Prostate Cancer 101

What is the Prostate?

The prostate is an organ that plays a crucial role in the male reproductive system. It is located directly below the bladder and in front of the bowel system. The prostate gland is contoured around part of the urethra.

The prostate gland’s primary function is to produce fluid that protects and enriches sperm. This fluid, called prostatic fluid, is secreted at the time of ejaculation and extends the lifespan of sperm in the vaginal tract. Prostatic fluid makes up roughly 30 percent of the volume of semen.

The prostate also produces PSA (prostate-specific antigen) a protein that helps to keep semen in a liquid state. Some PSA protein escapes the prostate and leaks into the bloodstream. A blood test is used to identify a man’s PSA production levels and allows doctors to track relative changes of PSA production over time. High PSA levels are often an indication there is a problem with the prostate, which may – or may not – be prostate cancer. A high PSA score is not always directly correlated with a prostate cancer tumor.

Prostate Enlargement

The size of the prostate gland in younger men is approximately the size of a walnut. However, as men age the prostate gland can increase in size. Men with an enlarged prostate gland may experience:

• incomplete bladder emptying;
• an increase in the number of urinary releases throughout the day; and/or
• frequently waking up at night to urinate.

It is important to note an enlarged prostate gland in older men is not necessarily prostate cancer. It could be the result of benign prostatic hyperplasia (BPH), a common growth in the inner part of the prostate (closest to the urethra). Although BPH is a serious condition it is not cancerous and does not develop into prostate cancer.

Please consult with your primary care physician or urologist to discuss treatment options, which can include prescription drugs and/or surgery.

Unfortunately, science does not yet understand what precisely causes cells in the prostate gland to mutate and evolve into cancer. However, evidence-based medicine has learned that chemical changes in the DNA structure can cause mutations in our cells, leading to abnormal cell developments.

Cancer can begin by changing the DNA structure of oncogenes, genes that help cells to grow and divide. In this scenario oncogenes change their behavior to grow and divide faster than our immune’s system to eliminate the mutated gene. Cancer can also start with tumor suppressor genes, genes that slow down cell growth and/or eliminate old or malformed cells.

Many prostate cancer practitioners and researchers believe the early stages of prostate cancer development can be detected by identifying a certain condition of prostate cells called prostatic intraepithelial neoplasia (PIN). This is where ducts and glands within the prostate divide faster than normal and are more irregularly spaced within cells. PIN is a complex, precancerous condition that can be identified by viewing prostate cells through a microscope (a biopsy of the prostate is required).

• Low-grade PIN (LGPIN): changes are not far removed from normal cell patterns.
• High-grade PIN (HGPIN): cell structure is further removed from normal cell development.

Some men have PIN development in their early 20’s yet never develop prostate cancer. However, a HGPIN score is associated with prostate cancer in roughly 30 percent of cases. An aggregate pathology report of prostate glands that have been removed through a radical prostatectomy revealed a HGPIN score is associated with 85 to 100 percent of prostate cancer cases.

It remains important to note that most men have some cancer cells in their prostate by the age of 50. Additionally, most men diagnosed with prostate cancer will die of another, unrelated medical condition. However, this does not take away from the reality that prostate cancer can be a very serious health concern.

The truth of the matter is that nearly 30,000 American men are projected to die of prostate cancer in 2013. This is far too many. New research techniques have improved the ability of evidence-based medicine to screen and stage for prostate cancer – helping to reduce needless and often painful procedures that were common practice just a decade ago.