Prostate Cancer

Prostate cancer is the most commonly diagnosed cancer in Canadian men. One out of eight Canadian men will develop prostate cancer during their lifetime. Prostate cancer may be curable if diagnosed early. Even when the disease is advanced, treatment can eradicate symptoms and improve survival. The prostate is a gland wrapped around the urethra, the urine channel, between the bladder and its control muscle, the urethral sphincter. Its main function is to produce part of the semen ejaculated at male orgasm. Each vas deferens carrying sperm from the testicles connects to the prostate. The nerves carrying signals to produce erections run on either side of the prostate.

[Illustration: view of bladder, urethra, prostate, seminal vesicles, cavernosal nerves, rectum, sphincter and penis]

The diagnosis of prostate cancer is made after examination of your prostate (DRE) as well as investigations including a prostate specific antigen (PSA) test. PSA is a substance produced by the prostate and released in small amounts into the bloodstream. Most patients with prostate cancer have an increased level of PSA in their blood. PSA is not specific for prostate cancer and can be increased in men with benign enlargement of the prostate or with prostate infection. However, high levels of PSA mean that there is an increased risk of prostate cancer. Also, some men with small prostate cancers can have a low PSA reading.

If an abnormality is found at DRE or if there is a significant elevation in PSA level a transrectal ultrasound (TRUS) examination may be ordered.

This involves passing a narrow probe through the anus into the rectum, much like a DRE. Prostate ultrasound imaging allows the examiner to measure the prostate size and assess its texture. Biopsies (tissue samples) are obtained using a spring-loaded device that fires a thin needle into the prostate through the lining of the rectum.