Understanding What Prostate Cancer Is and Who's at Risk

Prostate cancer is a malignant tumor that starts in your prostate. Some prostate cancers are very slow- growing. Causing you no trouble unless you live a very long time. On the other hand. quick- growing prostate cancers - and I think most of the ones picked up by doctors are this kind - can kill you if the cancer spreads beyond the prostate. if the cancer isn’t diagnosed in time. or if you take no action after your diagnosis. However. you can often be cured of prostate cancer if the cancer is localized (or confined) to the prostate. I had surgery for my own localized prostate cancer in 1999. The surgery cured me. causing no side effects.

But even if a cure isn't possible. you can always be treated to at least temporarily shut down the cancer.

Sure. you may experience side effects from treatment. just like you may end up with a scar from a wound your doctor sews up. But you're alive. and you likely have good prospects for many years ahead. So read this book. talk to your doctor. decide what to do about your cancer. and then do it.

In this chapter. I discuss what prostate cancer is. who's most at risk for developing the disease. what you

can do about the disease. and how to handle the emotions you and your family may feel after a diagnosis of prostate cancer.

Understanding What Prostate Cancer Is and Who's at Risk

Any man can develop prostate cancer. but some men are at a greater risk for the disease. For example. If you haven't been diagnosed with prostate cancer. but your father. brother. or another male relative has (or has had) the disease. your risk for developing cancer increases. and you should have an annual screening for prostate cancer. Black men also have a higher risk for developing prostate cancer. although no one nows for sure why this is the case. Not to say that if you're not black. you don't have to worry about prostate cancer: All men are at risk for developing the disease. You can read more about the risks for developing prostate cancer in Chapter 3.

Prostate cancer isn't your fault. Experts really don't know what causes prostate cancer. so no one

can blame you for making yourself sick. (And you shouldn't blame yourself. either.) At the same

time. when you know that you have prostate cancer. you need to discover all you can about the

disease and the treatment options. And then. with your doctor’s help. you can select the best

treatment for you.

ldentifying Prostate Cancer lmpostors

You may be experiencing some symptoms that may indicate prostate cancer. such as urinary frequency and urgency. or a poor urinary stream. Because men often don’t experience any symptoms with prostate cancer. these same symptoms may indicate another illness altogether. The most common cancer impostors are

• Benign prostatic hyperplasia (BPH): The key word in BPH is benign. Benign is the opposite
• of cancer. and that has to be a good thing. However. BPH can be agonizingly painful for some men. BPH is a tissue overgrowth that can cause major pain and considerable trouble with urination. If you have symptoms of BPH. such as constantly having to urinate or having trouble urinating. you should see your doctor for treatment - which is often medication or sometimes surgery. Without treatment. BPH usually only gets worse. so don’t try to ignore it.
• Prostatitis: This condition is characterized by inflammation and pain in the prostate. (When you
• find -itis at the end of a medical word. it usually refers to inflammation.) Prostatitis is sometimes
• caused by a bacterial infection that's treatable with antibiotics or other drugs. If you ignore the
• infection. it can spread to your bladder. kidneys. or other organs. See your doctor if you're having pain and trouble urinating.
• Bladder infections: As men age. they develop a greater risk for bladder infections. (This

• condition is also known as cystitis. another -iIi.s' word.) The symptoms of a bladder infection

• difficulty with urination. for example - are similar to the symptoms that are characteristic of othergenitourinanv diseases (having to do with the kidney. bladder. prostate gland. penis. and testicles). including prostate cancer. BPH. and prostatitis.

If you have a bladder infection. you doctor usually prescribes antibiotics. Make sure that you take

all the antibiotics your doctor orders. If you take your antibiotics for only two days when your doctor ordered medication for seven days. you only wipe out the weak germs. The stronger germs. which are still there. will continue to multiply. Bladder infections that are not treated properly can be dangerous. because the bacteria can spread to your kidneys.

Check out Chapter 4 for more detailed information on these medical problems. as well as on several others that may be confused with prostate cancer.

Working with physicians

Working with physicians you trust is absolutely essential when you haVe prostate cancer. I say physicians  plural because you usually deal with at least two different types: Your primary care physician. who usually perl‘onns your annual physical examinations. an important ritual that can help Flag the early indicators of prostate cancer. and the speeialist(s) who eonfimis and treats the cancer. You inyariably need to see a urologist (an expert in treating diseases ofthc prostate. kidneys. bladder. and testes). but you may also need to work with urologie. radiation. or medical oncologists (physicians who specialize in treating cancer some urologists subspecializc in treating cancers of the genitourinary system). See C haptcr 6 for more about finding and working with specialists.

A self-test: Could you have prostate cancer?

Only a doctor can determine for sure whether you have prostate cancer. A self-test, such as the one I provide here, can give you possible indicators, at best. Keep in mind that in most cases, early prostate cancer has no symptoms whatsoever, which is why an annual physical examination and prostate specific antigen (PSA) blood test are so very important.

 Get some scrap paper and jot down your answers to the following yes or no statements. Then read my analysis at the end of the list.

1. My father and/or brother has been diagnosed with prostate cancer.
2.  I’m having trouble with urination. (You have trouble going or you have to go a lot. Or- Ouchl - you have both problems.)
3. I notice some blood in my urine.
4. l have constant, severe back pain.
5. I'm tired all the time.
6. I lose weight, even when I'm not trying to take off the pounds.

Now here’s an analysis of your answers. If you answered yes to even one of these statements,

you need to see your doctor.

Question 1: If you answered yes to this question, you have an increased risk for

developing prostate cancer. You should be diligent about having an annual physical exam,

which includes a rectal exam (I know, I know, nobody likes this test, but it can save your life)

and a PSA blood test, as well as a discussion with your doctor about your general health.

Question 2: Trouble with urination may just be a sign of an infection or another

correctable problem. See your doctor so that he can zero in on the culprit. If you have prostate

cancer, you need treatment. If you have a bladder infection, you also need treatment, because

it may get worse.

Question 3: If you see blood in your urine (doctors call it hematun'a), don't panic, but do

see your doctor right away. Having blood in your urine is not normal, and the cause needs to be

investigated. It may be a sign of an infection, prostate cancer, or cancer of the urinary system.

Your doctor can determine the source of the problem.

Question 4: Back pain has numerous causes, ranging from infection to a pulled muscle

to a disc problem (and on and on). Prostate cancer is another possible cause of back pain.