Prostate cancer affects the walnut-sized prostate gland which is located just below a man's bladder in a place which is impossible to feel from outside the body. Although it is the most common cancer in American men, it is not the major cause of cancer-related death, and men are more likely to die with prostate cancer than of it.

Prostate cancer grows very slowly, and may pass through several stages over many years before it is even detected. It begins as a small malignant lesion on the prostate, which is usually undetectable by any means. (These lesions can be discovered on the prostates of men who have died by other means, such as in car accidents.) A person's cancer is classified according to a TMN system. T refers to tumor, and tumors are ranked by size. If prostate cancer has a T classification it means that there is a primary tumor within the prostate itself, which may be removed by surgery]. The N (node) classification is given when the cancer has metastasized into the lymph nodes near the prostate. The M (metastasis) classification is given when the cancer has metastasized out the immediate area into other organs of the body. Cancers which have metastasized are always more difficult to treat with success.

Symptoms of prostate cancer are difficulty with normal] urination and sometimes persistent] lower back pain, but as these can be caused by a number of conditions, should you experience them, you shouldn't jump to conclusions, but instead go to your doctor. The most common diagnostic test for prostate cancer is the digital rectal examination (DRE), and I'm sorry to have to report that the digital in this case refers to a finger, not a computer. It can't be very pleasant to have your rectum clinically probed by a physician's finger, but this is what the exam entails. Unfortunately, too, the technique is subjective, which means that different doctors may interpret DRE's results differently, so it helps to have a skilled and experienced physician perform the exam. Another common exam involves a blood test for prostate specific antigen (PSA); elevated levels of PSA indicate the possibility, but not the certainty, that you have prostate cancer. Other diagnostic tools are currently being developed. If tests point to the possibility of prostate cancer, the doctor may recommend having a biopsy using transrectal ultrasound, which can be performed without anaesthetic (!) using ultrasound to guide a special needle which will take tissue samples.

If prostate cancer is diagnosed early the primary treatment is often "watchful waiting" or "active surveillance", which involves regular DREs and PSA tests and perhaps also transrectal ultrasound. It may sound rather passive, but for many men it is the best option. The patient's quality of life is unaffected by this treatment. It's safe. And it obviates the need for potentially dangerous, debilitating, and expensive surgical, radiation, or chemotherapy treatments. And you should know that impotence and [urinary ncontinence may be the results of these drastic medical interventions. Not to mention the normal risks associated with anesthesia and a major surgical procedure.

The primary risk factor for prostate cancer is age. Over the age of 65, apparently 80% of men will be diagnosed with prostate cancer, and by the age of 90, the proportion is more like 90%. In fact, the reason why the incidence of prostate cancer is higher today than a century ago is because of the aging population. It appears that black] men have more prostate cancer, at a younger age, and of a more aggressive type, than men of other races; white have less, followed in descending order by Hispanics, First Nations, and Asians. As they say in the medical profession, the reasons for this aren't well understood. A strong family history - if your father and brother have prostate cancer, for example - is an indicator of a higher risk. Finally, as with all cancers, smoking, lack of exercise, and a poor diet are all risk factors. A diet high in saturated fats may increase the production of testosterone, which speeds the development of the cancer cell], so eating less fat and more fruits, vegetables, and whole fibre will reduce your risk.

As the concern about prostate cancer has grown, and as the public becomes more interested in alternative treatments, a number of ideas have spread about "natural" treatments for prostate cancer. It's just common sense to eat well and exercise, and doctors tend to be leery of many "natural" treatements because they are not always tested in rigorous ways. An exception is saw palmetto, which has been widely tested and shows promise. One drawback of this herb, and many other such herbal products, is that it may suppress PSA levels in your blood, which can interfere with the effectiveness of the PSA test. That's why if you take saw palmetto or other herbal medicines, you should tell your doctor before having a PSA test.

Websites used to research this node, and which you should visit for more information, include
www.phoenix5.org/Infolink/index.html
www.prostate-cancer.org/resource/pamphlet.html
www.mayoclinic.com/home?id=DS00043

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