What are the signs of prostate cancer? Prostatic enlargement is a sign of prostate cancer. Other signs include increased urinary frequency and urgency, sudden change in frequency or urgency of urination, unexplained blood in the urine and increased blood in the men's semen.
Men who are diagnosed with localized [prostate cancer](https://www.withpower.com/clinical-trials/prostate-cancer)s, where clinical risk stratification and Gleason score of 7 (with PSA ≤20 ng/mL) have similar outcomes, may be considered for active surveillance, watchful waiting, or active treatments such as radical prostatectomy or radiation therapy.
Many patients who develop symptomatic prostate cancer are not receiving the recommended treatment by their physicians, but rather will typically be receiving treatments that are frequently prescribed in accordance with practice guidelines. While the most common treatment for prostate cancer is surgery, the most common alternative treatment is active surveillance. These data support the ongoing need for improved practice patterns for prostate cancer care at the individual patient level and at the population level.
About 1 in 2 men aged 50-59 years diagnosed in the past year were diagnosed with prostate cancer. The number is nearly equal among White and Black men and approximately one-third of men in his fifties (age range 50-59 years) were diagnosed with it. However, more African-American men were diagnosed with benign prostatic hyperplasia than any other racial group.
Prostate cancer is a serious and life-threatening disease. The five-year survival rate with radical prostatectomy in men with prostate cancer is 85 to 90%. Even among men with localized disease, the five-year survival rate after prostatectomy (without adjuvant therapies) is 55%. In an attempt to reduce prostatectomy side effects and the risks of adjuvant therapy, men without symptoms, on digital rectal examination or have PSA values of<20 ng/mL should undergo a prostate biopsy to assess for prostate cancer. In a subsequent procedure, a biopsy guided by suspicion, a needle biopsy or open biopsy is performed, and if this shows suspicious findings, radical prostatectomy is recommended.
[prostate cancer](https://www.withpower.com/clinical-trials/prostate-cancer) does not have a clear cause. It is more likely that it develops because of a problem with cells in the prostate that has affected the patient's health and/or their environment. At a basic level, prostate cancer happens because cells in the prostate have problematic changes to their DNA.
Long-term followup and medical imaging for PCa survivors show that only 2 of 8 patients had PCa surveillance after 10 years. However, in all patients there are signs of late effects, such as LUTS, osteopenia and osteoporosis, increased cardiovascular risk, and hormonal alterations. Thus, the long-term followup and medical imaging shows that PCa survivors are exposed to significant risks. Therefore, it would be prudent to reconsider the role of PCa surveillance and to develop a comprehensive management program for survivors.
No studies have been reported examining the long-term effects of long-term follow-up (or “watch-and-wait”) of patients with BPH. Because the rate of tumor progression and symptoms are the same for all prostate cancer patients and no studies have shown differences between them, we believe that other randomized trials using an active surveillance strategy would be challenging to conduct.
New developments have permitted surveillance of patients to permit us to confirm the good prognosis of prostate cancer with long-term clinical controls before recommending the end of follow-up.
Results from a recent clinical trial suggest that prostate cancer may have a familial component and are consistent with a multifactorial etiomy for this disease.
The most important side effects of active surveillance and watchful waiting are a decrease in testosterone and an increase in prostate-specific antigen. Prostate-specific antigen levels are often not associated with actual tumor progression; thus, they do not seem to be a useful marker for progression prevention. The most frequently observed side effects are erectile dysfunction, urgency, ejaculation disorders and urinary continence disturbances. Other common side effects include fatigue, dysprosia, depression, headaches, dizziness and insomnia. No correlation is found between side effects and gender or age.
Findings from a recent study indicates that 1 in 20 Caucasians of ages 50 to 70 are likely to develop prostate cancer in the next 15 years. The prevalence of prostate cancer among black men is substantially higher than among white and Hispanic men.