trials, all
patients receive the new treatment. In the trials, doctors compare
different therapies by giving the new treatment to one group of
patients and the standard therapy to another group; or they may
compare one standard treatment to another.
People who take part in these studies have the first chance
to benefit from treatments that have shown promise in earlier
research. They also make an important contribution to medical
science.
Many clinical trials of treatments for prostate cancer are under
way. For example, researchers are comparing treatment against
careful observation of men with early stage prostate cancer. The
results of this work will help doctors to know whether to treat
early stage prostate cancer immediately or only later on, if symptoms
occur.
Doctors are studying new ways of using radiation therapy and
hormone therapy. Some doctors also are exploring the use of cryosurgery,
which uses extreme cold to destroy cancer cells, as an alternative
to surgery and radiation therapy. In cryosurgery, an instrument
called a cryoprobe is placed in direct contact with the tumor
to freeze it, sparing nearby healthy tissue.
Researchers also are testing the effectiveness of chemotherapy
and biological therapy for patients whose cancer does not respond
or stops responding to hormone therapy. In addition, scientists
are looking for new ways of combining various types of treatment.
Men with prostate cancer who are interested in taking part in
a clinical trial should discuss this option with their doctor.
Taking Part in Clinical Trials: What Cancer Patients Need To Know
is a National Cancer Institute booklet that explains the possible
benefits and the risks of participating in treatment studies.
One way to learn about clinical trials is through PDQ, a computerized
resource developed by the National Cancer Institute. This resource
contains information about cancer treatment and about clinical
trials in progress all over the country. The Cancer Information
Service can provide PDQ information to patients and the public.
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Side Effects of Treatment
Although doctors plan treatment very carefully, it is hard to
limit the effects of treatment so that only cancer cells are removed
or destroyed. Because treatment also damages healthy cells and
tissues, it often causes unwanted, and sometimes serious, side
effects.
The side effects of cancer treatment depend mainly on the type
and extent of the treatment. Also, each patient reacts differently.
Doctors and nurses can explain the possible side effects of treatment,
and they can often suggest ways to help relieve symptoms that
may occur during and after treatment. It is important to let the
doctor know if any side effects occur.
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Surgery
Although patients are often uncomfortable during the first few
days after surgery, their pain can be controlled with medicine.
Patients should feel free to discuss pain relief with the doctor
or nurse. It is also common for patients to feel tired or weak
for a while. The length of time it takes to recover from an operation
varies for each patient.
Surgery to remove the prostate may cause permanent impotence
and sometimes causes urinary incontinence. These side effects
are somewhat less common than in the past. Some surgeons use new
methods, especially when removing small tumors. These techniques,
called nerve-sparing surgery, may prevent permanent injury to
the nerves that control erection and damage to the opening of
the bladder. When this surgery is fully successful, impotence
and urinary incontinence are only temporary. However, men who
have a prostatectomy no longer produce semen, so they have dry
orgasms.
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Radiation Therapy
Radiation therapy may cause patients to become very tired as
treatment continues. Resting is important, but doctors usually
advise patients to try to stay as active as they can. Patients
may have diarrhea or frequent and uncomfortable urination. In
addition, when patients receive external radiation therapy, it
is common for the skin in the treated area to become red, dry,
and tender. Radiation therapy can also cause hair loss in the
pelvic area. The loss may be temporary or permanent, depending
on the amount of radiation used.
Radiation therapy causes impotence in some men. This does not
occur as often with internal radiation therapy as with external
radiation therapy; internal radiation therapy is not as likely
to damage the nerves that control erection.
The National Cancer Institute publication Radiation Therapy
and You offers helpful suggestions about coping with the side
effects of this form of treatment.
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Hormone Therapy
Orchiectomy, LHRH agonists, and estrogen often cause side effects
such as loss of sexual desire, impotence, and hot flashes. When
first taken, an LHRH agonist tends to increase tumor growth and
may make the patient's symptoms worse. This temporary problem
is called "tumor flare." Gradually, however, the drug causes a
man's testosterone level to fall. Without testosterone, tumor
growth slows down and the patient's condition improves. Prostate
cancer patients who receive estrogen or an antiandrogen may have
nausea, vomiting, or tenderness and swelling of the breasts. (Estrogen
is used less now than in the past because it increases a man's
risk of heart problems. This form of treatment is not appropriate
for men who have a history of heart disease.)
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Chemotherapy
The side effects of chemotherapy depend mainly on the specific
drugs that are used. The National Cancer Institute publication
Chemotherapy and You may be helpful to patients experiencing the
side effects of chemotherapy.
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Biological Therapy
Biological therapy may cause flu-like symptoms such as chills,
fever, muscle aches, weakness, loss of appetite, nausea, vomiting,
or diarrhea. Patients may also bleed or bruise easily, and some
get a rash. Some of these problems can be severe, but they go
away after the treatment stops.
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Nutrition for Cancer Patients
Good nutrition is important. Patients who eat well often feel
better and have more energy. Eating well during cancer treatment
means getting enough calories and protein to prevent weight loss,
regain strength, and rebuild normal tissues.
Some patients find it hard to eat well during treatment. They
may lose their appetite. In addition to loss of appetite, common
side effects of treatment, such as nausea and vomiting, can make
eating difficult. Foods taste different to some patients. Also,
people undergoing treatment may not feel like eating when they
are uncomfortable or tired.
Doctors, nurses, and dietitians can offer advice for healthy
eating during cancer treatment. Patients and their families also
may want to read the National Cancer Institute booklet Eating
Hints for Cancer Patients, which has helpful information about
cancer treatment and coping with side effects.
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Followup Care
Regular followup exams are important for any man who has had
prostate cancer. The doctor will suggest an appropriate followup
schedule. The doctor will examine the patient regularly to be
sure that the disease has not returned or progressed, and decide
what other medical care may be needed. Followup exams may include
x-rays, scans, and laboratory tests, including the PSA blood test.
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Support for Cancer Patients
Living with a serious disease is not easy. People with cancer
and those who care about them face many problems and challenges.
Coping with these problems is often easier when people have helpful
information and support services. Several useful booklets, including
the National Cancer Institute booklet Taking Time, are available
from the Cancer Information Service.
Friends and relatives can be very supportive. Also, patients
may find it helpful to discuss their concerns with others who
have or have had cancer. Cancer patients often get together in
support groups, where they can share what they have learned about
coping with cancer and the effects of treatment. It is important
to keep in mind, however, that each patient is different. Treatments
and ways of dealing with cancer that work for one person may not
be right for another--even if they both have the same kind of
cancer. It is a good idea to discuss the advice of friends and
family members with the doctor.
People with cancer may worry about holding their job, caring
for their family, or keeping up with daily activities. Worries
about tests, treatments, hospital stays, and medical bills are
common. Doctors, nurses, and other members of the health care
team can answer questions about treatment, working, and other
activities. Also, meeting with a social worker, counselor, or
member of the clergy can be helpful to patients who want to talk
about their feelings and discuss their concerns.
It is natural for a man and his partner to be concerned about
the effects of prostate cancer and its treatment on their sexual
relationship. They may want to talk with the doctor about possible
side effects and whether these side effects are likely to be temporary
or permanent. Whatever the outlook, it may be helpful for patients
and their partners to talk about their concerns and to help one
another find ways to be intimate during and after treatment.
Often, a social worker at the hospital or clinic can suggest
local and national groups that can provide emotional support,
financial aid, transportation, home care, or other services. The
Cancer Information Service also has information on local resources.
The American Cancer Society is one such resource. This nonprofit
organization has many services for patients and their families
and offers a free booklet on sexuality and cancer.
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What the Future Holds
Researchers are finding better ways to treat prostate cancer,
and the outlook for men with prostate cancer keeps improving.
Still, it is natural for patients and their families to be concerned
about what the future holds. Sometimes people use statistics to
try to figure out the chances of being cured. It is important
to remember, however, that statistics are averages based on large
numbers of patients. They cannot be used to predict what will
happen to a particular patient because no two patients are alike;
treatments and responses vary greatly. The doctor who takes care
of the patient is in the best position to discuss the patient's
prognosis (chance of recovery or control of the disease).
When doctors talk about surviving cancer, they may use the term
remission rather than cure. Even though many prostate cancer patients
recover completely, doctors use this term because the disease
can recur, or reappear after treatment.
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Research To Understand Prostate Cancer
Prostate cancer is an important public health problem. Prostate
cancer accounts for one of every three cancers among American
men. Researchers are conducting studies to learn more about the
causes and early detection of this common disease.
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Causes and Prevention
The causes of prostate cancer are not yet understood. Researchers
are looking at factors that may increase the risk of this disease.
The more they can learn about these risk factors, the better the
chance of finding ways to prevent and treat prostate cancer.
Studies in the United States show that prostate cancer is found
mainly in men over age 55; the average age of patients at the
time of diagnosis is 72. This disease is more common in black
men than in white men. In fact, black men in the United States
have the highest rate of prostate cancer in the world. Doctors
cannot explain why one man gets prostate cancer and another does
not, but they do know that no one can "catch" prostate cancer
from another person. Prostate cancer is not contagious.
Some studies have shown that a man has a higher risk for prostate
cancer if his father or brother has had the disease. However,
researchers are uncertain why some families have a higher incidence
of prostate cancer.
Scientists are studying the effects of diet. Some evidence suggests
that a diet high in fat increases the risk of prostate cancer
and a diet high in fruits and vegetables decreases the risk, but
these links have not been proven.
Researchers have studied whether having a vasectomy increases
a man's risk for prostate cancer. Some studies suggest there may
be such a link, but other studies have not supported this claim.
Other studies show that farmers and workers exposed to the metal
cadmium during welding, electroplating, or making batteries may
have an increased risk of getting this disease. Also, workers
in the rubber industry appear to develop prostate cancer more
often than members of the general public. However, more research
is needed to confirm these results.
Scientists are also doing studies to determine whether BPH or
a sexually transmitted virus increases the risk for prostate cancer.
At this time, they do not have clear evidence of increased risk
in either case.
Men over age 55 are taking part in a study of finasteride (trade
name Proscar®), a drug used to treat BPH. This nationwide NCI
study, called the Prostate Cancer Prevention Trial, is designed
to help doctors learn whether finasteride can prevent prostate
cancer. The Cancer Information Service can provide information
about this study.
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Detection
Researchers are studying ways to screen men for prostate cancer
(check for the disease in men who have no symptoms). At this time,
it is not known whether screening actually saves lives. The NCI-supported
Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
is designed to show whether certain tests can detect these cancers
early enough to reduce the number of deaths they cause. For prostate
cancer, this trial is looking at the usefulness of screening with
digital rectal exam and checking the PSA level in the blood in
men ages 55 to 74. The results of this trial may change the way
men are screened for prostate cancer. The Cancer Information Service
can provide information about this trial.
Men should talk with their doctor about prostate cancer, the
symptoms to watch for, and an appropriate schedule of checkups.
The doctor's advice will be based on the risks and benefits of
diagnosis and treatment, as well as a man's age, medical history,
and other factors.
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Other Federal Resources
National Institute on Aging Information Center
The National Institute on Aging, an agency of the Federal Government,
is concerned with the health problems of older Americans. The
Information Center can send free printed material, including fact
sheets about going to the hospital and about prostate problems,
sexuality, and urinary incontinence. The phone number for the
Center is 1-800-222-2225.
National Kidney and Urologic Diseases Information Clearinghouse
This Clearinghouse is a service of the Federal Government's
National Institute of Diabetes and Digestive and Kidney Diseases.
It can supply free information about benign prostate enlargement
and other noncancerous urinary tract problems. The phone number
for the Clearinghouse is 301-654-4415.
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Other Booklets
These National Cancer Institute booklets are available from
the Cancer Information Service by calling 1-800-4-CANCER.
Booklets About Cancer Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Chemotherapy and You: A Guide to Self-Help During Treatment
Helping Yourself During Chemotherapy: 4 Steps for Patients
Taking Part in Clinical Trials: What Cancer Patients Need To
Know
Questions and Answers About Pain Control
Get Relief From Cancer Pain
Booklets About Living With Cancer
Taking Time: Support for People With Cancer and the People Who
Care About Them
Facing Forward: A Guide for Cancer Survivors
When Cancer Recurs: Meeting the Challenge Again
Advanced Cancer: Living Each Day
Sexuality & Cancer: For the Man Who Has Cancer and His Partner
(also available from the American Cancer Society)
National Cancer Institute Information Resources
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You may want more information for yourself, your family, and
your health care provider. The following National Cancer Institute
(NCI) services are available to help you.
Telephone
Cancer Information Service (CIS)
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its programs.
http://cancertrials.nci.nih.gov
cancerTrials™; NCI's comprehensive clinical trials information
center for patients, health professionals, and the public. Includes
information on understanding trials, deciding whether to participate
in trials, finding specific trials, plus research news and other
resources.
http://cancernet.nci.nih.gov
CancerNet™; contains material for health professionals, patients,
and the public, including information from PDQ® about cancer treatment,
screening, prevention, supportive care, and clinical trials; and
CANCERLIT®, a bibliographic database.
E-mail
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Includes NCI information about cancer treatment, screening,
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with the word "help" in the body of the message.
Fax
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Includes NCI information about cancer treatment, screening,
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301-402-5874 from a fax machine hand set and follow the recorded
instructions.
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Glossary
abdomen (AB-do-men): The part of the body that contains the
pancreas, stomach, intestines, liver, gallbladder, and other organs.
adrenal glands (a-DREE-nal): A pair of small glands, one located
on top of each kidney. The adrenal glands produce the hormones
epinephrine and norepinephrine that help control heart rate, blood
pressure, the way the body uses food, and other vital functions.
antiandrogens (an-tee-AN-dro-jens): Drugs used to block the
production or interfere with the action of male sex hormones.
anus (AY-nus): The opening of the rectum to the outside of the
body.
benign (beh-NINE): Not cancerous; does not invade nearby tissue
or spread to other parts of the body.
benign prostatic hyperplasia (hye-per-PLAY-zha): A benign (noncancerous)
condition in which an overgrowth of prostate tissue pushes against
the urethra and the bladder, blocking the flow of urine. Also
called benign prostatic hypertrophy or BPH.
biological therapy (by-o-LAHJ-i-kul): Treatment to stimulate
or restore the ability of the immune system to fight infection
and disease. Also used to lessen side effects that may be caused
by some cancer treatments. Also called immunotherapy or biological
response modifier (BRM) therapy.
biopsy (BY-ahp-see): A procedure used to remove cells or tissues
in order to look at them under a microscope to check for signs
of disease. When an entire tumor or lesion is removed, the procedure
is called an excisional biopsy. When only a sample of tissue is
removed, the procedure is called an incisional biopsy or core
biopsy. When a sample of tissue or fluid is removed with a needle,
the procedure is called a needle biopsy or fine-needle aspiration.
bladder : The organ that stores urine.
cancer : A term for diseases in which abnormal cells divide
without control. Cancer cells can invade nearby tissues and can
spread through the bloodstream and lymphatic system to other parts
of the body.
chemotherapy (kee-mo-THER-a-pee): Treatment with anticancer
drugs.
clinical trial : A research study that tests how well new medical
treatments or other interventions work in people. Each study is
designed to test new methods of screening, prevention, diagnosis,
or treatment of a disease.
cryosurgery (KRYE-o-SIR-jer-ee): Treatment performed with an
instrument that freezes and destroys abnormal tissues. This procedure
is a form of cryotherapy.
cystoscopy (sist-AHS-ko-pee): Examination of the bladder using
a thin, lighted instrument (called a cystoscope) inserted into
the urethra. Tissue samples can be removed and examined under
a microscope to determine if disease is present.
digital rectal examination : DRE. An examination in which a
doctor inserts a lubricated, gloved finger into the rectum to
feel for abnormalities.
dry orgasm : Sexual climax without the release of semen.
ejaculation : The release of semen through the penis during
orgasm.
estrogens (ES-tro-jins): A family of hormones that promote the
development and maintenance of female sex characteristics.
external radiation (ray-dee-AY-shun): Radiation therapy that
uses a machine to aim high-energy rays at the cancer. Also called
external-beam radiation.
genitourinary system (GEN-ih-toe-YOO-rin-air-ee): The parts
of the body that play a role in reproduction, in getting rid of
waste products in the form of urine, or in both.
grade : The grade of a tumor is determined by how abnormal the
cancer cells appear when examined under a microscope, the probable
growth rate of the tumor, and its tendency to spread. The systems
used to grade tumors vary with each type of cancer.
hormone therapy : Treatment of cancer by removing, blocking,
or adding hormones. Also called endocrine therapy.
hormones : Chemicals produced by glands in the body and circulated
in the bloodstream. Hormones control the actions of certain cells
or organs.
imaging : Tests that produce pictures of areas inside the body.
impotent (IM-po-tent): Inability to have an erection adequate
for sexual intercourse.
incision (in-SIH-zhun): A cut made in the body during surgery.
incontinence (in-KAHN-tih-nens): Inability to control the flow
of urine from the bladder (urinary incontinence) or the escape
of stool from the rectum (fecal incontinence).
internal radiation (ray-dee-AY-shun): Radiation therapy that
is given internally. This is done by placing radioactive material
that is sealed in needles, seeds, wires, or catheters directly
into or near the tumor. Also called implant radiation or brachytherapy.
intravenous pyelogram (in-tra-VEE-nus PYE-el-o-gram): IVP. A
series of x-rays of the kidneys, ureters, and bladder. The x-rays
are taken after a dye is injected into a blood vessel. The dye
is concentrated in the urine, which outlines the kidneys, ureters,
and bladder on the x-rays.
local therapy : Treatment that affects cells in the tumor and
the area close to it.
luteinizing hormone-releasing hormone agonist (LOO-tin-eye-zing.
. .AG-o-nist): LH-RH agonist. A substance that closely resembles
luteinizing hormone-releasing hormone (LH-RH), which controls
the secretion of sex hormones. However, LH-RH agonists affect
the body differently than does LH-RH. LH-RH agonists eventually
cause a decrease in the secretion of sex hormones.
lymph node : A rounded mass of lymphatic tissue that is surrounded
by a capsule of connective tissue. Also known as a lymph gland.
Lymph nodes are spread out along lymphatic vessels and they contain
many lymphocytes, which filter the lymphatic fluid (lymph).
lymphatic system (lim-FAT-ik): The tissues and organs that produce,
store, and carry white blood cells that fight infection and other
diseases. This system includes the bone marrow, spleen, thymus,
and lymph nodes and a network of thin tubes that carry lymph and
white blood cells. These tubes branch, like blood vessels, into
all the tissues of the body.
malignant (ma-LIG-nant): Cancerous; a growth with a tendency
to invade and destroy nearby tissue and spread to other parts
of the body.
medical oncologist (on-KOL-o-jist): A doctor who specializes
in diagnosing and treating cancer using chemotherapy, hormone
therapy, and biological therapy. A medical oncologist often serves
as the person's main caretaker and coordinates treatment provided
by other specialists.
metastasis (meh-TAS-ta-sis): The spread of cancer from one part
of the body to another. When cancer cells metastasize and form
secondary tumors, the cells in the metastatic tumor are like those
in the original (primary) tumor. The plural is metastases.
orchiectomy (or-kee-EK-toe-mee): Surgery to remove one or both
testicles.
pathologist (pa-THOL-o-jist): A doctor who identifies diseases
by studying cells and tissues under a microscope.
pelvis : The lower part of the abdomen, located between the
hip bones.
prognosis (prog-NO-sis): The likely outcome or course of a disease;
the chance of recovery.
prostate gland (PROS-tate): A gland in the male reproductive
system just below the bladder. It surrounds part of the urethra,
the canal that empties the bladder. It produces a fluid that forms
part of semen.
prostate-specific antigen : PSA. A substance that may be found
in an increased amount in the blood of men who have prostate cancer
or benign prostatic hyperplasia.
prostatectomy (pros-ta-TEK-toe-mee): An operation to remove
part or all of the prostate. Radical (or total) prostatectomy
is the removal of the entire prostate and some of the tissue around
it.
prostatic acid phosphatase (FOS-fa-tays): PAP. An enzyme produced
by the prostate. It may be found in increased amount in men who
have prostate cancer.
radiation oncologist (ray-dee-AY-shun on-KOL-o-jist): A doctor
who specializes in using radiation to treat cancer.
radiation therapy (ray-dee-AY-shun): The use of high-energy
radiation from x-rays, neutrons, and other sources to kill cancer
cells and shrink tumors. Radiation may come from a machine outside
the body (external-beam radiation therapy) or from material called
radioisotopes. Radioisotopes produce radiation and are placed
in or near a tumor or near cancer cells. This type of radiation
treatment is called internal radiation therapy, implant radiation,
or brachytherapy. Systemic radiation therapy uses a radioactive
substance, such as a radiolabeled monoclonal antibody, that circulates
throughout the body. Also called radiotherapy.
rectum : The last 8 to 10 inches of the large intestine.
recur : To occur again. Recurrence is the return of cancer,
at the same site as the original (primary) tumor or in another
location, after it had disappeared.
remission : Disappearance of the signs and symptoms of cancer.
When this happens, the disease is said to be "in remission." A
remission may be temporary or permanent.
risk factor : Anything that increases the chance of developing
a disease.
scrotum (SKRO-tum): The external pouch of skin that contains
the testicles.
semen : The fluid that is released through the penis during
orgasm. Semen is made up of sperm from the testicles and fluid
from the prostate and other sex glands.
staging : Doing exams and tests to learn the extent of the cancer
within the body, especially whether the disease has spread from
the original site to other parts of the body.
surgery : A procedure to remove or repair a part of the body
or to find out if disease is present.
systemic therapy (sis-TEM-ik): Treatment that uses substances
that travel through the bloodstream, reaching and affecting cells
all over the body.
testicles (TES-tih-kuls): The two egg-shaped glands found inside
the scrotum. They produce sperm and male hormones.
testosterone (tes-TOS-ter-own): A hormone that promotes the
development and maintenance of male sex characteristics.
transurethral prostatic resection (TRANZ-yoo-REE-thral ree-SEK-shun):
Surgical procedure to remove tissue from the prostate using an
instrument inserted through urethral. Also called TURP.
tumor (TOO-mer): An abnormal mass of tissue that results from
excessive cell division. Tumors perform no useful body function.
They may be either benign (not cancerous) or malignant (cancerous).
ultrasonography (UL-tra-son-OG-ra-fee): A study in which sound
waves (called ultrasound) are bounced off tissues and the echoes
are converted into a picture (sonogram).
urethra (yoo-REE-thra): The tube through which urine leaves
the body. It empties urine from the bladder.
urologist (yoo-RAHL-o-jist): A doctor who specializes in diseases
of the urinary organs in females and the urinary and sex organs
in males.
vasectomy (vas-EK-toe-mee): An operation to cut or tie off the
two tubes that carry sperm out of the testicles.
June 2000
related
info
*Cancer
Net - National Cancer Institute
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