What exactly is the prostate? What does it do?
The prostate is a gland that is about the size of a chestnut that sits right below the bladder. Its function is to provide secretions that mix with sperm and allow the semen necessary for the male reproductive system. It’s a very important gland in that it helps to liquefy the sperm made in the testes.
In addition, the urethra sits right in the middle of the prostate gland and is surrounded by the prostate gland, and it’s responsible for allowing us to empty urine from the bladder.
What are the symptoms and signs of prostate cancer?
There are very few signs of prostate cancer, but there are signs that there may be problems with the prostate. As men get older, they might notice a change in how they pass urine. The stream may become weak, or they may go to the bathroom more frequently. They may have slept like a rock before but now get up two or three times to use the bathroom. They may notice dribbling or increased urgency. Those can all be signs that the prostate gland is enlarging, which normally happens as a man ages. There are ways to diagnose an enlarged prostate gland (known also as benign prostatic hyperplasia) and there are medications that can be used.
There are very few signs in the early stages that there may be prostate cancer in the gland. That is why we get so concerned when there is no screening, because when you do begin to show signs, it typically means that if it is prostate cancer, it has advanced outside the prostate gland to other areas. We rely on screening tools to help detect when there is a problem.
What type of prostate tests are there?
There are two tests that primary care physicians begin to discuss with men who are around the age of 50 if the men are at average risk. The physician will discuss a PSA (prostate-specific antigen) test. This blood test can detect when there are problems with the prostate gland prior to any signs or symptoms that develop. The doctor will also do a digital rectal exam to make sure there’s not a mass or abnormality on the prostate.
Is there a segment of the male population that are at higher risk?
Yes. About 10 percent of all prostate cancers diagnosed are hereditary, meaning that an increased risk for the disease runs in the family. Family history is the strongest risk factor for prostate cancer.
African American men are more likely to develop prostate cancer compared with other ethnicities and are over two times more likely to die from the disease. They are considered a high risk population. Screenings and discussions about PSA tests and digital rectal exams should begin for high risk men between the ages of 40-45.
What are the treatment options in St. Charles County?
Yes. Many prostate cancers that are detected and diagnosed may not be life threatening. We have to discriminate which men should receive a recommendation for treatment and which should be watched closely. With low risk prostate cancers, you can have a discussion about active surveillance, where we don’t treat it, but we watch it closely and make sure we don’t need to offer treatment.
Treatment include surgically removing the prostate gland through an open incision or through a robotic-assisted, laparoscopic procedure. There are many radiation options – we just completed a national study that indicated that we can give radiation effectively over a short period of time (5 ½ weeks vs. the classic treatment program of 8+ weeks). We can also give radiation over 2 weeks due to advancement in the technology that we have. We also specialize in placing radiation “seeds” into the prostate gland; it’s about an hour-long procedure that we jointly perform with urologists in St. Charles. Most importantly, we recognize that some prostate cancers can be watched closely and don’t have to have radiation or surgery.
For more information – Call Siteman Cancer Center at 636.916.9920