Prostate cancer questions and answers – Info at-a-glance

This list of common prostate cancer questions and answers makes it easy for you to quickly understand the disease with key topics you can search for using our search box (top right) to find more in-depth articles or by using our site map.

Prostate cancer questions and answers: the prostate gland

What is the prostate gland?

The prostate gland (which is no bigger than the size of a walnut) creates part of the fluid that makes up semen.  It is not a vital organ and men can live the rest of their lives safely without it.

Where is the prostate gland located?

The prostate gland is located deep within the pelvis, between the rectum and the bladder. It:

  • Surrounds the upper part of the urethra, the tube that allows urine to flow from the bladder and through the penis
  • Is surrounded by major arteries, veins, and sphincters that facilitate urinary control
  • Is also surrounded by tiny, delicate nerves called neurovascular or “nerve bundles”

Prostate cancer questions and answers: the disease

What is prostate cancer?

Prostate cancer results when abnormal cells in a man’s body start to grow out of control. It is a cancer that only affects men.

How common is prostate cancer?

It is estimated that 220,800 men will be diagnosed with prostate cancer in 2015.

Prostate cancer questions and answers: causes & symptoms

What causes prostate cancer?

No one knows the exact causes of prostate cancer or why some types are more aggressive than others. It is believed that damage or mutations to DNA cause normal prostate cells to become cancerous cells. Other factors that may also play a role include:

  • Age
  • Family history
  • Race
  • Hormones
  • Ethnicity
  • Diet
  • Environment

What are the symptoms?

Most men do not have any physical symptoms with early prostate cancer. As prostate cancer advances, some men may need to urinate more often or may find their ability to urinate is slowed or weakened. Other symptoms can include:

  • Painful irritation
  • Blood in the urine or sexual problems (such as difficulty getting an erection)
  • Blood in semen
  • Pain in the back, hips, and ribs

Prostate cancer questions and answers: diagnosis

How is prostate cancer diagnosed?

Prostate cancer diagnosis is commonly confirmed by a procedure called a transrectal ultrasound-guided biopsy. It is a procedure that is generally done in the doctor’s office.

What is a PSA test?

Prostate-specific antigen, or PSA, is a protein that the prostate gland produces. A PSA test is a simple test that measures the amount of prostate-specific antigen a man has in his blood. When the prostate gland is healthy, usually very little PSA escapes through the wall of the gland into the blood.

What is a prostate exam?

A prostate exam typically includes a digital rectal exam (DRE), which allows the doctor to physically feel the prostate gland to determine if it is:

  • Enlarged
  • Abnormally hard
  • Has lumps or other irregularities

Prostate cancer questions and answers: grading & staging

What is a Gleason score?

The Gleason score helps determine how quickly a tumor may grow or spread:

  • The numbers 1 to 5 are used
  • A number is assigned to two of the areas of the prostate that have the most cancer
  • Once those two numbers are determined, they are added together to come up with the Gleason score, which ranges from 2 to 10

What is staging?

Prostate cancer staging is based on the results of all of your loved one’s tests, physical exams, and biopsy. The TNM staging system is the most commonly used system for determining prostate cancer stages.

What is advanced prostate cancer?

Advanced prostate cancer means that the cancer has moved beyond the prostate gland. It is not localized cancer (cancer that is only confined to the prostate gland). It may further be defined as:

  • Locally advanced;
  • Regionally advanced;
  • Or metastatic cancer

Prostate cancer questions and answers: choosing treatment

How do you decide on a treatment?

There are many factors that will help determine the course of treatment, including the stage of the cancer and the Gleason score.  Other factors to consider include:

  • Age and health of your loved one
  • Recovery time
  • Rate of long-term side effects

Prostate cancer questions and answers: surgical treatment

What is radical retropubic prostatectomy?

During radical retropubic prostatectomy, an incision is made from just below the man’s bellybutton to the top of the pubic bone (retropubic means behind the pubic bone). This surgery for prostate cancer gives the surgeon easy access to:

  • Lymph nodes
  • Nerves
  • Blood vessels

Lymph nodes can be removed and examined, if it is suspected that the cancer has spread.

What is radical perineal prostatectomy?

Radical perineal prostatectomy is generally presented as an option when:

  • Men cannot undergo retropubic surgery due to other medical problems
  • The surgeon believes there is little chance that the cancer has spread to the lymph nodes

What is laparoscopic radical prostatectomy?

During this type of surgery, several long instruments, including a thin lighted tube with a small video camera to guide prostate removal, are inserted into the body through small incisions.

What is robotic-assisted laparoscopic radical prostatectomy?

During robotic-assisted laparoscopic radical prostatectomy, a laparoscopic radical prostatectomy is performed using a robotic device (a machine with robotic arms that is known as the da Vinci surgical system) that is controlled by a surgeon in the operating room.

Prostate cancer questions and answers: other treatments

What is radiation therapy?

There are two main types:

  • External radiation (often called external beam radiation therapy)
  • Internal radiation (called brachytherapy), which is also referred to as seed implantation or interstitial radiation therapy

What is hormone therapy?

The main purpose of hormone therapy for prostate cancer is to either:

  • Lower the amount of hormones that are produced in a man’s body
  • Stop the cancer cells from using these hormones

This is why hormone therapy is sometimes referred to as “androgen deprivation therapy” or “androgen suppression” therapy.

Is chemotherapy ever used?

Chemotherapy may be used when prostate cancer has spread beyond the prostate gland and hormone therapies have failed to control it. With prostate cancer, chemotherapy may also be used to treat pain caused by cancer that has spread to the bone.

What is cryosurgery?

Cryosurgery is a more recent procedure that uses gases (such as liquid nitrogen) to freeze and destroy the cancer. It is also commonly referred to as cryotherapy or cryoablation.

What is watchful waiting?

Watchful waiting, which is also called “expectant management” or “active surveillance,” is when the doctor doesn’t start any treatment, but carefully monitors the growth of the cancer.

What is alternative treatment?

Alternative prostate cancer treatment is generally described as nontraditional treatment that some men may choose in the hope of curing their prostate cancer.

Prostate cancer questions and answers: incontinence

What is incontinence?

Urinary incontinence is a troubling side effect that can occur after treatment for prostate cancer. While there are different types—and varying levels of “leakage”—it may generally be described as the inability to control or stop urine from flowing.

What are Kegel exercises?

Kegel exercises (also called pelvic floor exercises) are an attempt to help strengthen the muscles that support the bladder. These muscles also play a role in a man’s sexual function.

Are there drugs to help with incontinence?

The drugs used for “male incontinence” following treatment for prostate cancer are usually the same drugs that are used to treat a common condition called overactive bladder. While these drugs may contain different ingredients, they are typically prescribed to help reduce the frequent or urgent need to urinate and accidental wetting.

What about collagen injections?

Collagen injections may be suggested for a very mild form of bladder incontinence, or if a man cannot have surgery to correct long-term incontinence (perhaps due to other health problems or his age).

What is a male sling?

The male sling supports the urethra, which is the tube that carries urine from the bladder through the penis; where it is released when a man urinates.

The sling helps return the urethra to its normal position to help reduce the risk of urine leakage, particularly when a man:

  • Coughs
  • Sneezes
  • Engages in strenuous activities

What is an artificial urinary sphincter?

This device (which typically consists of a cuff, a pump, and a balloon) is surgically implanted. The cuff, which is filled with a saline fluid, compresses the urethra to keep it closed. This prevents urine from leaking.

When a man is ready to urinate, he squeezes the pump, which is implanted into his scrotum. This pulls the fluid from the cuff into the balloon, releasing the compression on the urethra—and allowing it to open—so he can urinate.

Prostate cancer questions and answers: recurrence

How common is prostate cancer recurrence?

Up to 70,000 men will have what’s termed a PSA recurrence after their initial treatment (which also may be called a biochemical recurrence or biochemical failure).

It means that some prostate cancer cells were either left behind during surgery, or survived radiation or cryotherapy, and they are now growing:

  • Near the area where the prostate gland was (if the man had surgery)
  • Within the prostate gland (if he had radiation or cryotherapy)
  • Or they have spread to another area of the body (called metastasis)

What is salvage radiation?

Salvage radiation treatment (or salvage radiotherapy) may be suggested if PSA rises after radical prostatectomy. Salvage radiation usually means external beam radiation.  Some men may receive hormone therapy for a few months prior to treatment.

While salvage brachytherapy is sometimes performed on men who have a recurrence of prostate cancer after they have had external beam radiation, it is not as common after surgery for prostate cancer.

What is salvage radical prostatectomy?

Generally, this is a treatment option when doctors believe the cancer is still localized, which means it has not spread beyond the prostate gland.

The challenge with this procedure is that the tissues that surround the prostate gland have undergone substantial damage from radiation. This makes it harder for the surgeon to see and cut out all of the areas that need to be removed. It may also prevent the surgeon from being able to perform a nerve-sparing procedure.

What is salvage cryotherapy?

Salvage cryotherapy (or cryosurgery or cyroablation) after failed radiation treatment for prostate cancer is a minimally invasive procedure that uses gases (such as liquid nitrogen) to freeze and destroy the cancer. Some physicians now use a “brachytherapy-like” approach to administer treatment.

More prostate cancer questions and answers:

Are there earlier signs of prostate cancer?
What is PSA velocity?
Is proton therapy for prostate cancer better than external beam radiation therapy?
What is late stage prostate cancer?

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