Cancer of the Prostrate: Causes and Treatments

QUESTION: I'm worried about cancer of the prostrate. Please explain its
causes and treatments.
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ANSWER: Prostate cancer is the most common malignancy found in older men.
Usually it is first discovered during a rectal examination as a nonsymptom
producing lump or swelling in the prostate gland. The nodule is most often
small (less than 2 cm in diameter), hard, irregular in shape, and
self-contained. Other indicators of prostate cancer are unexplained bone pain
in the pelvis and lower spine, and bladder problems such as painful urination,
dribbling, and straining to void, which might indicate an obstruction.
While the exact cause of this type of malignancy remains a mystery, the
predictable way it progresses helps the physician make an accurate and quick
diagnosis so that proper treatment can begin. Blood tests, a needle biopsy,
x-rays of the kidneys and the urinary tract, and computerized ultrasound
pictures (CT scans) of the lower abdomen to see if the lymph nodes are
involved are useful components of a complete workup that may be performed to
define what stage the carcinoma is in. These stages range from (A) diseased
tissue with no lumps to (B) lesions confined to the prostate capsule to (C)
tumors which cover the outside of the capsule, and finally (D) disease which
spreads to other body parts.
Treatment varies according to the severity of the condition and other
factors such as patient's age (young men tend to develop fast growing
cancers), desire to remain sexually potent, and other medical problems that
may exist. For instance, early stage A cancers are without symptoms and are
discovered when tissue removed during operations for enlarged prostates
considered benign, are examined under the microscope. No further treatment
may be necessary, unless the patient is under 55, and the cancer cells seem
advanced, in which case radiation therapy is suggested. Stages B and C
require either a complete surgical removal of the prostate gland or intensive
radiation therapy, which reaps a similar result. The symptoms of stage D
(advanced) disease can be lessened with hormone therapy as well as surgery.
Though the manner and timing of such therapy remains controversial, its goal
is to reduce symptoms and make the patient more comfortable.
New advances in treatment are being developed every day. For example, a
new surgical technique called a subcapsular prostatectomy (or partial removal
of the prostate gland) seems to be successful in halting some cancers without
causing the patient to become impotent. Unfortunately, long-term results are
not yet known.