The prostate is a golf-ball-sized gland that sits between the bladder and the penis. It secretes fluid that nourishes and protects sperm. Most older men have some cancer cells in their prostate glands. But because these cells usually grow slowly, they don't cause symptoms or affect health in most men. That said, about 230,000 American men are diagnosed with prostate cancer each year, and nearly 30,000 die of it.
Exactly why some men develop full-blown prostate cancer and others don't is a mystery. But researchers have identified several factors that raise a man's risk of the disease. These include:
Age. Older men are far more likely to develop prostate cancer than younger men.
Race. African-American men are more likely to get prostate cancer than other men, and to be diagnosed with more advanced-stage cancer.
Family history. A man whose father or brother has been diagnosed with prostate cancer is two to three times more likely to develop prostate cancer than a man who doesn't have family members with the disease.
Lifestyle. Men who eat a lot of red meat or high-fat dairy products seem to have a higher risk of prostate cancer.
Treatments for prostate cancer include an operation to remove the prostate (prostatectomy) and radiation therapy. Both often cause side effects such as incontinence and erectile dysfunction. Since early treatment with surgery or radiation doesn't necessarily "cure" the disease, and prevents relatively few men from dying from prostate cancer, more and more men are opting for a strategy known as watchful waiting or active surveillance. They and their doctors monitor the low-risk cancer closely and choose treatment only when the disease appears to make threatening moves toward growing and spreading.
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There is a small but growing body of evidence that lifestyle therapy (low-fat diet, exercise, certain supplements, stress reduction), in conjunction with traditional therapy, can improve a man's chances of surviving prostate cancer.
We can thank the Greeks for the name doctors apply to male hormones. Androgen comes from the words meaning "man-maker," and it's a well-chosen term. Testosterone is the most potent androgen, and it does make the man. It's responsible for the deep voice, increased muscle mass, and strong bones that characterize the gender, and it also stimulates the production of red blood cells by the bone marrow.
In addition, testosterone has crucial, if incompletely understood, effects on male behavior. It contributes to aggression, and it's essential for the libido or sex drive, as well as for normal erections and sexual performance. Testosterone stimulates the growth of the genitals at puberty, and it is one of the factors required for sperm production throughout adult life.
Finally, testosterone also acts on the liver. Normal amounts are harmless, but high doses can cause liver disease and boost the production of LDL ("bad") cholesterol while lowering the amount of HDL ("good") cholesterol.
But the new study, published in the June 19, 2002, Journal of the American Medical Association, should ease men's minds. It involved over 2,000 men of European descent living in New Zealand, the country with the highest rate of vasectomies.
Researchers asked 953 men with prostate cancer and 1,260 who were cancer free about their medical histories — including whether they had had a vasectomy. It turned out that slightly fewer men with prostate cancer had undergone the surgery, which supports claims that going under the knife doesn't cause cancer. The same held true for the 38% of men studied who had had the procedure more than 25 years ago, which suggests that there are no long-term effects.
One reason why the link may have been found in earlier studies is that men who have vasectomies generally see their urologists more often, which may lead to more tumors being found in these men as compared to others, the researchers said. The study also found no link between prostate cancer and history of sexually transmitted disease, smoking, drinking alcohol, and number of children.