Information about Prostate Cancer
Worldwide, prostate cancer is one of the most common types of cancer found in men. Learning more about prostate cancer and treatment options can help you and your loved ones take an active part in making choices about care.
What is Prostate Cancer?
Prostate cancer occurs when cells within the prostate grow uncontrollably, creating small tumors. The term "cancer" refers to a condition in which the regulation of cell growth is lost and cells grow uncontrollably. Most cells in the body are constantly dividing, maturing, and then dying in a tightly controlled process. Unlike normal cells, the growth of cancer cells is no longer well-regulated. Instead of dying, as they should, cancer cells outlive normal cells and continue to form new, abnormal cells.
Abnormal cell growths are called tumors. The term "primary tumor" refers to the original tumor; secondary tumors are caused when the original cancer spreads to other locations in the body. Prostate cancer typically is comprised of multiple very small, primary tumors within the prostate. At this stage, the disease is often curable (rates of 90% or better) with standard interventions such as surgery or radiation that aim to remove or kill all cancerous cells in the prostate. Unfortunately, at this stage the cancer produces few or no symptoms and can be difficult to detect.
What is Metastatic Prostate Cancer?
If untreated and allowed to grow, the cells from these tumors can spread in a process called metastasis. In this process, prostate cancer cells are transported through the lymphatic system and the bloodstream to other parts of the body, where they lodge and grow secondary tumors. Once the cancer has spread beyond the prostate, cure rates drop dramatically.
In most cases, prostate cancer is a relatively slow-growing cancer, which means that it typically takes a number of years for the disease to become large enough to be detectable, and even longer to spread beyond the prostate. However, a small percentage of patients experience more rapidly growing, aggressive forms of prostate cancer. Unfortunately, it is difficult to know for sure which prostate cancers will grow slowly and which will grow aggressively – complicating treatment decisions.
The spread of cancer outside the prostate can be detected by the presence of prostate cancer cells in areas surrounding the prostate such as the seminal vesicles, lymph nodes in the groin area, the rectum, and bones. When prostate cancer spreads to another site, such as bone, the new tumor is still considered to be prostate cancer, not bone cancer.
What Types of Doctors Treat Prostate Cancer?
Most physicians who treat men with prostate cancer are specialists such as:
- Urologists: specialize in the treatment of diseases and cancer of the urinary organs in females and the urinary and sex organs in males.
- Oncologists: specialize in treating patients with cancer and some may further specialize in a particular type of cancer treatment, such as:
- Medical oncologists: treat patients with cancer and manage the patient's course of treatment with chemotherapy or other medications.
- Radiation oncologists: specialize in using radiation to treat patients with cancer.
- Surgical oncologists: perform biopsies and other surgical procedures in patients with cancer.
What Types of Treatment are Available?
Men with metastatic prostate cancer have treatment options including hormone therapy, chemotherapy, and radiation therapy, or a combination of these therapies. Another option is participating in a clinical trial, which is a research study of an experimental therapy which may also be combined with a currently approved treatment.
Hormone Therapy
Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. In prostate cancer, male sex hormones can cause prostate cancer to grow. Medications, surgery, or other hormones are used to reduce the production of male hormones or block them from working.
Hormone therapy used in the treatment of prostate cancer may include the following:
- Luteinizing hormone-releasing hormone agonists (LHRH) can prevent the testicles from producing testosterone.
- Antiandrogens can block the action of androgens (hormones that promote male sex characteristics).
- Medications that can prevent the adrenal glands from making androgens.
- Orchiectomy is a surgical procedure to remove one or both testicles, the main source of male hormones, to decrease hormone production.
Chemotherapy
Chemotherapy may be used for prostate cancer that has spread and no longer responds to hormone therapy.
Chemotherapy, such as docetaxel, is a medication to kill cancer cells and is often used to treat patients with metastatic disease.
Chemotherapy kills fast-growing cancer cells, but the medications can also harm normal cells that grow rapidly, such as those in hair follicles and cells that line the digestive tract.
Radiation Therapy
Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or to keep them from growing. There are 2 types of radiation therapy:
- External radiation therapy uses a machine outside the body to send radiation toward the cancer.
- Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wire, or catheters that are placed directly into or near the cancer.
Clinical Trials: Another Option to Consider
Clinical trials are a part of the cancer research process. They are conducted to evaluate whether experimental treatments are safe, effective, and potentially provide a better option for patients.
Many of today's standard treatments for cancer are based on earlier clinical trials.
Patients who take part in clinical trials may help improve the way cancer patients will be treated in the future. Even when clinical trials do not lead to new treatments, they often answer important cancer questions.
Click here for a list of additional online resources to learn more about prostate cancer and support.