Understanding Prostate Cancer

What is Prostate Cancer Dr. Kevin Zorn, MD, FRCSC, FACS, Urologist

Prostate cancer is the most common male cancer diagnosed in Canada—one out of every eight men will develop it in their lifetime. Prostate cancer starts in the cells of the prostate, and can grow into nearby tissue. The cancerous tumour can also spread (metastasize) to other parts of the body.

The prostate is a walnut-sized organ that sits below the bladder. It surrounds the passage that carries urine from the bladder through the penis during urination. This tube is called the urethra. The prostate functions to support male fertility. It secretes fluid, which forms some of the semen in which sperm are transported.

The Cause of Prostate Cancer

Health experts don’t know the exact cause of prostate cancer. However, risk factors include: 1. Family history: If you have a father or a brother who has had prostate cancer, your risk of developing the disease increases. 2. Race: Men of African ancestry appear to have the highest risk of getting prostate cancer. Asian men have the lowest risk. 3. Age: As men get older, their risk of prostate cancer gets higher. Newly diagnosed prostate cancer often occurs in men over the age of 60.

How Prostate Cancer is Diagnosed in Men

In Canada, most prostate cancer is found due to abnormalities of a prostate specific antigen (PSA) test. The PSA test is usually given to men over the age of 50 to assess for prostate cancer risk. The higher the PSA levels, the greater the risk you have of developing prostate cancer.

Since most prostate cancers grow on the outside layer of the prostate (called the peripheral zone), doctors may also feel a lump during a digital rectal exam (DRE). A digital rectal exam can be an important step in diagnosing prostate cancer. It can also help determine how big or aggressive the prostate cancer is. Contrary to what you may have seen on a TV show or in a movie, a DRE typically isn’t painful.

The most common type of cancer that starts in the prostate is called adenocarcinoma. This type of cancer comprises over 95% of prostate cancers. Most men who are diagnosed with prostate cancer have no symptoms.

If an abnormality is found in your prostate, either by a PSA test and/or a DRE, a physician will order a prostate biopsy. The tissue from the prostate can then be assessed for cancer under a microscope. In Canada, this is most commonly done through the rectum with ultrasound. However, it can also be performed through the space between the scrotum and rectum (the perineum).

Presenter: Dr. Kevin Zorn, Urologist, Montreal, QC

Local Practitioners: Urologist