1. Q: What is the prostate?

The prostate is a gland in the male reproductive system. The prostate makes and stores a component of semen and is located in the pelvis, under the bladder and in front of the rectum. The prostate surrounds part of the urethra, the tube that empties urine from the bladder. A healthy prostate is about the size of a walnut. Because of the prostate’s location, the flow of urine can be slowed or stopped if the prostate grows too large.

2. Q: What is prostate cancer?

Except for skin cancer, cancer of the prostate is the most common malignancy in American men. In most men with prostate cancer, the disease grows very slowly. The majority of men with low-grade, early prostate cancer (confined to the gland) live a long time after their diagnosis. Even without treatment, many of these men will not die of the prostate cancer, but rather will live with it until they eventually die of some other, unrelated cause.

3. Q: Who is at risk for prostate cancer?

All men are at risk. The most common risk factor is age. More than 70 percent of men diagnosed with prostate cancer each year are over the age of 65. African American men have a higher risk of prostate cancer than white men. Dramatic differences in the incidence of prostate cancer are also seen in different countries, and there is some evidence that a diet higher in fat, especially animal fat, may account for some of these differences. Genetic factors also appear to play a role, particularly for families in whom the diagnosis is made in men under 60 years of age. The risk of prostate cancer rises with the number of close relatives who have the disease.

4. Q: How much does family history of prostate cancer increase the risk for it?

In the general population, about one in six men is diagnosed with prostate cancer, and it is recommended screening for prostate cancer at age 40 for the general population.
But for men with a primary relative with prostate cancer (a brother or father), the risk is two-fold higher. It is especially important for men with a primary relative who had prostate cancer to have regular checkups. Men with familial prostate cancer might develop the disease at an earlier age, so screening should be considered earlier, at age 35.

5. Q: What are other prostate diseases besides cancer?

The two main prostate diseases besides cancer are inflammation (prostatitis) and benign enlargement (BPH). Both of these can elevate the PSA level. Benign enlargement is treated with drugs, hormonal therapy, or surgery. Inflammation can sometimes effectively treated with antibiotics, but sometimes patients just have to live with it.

6. Q: What is benign enlargement of the prostate (BPH)?

BPH: Benign (non-cancerous) prostatic hypertrophy is an enlargement or growth of the area in the prostate gland that is nearest the urethra. This growth can block or constrict the urethra, causing urination problems

7. Q: Are enlarged prostates genetic? Do they run in families?

Yes, benign prostatic hyperplasia does run in families.

8. Q: What is a digital rectal examination (DRE)?

The digital rectal examination (DRE) is the physical examination of the prostate. The digital rectal examination is done through the anus. The DRE is a marker of prostate cancer risk.

The digital rectal examination aims to define basic characteristics of the prostate: size, tenderness, shape, and consistency. Each of these prostate characteristics has implications for the diagnosis of enlargement, prostatitis, and prostate cancer.

In early prostate cancer detection, prostate nodules take on special meaning because they are one of the warning signs of prostate cancer. A prostate biopsy can establish the presence of cancer in a nodule on the prostat

9. Q: What is the prostate PSA test?

PSA prostate specific antigen is a protein produced by the cells of the prostate that form the liquid secreted by the prostate during ejaculation. Prostate-specific antigen is also produced to lower concentrations in other types of cells in the body. Prostate-specific antigen is found in very high concentrations in the ejaculate, but normally only a small portion seems to leak into the bloodstream.

Infections, medications, and other factors can cause fluctuations in the blood concentrations of prostate-specific antigen. Prostate-specific antigen is not a diagnostic test. PSA as a test for early detection is done with digital rectal examination (DRE). Prostate cancer diagnosis requires biopsy.

10. Q: What is a biopsy of the prostate gland?

A biopsy of the prostate gland is a sampling of the prostate. Prostate biopsy is generally done under ultrasound guidance, to help distribute sampling to intended regions of the prostate. Prostate biopsy is almost exclusively done for prostate cancer detection.A biopsy is not a complete representation of a prostate: a positive biopsy means there is prostate cancer, but a negative biopsy may or may mean that there is no cancer. Depending upon assessment of risk, prostate biopsy may be repeated.

11. Q: What is radical prostatectomy?

Radical prostatectomy is the complete surgical excision of the prostate, seminal vesicles, tips of the vas deferens, and, depending on oncological considerations, surrounding fat, nerves, pelvic lymph nodes, and blood vessels.

Radical prostatectomy is one of the first-line prostate cancer treatments. It has been around for 100 years and for most of this time it was performed as an open operation.

12. Q: What is laparoscopic radical prostatectomy (LRP)?

Laparoscopic radical prostatectomy is a modern form of radical prostatectomy. Contrasted with older, open surgical forms of radical prostatectomy, laparoscopic radical prostatectomy does not require a large incision. Relying on modern technology, laparoscopic radical prostatectomy is a minimally invasive prostate cancer treatment and a departure from what historically required the application of relatively primitive surgical techniques. Laparoscopic radical prostatectomy is not a new prostate cancer treatment. Rather, laparoscopic radical prostatectomy is a modern means of performing prostate cancer surgery, the oldest treatment for prostate cancer.

13. Q: Is there a risk of relapse after prostate cancer surgery?

There can be recurrence, a relapse after prostate cancer surgery. Indeed, none of the prostate cancer treatments are guaranteed prostate cancer cures. The likelihood of prostate cancer cure varies as a function of grade and stage at the time of treatment; early treatment is thus a key to effective management. Because there is a risk of relapse after prostate cancer surgery, even if it is very low, all patients should have periodic checks of their prostate PSA tests after laparoscopic radical prostatectomy

14. Q: Is Prostate cancer catching?

No, cancer cannot be given to anyone else. You cannot give cancer to your partner by hugging, kissing, touching, or having intercourse.