Prostate cancer is the second most common form of cancer in men. It develops in a gland which produces seminal fluid but is usually slow-growing and can be detected relatively early with proper regular screenings. Almost all cases of prostate cancer are called adenocarcinomas which develop directly from the gland cells. Other rare types of prostate cancer which develop in other particular cells of the prostate include sarcomas, small cell carcinomas, neuroendocrine tumors, and transitional cell carcinomas.
Prostate cancer usually develops in older men, with the average age of diagnosis at 66. However, men may begin showing signs of developing cancer earlier, and, according to the American Cancer Society, should be screened starting at the age of 50 for average risk patients and age 40 for very high-risk patients. Risk factors include family members who have developed the cancer, age, race and ethnicity, and geography. Prostate cancer is more common in North America, Europe, and Australia.
As with many slow growing cancers, it may be hard to detect prostate cancer without a screening for some time. Symptoms begin to develop when the cancer becomes more advanced. These symptoms include
- Difficult, painful, or abnormally frequent urination
- Blood present in the urine or semen
- Erectile dysfunction
- Pain in the bones of the hips, spine, or chest from spreading cancer
- Loss of bladder or bowel control if the cancer is pressing against the spinal cord
- Weakness in the legs and/or feet
Many of these symptoms can occur due to other health issues, such as non-cancerous growths, bladder infections, or simple aging, but it is always best to see a doctor if symptoms are persistent or concerning.
If prostate cancer is suspected, a doctor will most likely perform either a digital rectal exam (DRE) or a PSA blood test, or both. In the DRE the doctor will physically examine a patient and check for abnormalities or growths in the prostate. A PSA blood test can be screened for a particular antigen (PSA) which can signal whether or not someone is likely to have prostate cancer. Higher PSA levels are associated with prostate cancer, although low levels do not necessarily mean that a patient is cancer free.
After the initial exam, if the results are abnormal or the PSA level is high, a doctor usually administers a transrectal ultrasound (TRUS), during which a small ultrasound probe is inserted into the rectum so that it can use sound waves to construct a picture of the gland. If there are signs of cancer, a biopsy will most likely be performed by a urologist, who will insert a needle into the prostate to obtain a sample for analysis under a microscope.
Prostate cancer is then given a “Gleason score,” which is a number between one and ten which refers to the abnormality level of the cancerous cells. Cancerous cells which look more like normal prostate cells are given lower numbers while cells which look more abnormal are given higher ones. The higher the score, the more quickly and aggressively the cancer is likely to spread. Other tests may be given to determine if the cancer has spread throughout the body.
Prostate cancer is treated according to the stage of its development, its responsiveness to certain hormone therapies, and its location. Sometimes very early stages of the disease do not need to be treated because they are localized and non-aggressive. Patients in this position will simply be screened frequently for developments. The first line of treatment for low-grade prostate cancer is usually either localized radiation or surgery to partially or completely remove the prostate (prostatectomy).
If the cancer has spread beyond the prostate (stage II or stage III), radiation might be used before surgery to shrink the tumor or after surgery to help kill remaining cancerous cells. If the cancer recurs after stage I, hormone therapy, in which testosterone and dihydrotestosterone are repressed in the body chemically, may be used in addition to other methods. Chemotherapy is often a last resort and only used when other methods have failed or the cancer has returned.
Treating Prostate Cancer with Taxotere
In 2004, Taxotere was actually the first chemotherapy drug approved to treat prostate cancer. It is most often used after a combination of surgery, radiation, and hormone therapy as a final line of defense against the further development of the disease. If the cancer is continuing to develop or spreading (metastasizing) throughout the body, the first chemotherapy option is usually Taxotere, administered in conjunction with prednisone, a steroid which can reduce the side effects of the drug. While Taxotere has been proven in clinical trials to extend a patient's life by reducing the cancer's rate of growth, it will almost certainly not cure a patient. Developing research suggests that given patients docetaxel (Taxotere) earlier in the treatment process for metastatic prostate cancer, such as during hormone therapy, may improve a patient's survival rate.