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Overview of the Prostate

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The prostate is a walnut sized gland found on a male between the bladder and the penis.  The urethra runs through the center of the prostate from the bladder and allows urine to be removed from the body.  The prostate secretes fluid that feeds and protects sperm so when a man ejaculates the prostate squeezes this fluid into the urethra and it is expelled with sperm from the testes as semen.

Prostate cancer is the most widely diagnosed cancer in America.  Where one in 8 women will be diagnosed with breast cancer, one in 6 men will be diagnosed with prostate cancer.  Prostate cancer is the second leading cause of death in men behind lung cancer.  One in 36 men will die from prostate cancer.

Prostate cancer like most cancers is the result of normal cell function going wrong.  Androgens are hormones like testosterone in males that are responsible for normal male characteristic development.  Hormones require receptors so their instructions can be implemented at the cell level.   Therefore, androgen receptors allow the body to respond correctly to the androgen hormones.  Typically cells grow, divide, and die.   In a normal healthy male, 1 – 2 % of prostate cells die and are replaced every day.  This function is performed by the androgen receptor.  When the androgen receptor starts to malfunction, more cells are made than die.  These are typically abnormal cells that have damaged DNA (a chemical that makes up our genes which directs the cell’s actions) and therefore, they do not behave like normal cells and die when they should.  They grow out of control making new cells with damaged DNA.  This is often the beginning of prostate cancer.

The cause of prostate cancer like many cancers is not completely clear but over time researchers have determined several risk factors that may change the chance of getting the disease.  The most significant risk factor for prostate cancer is age.  Sixty-six percent of all prostate cancers are diagnosed in men 65 and older.  Family history can also be an indicator of risk for prostate cancer.   Having a father or a brother with the disease more than doubles the risk.  Having a brother with the disease is more of an indicator than having a father who is affected.  Having multiple family members affected further increases the risk although experts agree that the heredity form of prostate cancer only accounts for 5 – 10% of all cases.  Race may also be an indicator.  Studies have shown that African American males are 60% more likely to get prostate cancer than white American men.  However, African and Japanese males living in their native countries have a lower percentage of prostate cancer.  Diets high in fat may also be a contributing factor to prostate cancer.  Countries where red meat and dairy products are a common staple have a much higher incidence of prostate cancer than countries where vegetables, fruit, and soy products make up the main portion of the diet.

Prostate health is normally checked during a physical with a digital rectal exam during which a physician can determine if the prostate is enlarged and whether further testing is needed.  When a male reaches 40, PSA (Prostate Specific Androgen) level testing is typically added to a routine physical exam.  The level of this protein is often elevated in the blood of a male with prostate cancer.  Because again, if the level of the androgen is high it typically means that the androgen receptor is malfunctioning and therefore could be cancer-driven.

As with breast cancer in women, men should monitor their health and watch for warning signs such as a change in urination patterns, difficulty urinating, weak flow or painful urination.  If any of these warning signs are noticed for more than 2 weeks a checkup should be scheduled.




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