Prostate Cancer: Practice Essentials, Background, Anatomy

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In the year of 2018, researchers predict that 164,690 new cases and 29,430 deaths will arise from the most common type of male reproductive cancer (American Cancer Society [ACS], 2018). Reproductive cancers affect the organs that are responsible for reproduction in the human body. For males, this constitutes their organs; the testicles, prostate gland, and the penis (U.S. Department of Health and Human Services [HHS], 2017). So, what is the most common type of reproductive cancer in males? According to the Mayo Foundation, it is prostate cancer. Prostate cancer is defined as a cancer that originates from the prostate gland due to the uncontrollable growth of its cells (ACS, 2018). The function of the prostate gland is to produce seminal fluid which is a component of semen. Then during ejaculation, the prostate aids in the release of this seminal fluid into the urethra (Ashford, 2010).

While it is still unclear what specifically causes prostate cancer, researchers have identified multiple risk factors that contribute to the increased likelihood of contracting the disease. According to the ACS, as the age of males increase, the chance of having prostate cancer also increases (2018). Research has shown that it is uncommon for men below the age of 40 to develop prostate cancer. It isn’t until the age of 50 that the risk drastically increases. Another risk factor for prostate cancer is race. Studies have shown that African-American males are more likely to have prostate cancer than other races. Additionally, African-American males tend to have a more aggressive stage of the cancer and therefore two times more African-American males die as opposed to white males. The reason for this is unknown (ACS, 2018). Further research correlated family history as a risk factor for prostate cancer as well. Men who have a family member that had prostate cancer are at a higher risk. It was also was investigated that if male also had a family history of breast cancer, then this could also increase the risk of prostate cancer (Mayo Foundation for Medical Education and Research [MFMER], 2018).

In the early stages of any type of cancer, it can be difficult to ascertain whether symptoms are present. In the case of prostate cancer, this is no exception. A male may not have any signs or symptoms until the disease has progressed further to a more aggressive stage. At the later stages of prostate cancer however, men may experience symptoms such as difficulty urinating, discomfort in the pelvic region, or erectile dysfunction. Additionally, men may notice blood in their semen, a decrease in the force at which they urinate, or pain that originates from their bones (MFMER, 2018).

If a male presents any of the above signs and symptoms, a physician would conduct certain diagnostic tests to determine if they are in fact caused by cancer in the prostate gland. First a screening test, such as a Digital Rectal Exam (DRE) or Prostate-Specific Antigen (PSA) test may be performed. A DRE consists of a physician inserting a lubricated, gloved finger into the rectum of a male to palpitate the prostate gland which is located adjacent to the rectum. Any changes in the size, texture, or shape of the prostate gland would result in further diagnostic tests. On the other hand, the PSA test takes a sample of blood and screens it for the substance PSA which is naturally produced by the prostate gland. If there are abnormally high levels of PSA in the blood this indicates there is a problem with the prostate gland which could include cancer (MFMER, 2018). If any of the screening tests come back with abnormal results, additional testing would be recommended by the physician. One diagnostic test involves a lubricated small probe inserted into the rectum that releases sound waves which creates echoes in the prostate and turns them into black and white images on the computer. This technique is a transrectal ultrasound (TRUS). A physician could also biopsy the prostate by using TRUS and a hollow needle. The needle would obtain a small portion of the prostate to be examined by a lab for any cancerous cells (ACS, 2018).

After a male is diagnosed with prostate cancer, there are various treatment options. Physicians determine the best treatment option by first ascertaining a male’s overall health, if the cancer has spread throughout the body, as well as the benefits and side effects of the treatment in question. It is possible that the cancer found in the prostate gland is not an immediate risk to the individual and no treatment is needed. For men in this situation, their suggested treatment is active surveillance which entails regular check-ups to ensure the cancer has not progressed or spread. Another option for men with a low-grade stage of this cancer is radiation therapy. There are two types of radiation therapies; external beam radiation therapy (EBRT) or brachytherapy which occur internally. Either of these treatments beam radiation on the prostate gland. If the cancer returns after radiation therapy, another treatment option that physicians may want to attempt is cryotherapy. Cryotherapy involves inserting TRUS and several hollow needles into the rectum while the patient is under general anesthesia that omits extremely cold gases to freeze and kill the prostate cancer cells (ACS, 2018) On the other hand, if the cancer in the prostate gland is at an advanced stage, a prostatectomy can be recommended. A prostatectomy is the removal of the prostate gland. The prostate gland is an organ that is not essential for life and therefore it has the ability to be removed to hopefully rid the body of the cancerous cells that it contains. The prostate gland can be removed via robotically or by an incision in your abdomen. Other recommendations for advanced stages of prostate cancer are hormone therapy and chemotherapy. Hormone therapy, also known as androgen deprivation therapy, seeks to eliminate or decrease the amount of the androgen hormones. One of the functions of androgen is to help prostate cells to grow and so by reducing the numbers of androgens in the body this may help reduce the cancer cells from multiplying.

In the state of Nebraska, males diagnosed with prostate cancer can be treated at Nebraska Hematology Oncology (NHO). The physician who specializes in the male reproductive tract, known as a urologist normally is the one to diagnose and treat the patients with prostate cancer. At NHO, there are a wide range of treatment options including biopsy, surgery, cryotherapy, and hormone therapy. Another provider in Nebraska that provides radiation therapy for prostate cancer is Radiation Oncology at Village Point up in the Omaha. Additionally, a center located up in Omaha that is geared towards cancer treatment is the Fred and Buffett Cancer Center. While a multitude of cancers can be treated here, prostate cancer is an area of focus for this center. They have a multidisciplinary team of surgeons, oncologists, and other specialists that can aid in treating prostate cancer.