Dr. Danny Vesprini, radiation oncologist at Sunnybrook’s Odette Cancer Centre, answers nine frequently asked questions about prostate cancer.
1. What exactly is a prostate?
The prostate is part of the male reproductive system. It is about the size of a walnut and is located between a man’s bladder and his penis, and in front of his rectum. It is a tubuloalveolar gland — that means it is a gland that makes something that is then excreted from the gland to another part of the body.
2. What does a prostate do?
The prostate makes a fluid that is part of a man’s ejaculate. It has the right acid:base balance to allow sperm to live and swim freely. The prostate also makes Protein-specific antigen – or PSA – which is a protein that helps sperm swim in the vaginal tract. It is also thought to be important in breaking down a mucous plug found on the cervix, thus allowing the sperm to have access to the eggs and aiding in conception.
3. Is it the most common spot for men’s cancer?
Prostate cancer is the most commonly diagnosed cancer in men. Cancers in the prostate can form anywhere in the gland and are usually what we call ‘multifocal’ — with more than one area developing into cancer at the same time.
4. What are the symptoms of trouble in your prostate?
With PSA screening, which tests the amount of PSA in the blood, it is rare to have symptoms. But for those that do not get PSA testing, or have a prostate cancer that does not secrete PSA, the symptoms that a man may be in trouble include new pain in the bone that is increasing, slow urinary flow and weight loss.
5. When should a man get screened for prostate cancer?
At age 50, all men should talk to their doctors about PSA blood test screening. For those men thought to be at increased risk (see question 8 below), earlier screening at age 40 is considered, though the pros and cons of screening need to be discussed with your care provider.
6. What’s prostatitis?
Prostatitis is inflammation of the prostate, which may or may not be associated with a bacterial infection. Common symptoms of prostatitis include pain with urination, slower urinary flow, and a ‘boggy’ pressure-like feeling in the pelvis. Prostatitis is a common reason that PSA levels can be artificially elevated. Although prostatitis is not related to the development of prostate cancer, it’s a common reason men are referred to urologists. The treatment of prostatitis include antibiotics and anti-inflammatory medications such as ibuprofen. Some men will develop chronic prostatitis that recurs for many years.
7. Is there anything men can do to help prevent prostate cancer?
There is no conclusive evidence that men can prevent prostate cancer but a lot of research is being done to look at diet and physical activity as well as supplementation (for example, with vitamins). The most important thing you can do is yearly screening with a PSA test and DRE after age 50, because although we may not know the most effective ways to prevent prostate cancer now, we know that early detection is key to decrease the chance of developing aggressive disease and long-term prostate cancer death.
8&9. Are some men more at risk? Why?
Men thought to be at increased risk are those with a strong family history, those of western African/Caribbean heritage and those with a known genetic predisposition such as a BRCA2 mutation. These men are all thought to have some inheritable risk factor that increases the likelihood of developing prostate cancer at an earlier age and unfortunately at a later stage.
Do you have more questions about prostate cancer? Email us.
*This post was been updated Feb. 13/18 to reflect PSA screening recommendations by the Ministry of Health in Ontario and a US prostate screening task force. Learn more about PSA tests here.