Prostate cancer is cancer that occurs in the prostate. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of cancer.

What is prostate cancer?Prostate cancer is the most common male cancer in Canada. One out of every 8 men, 12% of all men in Canada, will develop the disease during his lifetime. The Prostate is a walnut sized organ that is below the bladder that surrounds the passage that carries urine from the bladder through the penis during urination- this tube is called the urethra.

The prostate secretes fluid, which forms part of the semen in which sperm are transported.  During sexual activity and orgasm, the semen enters the urethra and passes along it, through the penis to the outside, otherwise known as ejaculation.

Prostate cancer starts in the cells of the prostate. A cancerous tumour, otherwise known as a malignancy, consists of cancer cells that can grow into nearby tissue and destroy it. The tumour can also spread to other parts of the body. Cancer that has spread to other parts of the body are called metastases.

The exact cause of prostate cancer is unknown. However, risks factors include:

1. Family history.  If you have a brother or father with prostate your risk of prostate cancer goes up.
2. Race. Men of African ancestry seem to have the highest risk, whereas Asians have the lowest risk.
3. Age.  As men get older, the risk of prostate cancer rises. A majority of newly diagnosed prostate cancer occurs in men over the age of 60.

The most common type of cancer that starts in the prostate is called adenocarcinoma. This type of cancer comprises over 95% of prostate cancers.

In Canada, most men with prostate cancer are found due to abnormalities of their PSA test. This is a test usually given to men over the age of 50 to assess for prostate cancer risk: the higher the PSA the greater the risk of prostate cancer.  Most men that are newly diagnosed with prostate cancer have no symptoms. 

Since most prostate cancers grow on the outside layer of the prostate, called the peripheral zone, sometimes doctors can feel the cancer during a prostate exam, otherwise known as a digital rectal exam or DRE. A DRE is an important step in diagnosing prostate cancer as well as determining how big or aggressive the prostate cancer is. Contrary to what you may have seen in movies or television, a DRE is usually not painful and is an important part of the male physical exam. Once an abnormality is found, either by a PSA test and / or DRE, a prostate biopsy can be ordered so the tissue from the prostate can be assessed for cancer. This is when tissue from the prostate is looked at under the microscope to determine if any cancerous cells are present. In Canada, this is most commonly done through the rectum with ultrasound, but it can also be performed through the space between the scrotum and rectum, which is called the perineum. 

In summary, the prostate gland is an organ that functions to help in the fertility of males.  A cancer that originates in this organ, called prostate cancer, is the most common cancer in males in Canada and is usually found after a PSA test or digital rectal examination. Dr. Alan So (FRCSC), Urologist, Vancouver, BC Local Practtioner:  Local Urologist 

One of the most common questions asked in regards to prostate cancer is what can I do to reduce my risk of getting the disease? And, there are a lot of things that are being explored. There's good data on some things, for example, lycopenes, which are in tomatoes, may help reduce the risk. There's a new idea that a group of medications may help, they're called 5-alpha-reductase. They affect how testosterone is metabolized in the prostate. And a couple of very new studies indicate that taking this medication may reduce the risk of getting prostate cancer, and that's something men have to talk to their general practitioner about and see if it's the right thing for them.

It's interesting, too, just recently a big study was published on looking at vitamin E and selenium and that gained some popular support as something that might prevent prostate cancer. The general thinking is that something like that can't harm, but the study actually showed that maybe it does cause harm. There's an increased risk of prostate cancer in men getting vitamin E, and an increased risk of men getting diabetes in men taking selenium. So you have to be careful, and it's wise to take things where there's really only good evidence that it actually helps. Presenter: Dr. Peter Black, Urologist, Vancouver, BC

Now Health Network Local Practitioners: Urologist