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Prostate cancer is a disease in which some of the cells of the prostate gland grow and divide in an uncontrolled way. The resulting mass is called a malignant tumor, which often originates in the outer part of the prostate. This guide will focus on the most common type, called prostatic adenocarcinoma. There are a few other types of prostate cancer, but they are extremely rare.
Other than skin cancer, prostate cancer is the most common cancer in men: nearly 200,000 cases are diagnosed in the United States each year. Fortunately, most prostate cancer is discovered when it is still confined to the prostate gland and does not show evidence of having spread (or metastasized) from its original location. Prostate cancer is often very treatable, and men diagnosed with prostate cancer do not usually die from it. This type of cancer can be more dangerous in its advanced stages, when it may become aggressive and spread to other organs. However, prostate tumors tend to grow slowly, and some men who have prostate cancer may never be affected by it.
The prostate gland, which is part of the male reproductive system, secretes fluid that contributes to semen. Located near the rectum and the bladder, it is usually the size of a walnut but can grow much larger. The gland starts to develop before birth and then grows rapidly during puberty. The prostate surrounds the urethra, the tube that carries urine from the bladder, which is why an enlarged prostate can result in urination problems. The urethra also carries semen from the seminal vesicles (two small glands that supply most of the fluid in the semen) during ejaculation. The duct leading from the seminal vesicles to the urethra passes through the prostate.
Men whose cancer is confined to the prostate rarely have any symptoms. Those with more advanced cancer can have pelvic pain, pain in the bones, blood in their urine (hematuria), bladder obstruction causing urinary problems or impacting their kidney function, and other signs of advanced disease such as fatigue, weakness, and decreased appetite.
Age, race/ethnicity, and family history all affect your chance of getting prostate cancer. The disease is very rare in men younger than age 40, but the risk rises rapidly after you reach 50. Most prostate cancers are diagnosed in men older than 65, and most deaths from prostate cancer occur after age 75. Prostate cancer occurs more often in African-American men and Caribbean men of African descent, and less often in Asian-American and Hispanic/Latino men. A family history of prostate cancer also increases your chances of having the disease; a father or brother with prostate cancer more than doubles the risk.
A number of other factors — both genetic and environmental — appear to influence the risk of prostate cancer as well. At Fox Chase, our team of physicians and scientists continues to investigate the relationship between these risk factors and the actual development of prostate cancer.
If your doctor has said you are at high risk of getting prostate cancer, you may benefit from genetic counseling and/or genetic screening through Fox Chase’s Risk Assessment Program (RAP). Fox Chase holds monthly high-risk prostate clinics for men who want to explore these options. Most men who attend choose to receive genetic counseling, and some also opt for genetic testing. If you are a member of a high-risk group — for instance, if you are of African descent or have some family history of prostate cancer — you may wish to attend a clinic. If you and your doctor decide screening is an appropriate next step, you will receive a “multi-gene panel” screening, which tests for many genes at once. If the screening reveals genes that put you at high risk, you will know to keep a close eye on the situation and make sure to get screened for prostate cancer at least once a year. We offer PSA and digital rectal exam screenings as part of the RAP program. Our genetic counselors can discuss with you other precautions you can take to help lower your chances of developing cancer.
To schedule an appointment with the prostate risk assessment team, please call 888-369-2427.