Prostate Cancer (cont.)

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What is prostate cancer?

Prostate cancer is a malignant (cancerous) tumor (growth) that consists of cells from the prostate gland. Generally, the tumor usually grows slowly and remains confined to the gland for many years. During this time, the tumor produces little or no symptoms or outward signs (abnormalities on physical examination). However, all prostate cancers do not behave similarly. Some aggressive types of prostate cancer grow and spread more rapidly than others and can cause a significant shortening of life expectancy in men affected by them. A measure of prostate cancer aggressiveness is the Gleason score (discussed in more detail later in this article), which is calculated by a trained pathologist observing prostate biopsy specimens under the microscope.

As the cancer advances, however, it can spread beyond the prostate into the surrounding tissues (local spread). Moreover, the cancer also can metastasize (spread even farther) throughout other areas of the body, such as the bones, lungs, and liver. Symptoms and signs, therefore, are more often associated with advanced prostate cancer.

Why is prostate cancer important?

Prostate cancer is the most common malignancy in American men and the second leading cause of deaths from cancer, after lung cancer. According to the American Cancer Society's most recent estimates, 238,590 new cases of prostate cancer would be diagnosed in 2013 and 29,720 would die from the disease.

The estimated lifetime risk of being diagnosed with the disease is one in six men. The lifetime risk of death from prostate cancer one of 36 men. As reflected in these numbers, prostate cancer is likely to impact the lives of a significant proportion of men that are alive today.

Over the years, however, the death rate from this disease has shown a steady decline, and currently, more than 2 million men in the U.S. are still alive after being diagnosed with prostate cancer at some point in their lives.

Although it is subject to some controversy, many experts in this field, therefore, recommend that beginning at age 40, all men should undergo screening for prostate cancer. Screening recommendations can be confusing, as they refer to testing being done on large groups of people. Each patient's case should be considered on its own merits. Certainly, rectal examination is indicated beginning at age 40 in men, and should include palpation of the back of the prostate gland during such examination. Aftrican American men have a higher incidence of prostate cancer, and further screening is appropriate to consider in them beginning at age 40. Men with a family history of prostate cancer are also at increased risk and also should be considered for earlier evaluation than others. These subjects will be touched upon later.

Medically Reviewed by a Doctor on 12/9/2013

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