As men age, their prostate glands enlarge. In most cases, this natural occurrence, benign prostatic hypertrophy (BPH), causes few problems. Because of its anatomical position surrounding the urethra, BPH may block urination, and surgeons may need to remove the prostate if the condition becomes bad enough. Of far more concern than BPH is prostate cancer, which is one of the most common types of cancer found in American men (Postma & Schroder, 2005). It was estimated that there would be approximately 232,090 new cases of prostate cancer in 2005, and that 30,350 men would die of this disease (American Cancer Society, 2005e).
Although men of all ages can get prostate cancer, it is found most often in men over the age of 50. In fact, more than 80% of the men with prostate cancer are 65 or older (American Cancer Society, 2005e). For reasons not clearly understood, cancer is about twice as common among African American men as it is among Caucasian Americans (Shaver & Brown, 2002). In fact, African American men have the highest prostate cancer rates in the world. Interestingly, prostate cancer is relatively rare in Asia, Africa, and South America (Brawer, 1999).
Even so, it’s important to also realize that there are researchers who believe that prostate cancer is not as common as some suggest. For example, one study found that 29 to 44% of men diagnosed with prostate cancer were actually “overdiagnosed” (Etzioni et al., 2002). This is primarily because current testing methods (see below) have been yielding high false positive results.
Although we don’t know exactly what causes prostate cancer, we do know that there are several risk factors that have been linked to prostate cancer. These include aging, race, a diet high in fat, and a genetic risk. Signs of possible prostate cancer (or BPH) include lower back, pelvic, or upper thigh pain; inability to urinate; loss of force in the urinary stream; urinary dribbling; pain or burning during urination; and frequent urination, especially at night. Many deaths from prostate cancer are preventable, because a simple 5- or 10-second rectal examination by a physician, to examine for hard lumps on the prostate, detects over 50% of cases at a curable stage.
In 1986 the U. S. Food and Drug Administration approved the prostate-specific antigen (PSA) blood test that measures levels of molecules that are overproduced by
|
prostate cancer cells. This enables physicians to identify prostate cancer and is recommended yearly for men over the age of 50. The PSA test has been one of the most important advances in the area of prostate cancer (Brawer, 1999). Though not all tumors will show up on a PSA test, a high reading does indicate that something (such as a tumor) is releasing prostatic material into the blood, and a biopsy or further examination is warranted.
There are many treatments for prostate cancer, and almost all are controversial. Some argue that, in older men especially, the best thing is “watchful waiting” in which the cancer is simply left alone, because most men will die of other causes before the prostate cancer spreads. Men who are unmarried, have a history of poor health, or are living in a geographically undesirable location for medical treatment often opt for these more conservative treatments (Harlan et al., 2001).
Others choose radical prostatectomy or radiation treatment, each of which can contribute to erectile disorder or incontinence (Potosky et al., 2000). Cryosurgery uses a probe to freeze parts of the prostate and has had good success in reducing the occurrence of postsurgical erectile disorder and incontinence (Onik et al., 2002). Newer treatments include drugs that attack only cells with cancer, unlike radiation and chemotherapy, which both kill healthy cells in addition to those cells with cancer. Research has found that these drugs hold much promise in the treatment of prostate cancer (Bonaccorsi et al., 2004; Ryan & Small, 2005).
Two of the most common surgical side effects of prostate cancer treatment include erectile dysfunction and the inability to hold one’s urine. However, the likelihood of these problems depends on several things, including the extent and severity of the cancer and a man’s age at the time of surgery (Stewart et al., 2005). Although younger men who experienced satisfactory erections prior to any prostate cancer treatments have fewer erectile problems after surgery, for most men erections will improve over time. Difficulty holding urine or urinary leakage may also occur; however, there are treatments available to lessen these symptoms.
As you have learned throughout this chapter and the last, understanding anatomy and physiology is an important part of learning about human sexual behavior. We must understand all of the physiological and hormonal influences and how they affect both the female and male body before we can move on to the emotional and psychological issues involved in human sexuality. Anatomy and physiology, therefore, are really the foundations of any human sexuality class. With that in mind, in Chapter 6, we discuss “Communication: Enriching Your Sexuality.”
|
|
|
radical prostatectomy
The surgical removal of the prostate.
|
|
|
radiation
The use of radioactivity in the treatment of cancer.
|
|
|
cryosurgery
Surgery that uses freezing techniques to destroy part of an organ.
|
|
|
ReviewQuestion
Describe the cancers that can affect the emale reproductive organs.
|
|
|
|
|
|
