It is important for you to know if there is a family history. The relative risk in men with one affected immediate family member has been estimated as twice that of an individual without a family history of prostate cancer. If there are two affected relatives then the risk is approximately five times greater than normal. If you have a family history be sure to inform your physician and be sure to follow his instructions concerning the frequency of screening exams.

The prostate gland is a walnut size structure which is located around the urethra at the base of the bladder. The gland provides fluid for ejaculation. Beginning about the age of 30, the prostate gland undergoes a gradual change where the inner part of the gland begins to enlarge at a very slow rate. Men are generally unaware of this change unless the growing gland presses on the bladder or uretha which may cause a change in urination. This normal enlargement is known as benign prostatic hyperplasia.

• pain or a burning sensation when urinating
• difficulty in urination or a weak or interupted urine flow
• pain in the lower back, upper thighs or pelvis which is relatively constant.

If your physician feels something suspicious (usually a hard spot on the prostate) or finds the prostate to be enlarged, he/she may chose to do an ultrasound examination of the prostate and a biopsy of the prostate for analysis by a Pathologist. The transrectal ultrasound uses a probe that is inserted in the rectum and can identify irregularities in the prostate tissue. When abnormalities are found, the physician may obtain a sample of cells by inserting a fine needle through the rectum and removing some prostate cells from the abnormal area for examination by the pathologist. The pathologist examines the cells for cancer and grades the cancer if present. The grade of the cancer can be important in determing what type of treatment is chosen. A low grade tumor is generally easier to treat and has a better remission rate than a high grade tumor which is more aggressive and has the potential to have spread to the rest of the body. Should prostate cancer be present, additional studies may be ordered to determine the spread of the cancer to various organs or bone.

Surgery. This procedure involves the removal of the prostate gland and is generally performed in men who are 70 years or younger and otherwise in good health. While every attempt is made by the surgeon to avoid damage to surrounding structures like the urethra and nerves, in some cases the surgery can cause incontinence and/or impotence. Remember the primary goal is to remove all of the cancer and while every attempt is made to avoid these side effects, sometimes it is necessary to get rid of the cancer. Recovery from the surgery is usually less than a week in the hospital and the cost is usually covered by health issurance.

Radiation. This treatment is performed on an outpatient basis and involves high doses of x-ray beams directed at the prostate. The treatments are given every day for six to seven weeks. After the treatment side effects may include burning while urinating and diarrhea. The cost is generally covered by health issurance. This form of treatment is used when the tumor is confined to the prostate gland, but it can also be used when the cancer is spread outside the gland or if surgery is not an option.

Hormonal. The goal of this therapy is to put the cancer in remission and relieve pain and it is used when there is significant spread of the cancer or the individual is not a candidate for surgery. Hormonal therapy works by depriving the tumor cells of testosterone used for maintenance and growth of the malignant prostate cancer cells. This can result in a shrinkage of the tumor and a slowing of the cancer growth. The most common form of therapy involves the surgical removal of the testicles which can be done on an outpatient basis. For men who don't want this surgery, there are certain drugs, known as LH-RH analogs, which can be effective as well. These drugs are ussually given by injection monthly and prevent the body from making male hormones. Side effects may include hot flashes and impotence. The cost of this treament can be expensive but is generally covered by health issurance.

Although treatments continue to improve, early detection is still the key to fighting this disease by catching it before it has spread. Currently about 70% of all prostate cancer patients are alive at five years and half of these men had their cancer detected early. To improve these statisitcs, men need to make an annual physical exam a high priority. Making an annual physical a habit could save your life!