A message from Editor in Chief Marc Garnick, M.D. about exploring the possible reasons prostate cancer is more prevalent in African-American men, and previews of other articles in this issue.

African Americans are more likely to develop — and die from — prostate cancer than others. But why?

This year, the American Cancer Society estimates that nearly 1.5 million Americans will be diagnosed with some form of cancer — and that figure doesn't even include more than 1 million cases of certain skin cancers. The organization estimates that cancer will also claim 562,340 lives in 2009. Scientific evidence shows that about one-third of those deaths could have been prevented by making lifestyle changes. Smoking, being overweight or obese, not exercising, and eating a poor diet — all modifiable risk factors ...

Two prostate cancer survivors talk about raising awareness of the disease among African Americans and other men at high risk

Chances are, if you randomly asked men on the street about their lifetime risk of being diagnosed with prostate cancer, you'd be met with a handful of blank stares and several incorrect guesses. Probably only a few people, such as health care workers and cancer researchers, would know the correct answer: based on rates from 2004 to 2006, 15.9% of males born today will be diagnosed with prostate cancer at some point in their lifetime. Expressed another way, one ...

Michael P. O'Leary, M.D., M.P.H., looks at what may be ahead

Prostatitis gets little press, but it's an all-too-common genitourinary condition in men. It accounts for about 1.8 million visits to the doctor's office in the United States each year. Depending on how you define the term, 9% to 16% of men experience prostatitis. It's also an "equal opportunity" disorder. Unlike benign prostatic hyperplasia (BPH) and prostate cancer, which predominantly affect older men, prostatitis affects men of all ages.

Despite its commonness, little is known about what sparks prostatitis or, more importantly, how to treat it. Frustrated patients visit ...

A look at what the studies show

Until 1981, urologists believed that the nerves responsible for erections ran through the prostate. But that year, Dutch urologist Pieter Donker showed that the nerves ran down the sides of the gland, not through it. That discovery got urologic surgeons thinking: perhaps a cancerous prostate could be removed without harming the nerves, preserving a man's erectile function.

The following year, the first so-called nerve-sparing radical prostatectomy was performed. Today, most surgeons aim to spare the neurovascular bundles when performing prostate surgery. This helps men who were potent prior to surgery regain erectile function, ...

In the spring of 1996, André James* was under a great deal of stress. Married, with a young family to support, he was finishing his medical training at a big-city hospital and anxiously searching for a job. One day, he suddenly experienced severe testicular pain. It was as if someone grabbed both testicles and kept tightening his grip.

*Editor's note: To protect his privacy, the patient's name and some biographical details have been changed. All medical details are as reported. Although Perspectives does not typically name the patient's physicians, James requested that they be included in this article.

Frightened, James ...

This quarter, urologist Kevin R. Loughlin, M.D., M.B.A., answers your questions about prostate health

Q. How reliable is the prostate-specific antigen (PSA) test when it comes to detecting prostate cancer?

A. Although PSA testing can help catch prostate cancer at an early stage, having an elevated PSA (generally considered more than 4 ng/ml) doesn't necessarily mean that a man has cancer. Noncancerous conditions, including benign prostatic hyperplasia (BPH), or an enlarged prostate, and prostatitis, can raise PSA levels. In fact, studies have shown that about 70% to 80% of men with an elevated PSA who have a biopsy do ...

Reviewed by Per-Anders Abrahamsson, M.D., Ph.D.

Advances in the understanding and treatment of prostate disease are constantly being reported at scientific meetings and in peer-reviewed publications. What follows are some of the most interesting recent findings, placed in context by Per-Anders Abrahamsson, a member of Perspectives' editorial and advisory board and Secretary General of the European Association of Urology, the leading professional organization overseas.

Hormone therapy: How long should it last? When it comes to prolonging survival, external beam radiation therapy combined with long-term hormone therapy has been shown superior to radiation therapy and deferred hormone therapy. However, long-term ...

Brief instructions for using the PubMed database to read more detailed information about the studies cited in Perspectives on Prostate Disease, so you can evaluate the evidence on your own.