What You Need to Know About Prostate Cancer

At UIC Pharmacy we want to keep you informed so you can make the best decisions on your health. 

Prostate Cancer is the 3^rd most common cancer in men and leading cause of cancer death in men over 75 years of age.¹  So far in 2011, almost 241,000 men have been newly diagnosed with prostate cancer and over 33,000 deaths have occurred in the U.S. ²

Quick question…What is a prostate?

The prostate is a gland that is only found in men.  This gland secretes a fluid that helps carry sperm during ejaculation.³  It is about the size of a walnut and sits right under the bladder and in front of the rectum.

Is BPH the same as prostate cancer?

No.  Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland.¹  Many men have BPH and it does not increase the risk for prostate cancer.  Prostate cancer is the spread of cancerous cells in the prostate tissue.² 

What are some risk factors for prostate cancer?^3,4

Age:  As you age, your risk for prostate cancer increases.  Prostate cancer is rarely seen under the age  of 50.

Ethnicity:  Prostate cancer is more common in African Americans than in Whites or Hispanics.

Family history:  You have an increased risk of developing prostate cancer if your father or brother has the disease.  Also, if a female relative has the BRCA breast cancer gene, you are more likely to develop prostate cancer.

Location:  Depending on where you live can actually increase your chance of prostate cancer.  Those who live north of 40 degrees latitude, have a higher risk of developing prostate cancer.  This is thought to be attributed to the lack of sunlight during the winter months.

What symptoms would I be experiencing if I had prostate cancer?¹

Unfortunately, not all men will have symptoms and the symptoms of prostate cancer are not specific.  Here are some common symptoms of prostate cancer:

·       Urinating more frequently

·       Having trouble urinating

·       Pain or stinging while urinating

·       Blood in the urine or semen

·       Painful ejaculation

·       Stiff lower back, upper thighs, or hips

Are there any lifestyle changes I can make to prevent prostate cancer?⁵

Although there are no proven ways to stop prostate cancer from happening, there are some changes you can make that are thought to decrease the risk.  These include:

·       Minimize red meat and dairy products

·       Do not exceed the recommended daily allowance (RDA) of calcium (RDA 1000 mg/day for men ages 19 to 70 years old)⁶

·       Maintain a healthy weight with exercise (≥30 minutes/day of aerobic exercise most days of the week)⁷

·       Incorporate healthy food into your diet (fruits, vegetables, whole grains, olive oil and fish)

·       Avoid smoking and decrease alcohol intake (≤2 drinks/day for men)⁷

·       The increased intake of soy and coffee (caffeinated or decaffeinated) has been thought to decrease the risk of prostate cancer, although this has not yet been proven

Should I make an appointment with my physician?

Prostate cancer screening has not yet been proven to save lives.⁸  During yearly check-ups, you and your physician should have a long talk about the pros and cons of screening.  If you decide to be screened, the National Comprehensive Cancer Network recommends to offer screening at 40 years of age and checking again every year or 5 years, depending on the results.  For men that have risk factors, especially African Americans and men with a family history, it is beneficial to start screening around 40 or 45 years of age.  The National Comprehensive Cancer Network recommends men with a family history or black ethnicity should do annual screening with prostate specific antigen and a digital rectal exam.  However, if you are experiencing any of the symptoms previously mentioned, do not wait until you next check-up.  Schedule an appointment with your physician right away.

What kind of tests will my doctor run?^3,8

Digital Rectal Examination:  Your physician may gently insert a finger in your rectum to feel for any abnormalities of the prostate.

Blood Test:  You physician will take a sample of your blood to run a PSA test.  Prostate specific antigen (PSA) is a protein that can be detected in the blood of all men and is often elevated with prostate cancer.  However, there are other reasons why a PSA can be elevated and not be cancerous.  Some reasons include:

·       Injury to the prostate gland (sometimes from bike riding)

·       Ejaculation 48 hours prior to PSA testing

·       Infection in the prostate gland

·       Benign Prostatic Hyperplasia

Transrectal Ultrasound: This exam is often done when your physician is suspicious of abnormalities.  A probe is placed up the rectum that releases sound waves that bounce off the prostate and creates a picture on a computer.

Prostate Biopsy:  If the PSA is elevated after repeat testing, it is recommended for your doctor to take small pieces of prostate tissue to further analyze them.   

Where can I go for more information?

National Cancer Institute: www.cancer.gov

National Comprehensive Cancer Network: www.nccn.org

American Cancer Society: www.cancer.org

References

1. United States National Library of Medicine. Medline plus: prostate cancer.  http://www.nlm.nih.gov/medlineplus/ency/article/000380.htm.  Accessed August 8, 2011.

2.  National Cancer Institute at the National Institutes of Health: Prostate cancer. http://www.cancer.gov/cancertopics/types/prostate. Accessed August 8, 2011.

3. Hoffman, RM. UpToDate. Patient information: prostate cancer screening. http://www.uptodate.com/contents/patient-information-prostate-cancer-screening?source=search_result&selectedTitle=1%7E150. Accessed July 29, 2011.

4. Prostate Cancer Foundation.  Understanding prostate cancer: prostate cancer risk factors. http://www.pcf.org/site/c.leJRIROrEpH/b.5802027/k.D271/Prostate_Cancer_Risk_Factors.htm. Accessed August 10, 2011.  

5.  Sartor AO.  UpToDate. Risk factors for prostate cancer. http://www.uptodate.com/contents/risk-factors-for-prostate-cancer?source=search_result&selectedTitle=1%7E150. Accessed July 29, 2011.

6.  Institute of Medicine. Dietary reference intakes for calcium and vitamin D. http://iom.edu/Reports/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D.aspx. Accessed August 15.

7.  Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289(19):2560-2572.

8. Kawachi MH, Bahnson RR, Barry M, et al. NCCN clinical practice guidelines in oncology: prostate cancer early detection. J Natl Compr Canc Netw. 2010;8(2):240-262.

By: Tara Gallagly, PharmD Candidate, 2012