Facing a prostate cancer diagnosis is easier with open and honest communication. Though it may seem difficult to talk about something so personal, doing so can be both healing and helpful. A support group can offer valuable information from men who’ve been in your shoes. Talking with friends can be a source of strength and surprisingly enlightening if you discover that some of your friends have had prostate cancer themselves. And you could make a life-saving difference by sharing your diagnosis with a family member. As you learn more about your diagnosis, remember that the path ahead can be made clearer with a simple conversation.
Prostate cancer, one of the most common cancers diagnosed in men, begins in the prostate, a gland in the male reproductive system. Most prostate cancers are adenocarcinomas that start when healthy cells mutate into abnormal cells, growing uncontrollably and not dying when they should. The abnormal cells gradually accumulate to form a tumor.
These prostate cancers generally grow very slowly, may not cause symptoms for a long time (or ever) and often remain contained within the prostate gland. Sometimes, they spread outside the prostate gland to other parts of the body. Such spread is known as metastasis, and it can be accompanied by symptoms such as pain and fatigue.
To better understand prostate cancer and your specific diagnosis, it may help to know basic information about the prostate.
About the Prostate Gland
A healthy prostate is the size and shape of a walnut, situated under the bladder and in front of the rectum (see Figure 1). The prostate wraps around the urethra, which is the tube that carries urine from the bladder and semen from the prostate through the penis. The main job of the prostate is to produce seminal fluid that protects and transports sperm out of the body.
As men age, the prostate normally increases in size. This is benign prostatic hypertrophy (BPH) and may block the normal flow of urine. Though growth of a cancer in the prostate may also block the flow of urine, such blockage and the symptoms that result are usually due to BPH rather than cancer. Prostate cancer in the prostate usually causes no symptoms at all. Therefore, monitoring your prostate health through regular exams and tests enables your physician to determine whether you have age-related issues or prostate cancer.
All males are at risk of developing prostate cancer. Risk increases with age, and most cancers are diagnosed in men 50 years of age or older. African American men have a higher risk of prostate cancer than White or Asian men, as do men with a family history of the disease. Genetic factors also increase that risk. Genetic testing may be recommended based on a family history of prostate cancer.
Many of the symptoms and side effects, which may indicate prostate cancer, are personal and sensitive; this makes it important for you to fully understand your diagnosis and treatment options and to be comfortable with your health care team. Ask questions, consider the quality of life you wish to maintain and talk with other men who have had a similar diagnosis. The more you know, the more confident you will be moving forward.
Figure 1. Prostate Anatomy
Should you seek a second opinion?
Gathering as much information as you can about your diagnosis and treatment options may help you feel more prepared to make the decisions ahead. Consider the following:
- Doctors in each oncology specialty (surgery/urology, medical oncology or hematology oncology and radiation oncology) bring different training and experience to treatment planning. Some doctors may favor one treatment approach, while others might suggest a different combination of treatments.• Doctors in each oncology specialty (surgery/urology, medical oncology or hematology oncology and radiation oncology) bring different training and experience to treatment planning. Some doctors may favor one treatment approach, while others might suggest a different combination of treatments.
- Some cancer specialists are considered leaders in the field of caring for patients with prostate and other genitourinary cancers. Such specialists may have access to the newest and potentially improved therapies for prostate cancer. For example, such a surgeon may operate on the most complicated tumors that other surgeons will not approach, or a medical oncologist might use an experimental treatment that has been shown to be successful in preliminary studies but is still not widely offered.
- You may live in a small town or rural area where there are few oncology specialists. If so, you may want to get an opinion from specialists at a larger medical center or comprehensive cancer center with particular expertise in treating prostate cancer.
- A second opinion is also a way to make sure your pathology, diagnosis and staging are accurate, and that you are aware of clinical trials you might want to consider.
- Most doctors welcome a second opinion and may even recommend another physician or hospital. Above all, the goal is for you to have the best care available.