Prostate cancer is a very common tumour that increases in incidence as men get older. In many cases prostate cancers will grow slowly and for many years men may not be aware that a cancer is present. Since the introduction of PSA testing many cancers are now picked up when the PSA level rises above what is expected on an age related basis. Rectal examination of the prostate may also reveal an abnormality that would indicate the possibility of an underlying tumour.
If a man is found to have an elevated PSA or an abnormality palpable within the prostate, a biopsy of the prostate should be carried out to determine whether or not a tumour is in fact present. It must be understood however that there are several causes for an elevation of the PSA without the presence of an underlying cancer. Infection and ejaculation will cause a temporary rise in the PSA. Larger prostates tend to have higher PSA values than smaller prostates but this is not always the case. If your PSA is elevated you will need to give careful consideration to the likely cause and the potential need for biopsy.
Once a cancer is diagnosed there are several treatment options available. Both surgery and radiation are aimed at curing prostate cancers. Another form of management becoming more widely practised is that of careful ongoing surveillance of a man with prostate cancer. Some features of prostate cancers indicate that it would be very slow growing and if left untreated would probably not cause any problems for many years. In such situations regular checks of the PSA level as well as repeat biopsies every 12 to 24 months can be used to help determine whether or not the cancer is progressing. If there is any evidence the tumour is growing treatment can be instituted at any time.
Treatment of prostate cancer is rarely urgent and you will have plenty of time to discuss treatment options and decide which form of therapy you think is best for you in consultation with your Urologist. You should never feel you have been rushed into treatment.
Risk factors for Prostate include race, age and family history
Afro Americans have an increased risk.
As men get older, their risk of prostate cancer increases. As men age, their PSA also slowly rises so that the PSA level always needs to be referenced to your age. It should be noted that about 80% of 80 year old men will have prostate cancer but that in most of these men, it will either never cause them harm, or will not even be detected.
Men with a family history are at increased risk but mainly for those with a first degree relative with the disease, ie father or brother. The more first degree relatives with the disease, the higher the risk.