Prostate cancer is the second most common cancer among men in the United States of America, and around 1 in 9 American men will be diagnosed with the condition during their lifetime (American Cancer Society, 2019). It is a condition that is more prevalent in older males, males with a family history of the condition, and African American males. September is Prostate Cancer Awareness Month in the US.
The prostate is a male gland which forms part of the male reproductive system. It is located underneath the bladder between the penis and the rectum, with the urethra running through the middle of it. The prostate’s function is to produce prostatic fluid which protects sperm cells, and to assist in the ejaculation of sperm. The activity and growth of the prostate is stimulated by male hormones called androgens, the main one being testosterone.
In many cases, prostate cancer is a slow growing cancer, and patients who are diagnosed with non-metastatic prostate cancer usually go on to have long survival rates (often their eventual cause of death is unrelated to their prostate cancer). However there can be more aggressive and faster growing forms of prostate cancer, and it can spread to other parts of the body including the bones. Currently there are over 2.9 million men living with prostate cancer in the US. Some famous men who have been diagnosed with prostate cancer at various ages in their lives are Robert Di Nero, Sir Roger Moore, Nelson Mandella and Ben Stiller.
Usually early-stage prostate cancer causes few or no symptoms, as the tumour is so small. As the cancer grows, symptoms may include:
- A frequent urge to urinate
- Difficulty starting or holding back urination
- A weak or interrupted flow of urine
- Blood in the urine or semen
- Difficulty getting an erection
- Pain in the lower back and hips
Some of these symptoms may also be caused by noncancerous enlargement of the prostate, known as Benign Prostatic Hyperplasia (BPH), or inflammation of the prostate known as prostatitis. Men with metastatic prostate cancer may experience other symptoms, such as bone pain, as the cancer spreads.
As there are few early warning signs, screening is recommended to check for early stage disease, but the age at which this is recommended to start varies dependant on risk factors. If no other risk factors are present, screening is recommended to start at 50 years of age. If there is a family history of prostate cancer or the person is of African descent, screening is recommended to start earlier. Tests usually include a Digital Rectal Examination (DRE) and blood tests to look for Prostate Specific Antigen (PSA), a protein that is produced by the prostate.
Treatment options for prostate cancer vary depending on the size and stage of the tumour, and how much effect it is having on the patient’s life. Treatment may include:
- Active surveillance – no active treatment, but more frequent screening to assess the growth of the tumour
- External Beam Radiotherapy
- Brachytherapy – internal radiotherapy seeds (low dose) are planted into the prostate and remain there, or catheters (high dose) are inserted into the urethra for a short period then removed
- Radical prostatectomy – surgical excision of the prostate and surrounding tissues
- Some other treatments for more advanced or metastatic prostate cancer include hormone therapy, chemotherapy and immunotherapy
More information can be found at:
- Prostate Cancer Foundation: https://www.pcf.org/
- American Cancer Society: https://www.cancer.org/
The following link leads to a full text journal article discussing multifactorial decision support systems to generate case specific advice regarding treatment for prostate cancer:
The journal article is accessed through our nursing literature database search that you can use to research healthcare topics related to your own practice or interests. Please feel free to use the service for your own professional development!