According to the Centers for Disease Control and Prevention, the most common cancer among American men is prostate cancer. Lung cancer is the most common cause of cancer death, while prostate cancer is the second highest cause. In 2006, 203,415 American men received the diagnosis of prostate cancer. In that same year, there were 28,372 associated deaths. However, the PSA, or prostate-specific antigen, is not just a marker for prostate cancer. It is made by benign prostate tissue as well.
Prostatitis
Prostatitis is the inflammation of the prostate. As explained by Gerald Andriole, M.D., chief of urologic surgery at Barnes-Jewish Hospital in "The Merck Manual for Healthcare Professionals," the inflammation can be due to bacteria, but most of the time, bacteria are not the culprit. Physicians are not yet sure what causes prostatitis when bacteria are not involved, but some believe it is due to the reflux of urine into the prostate. Symptoms can include pain when urinating, fever and chills, or there may not be any symptoms at all.
PSA levels are elevated in cases of prostatitis, because PSA is made by the prostate.
Benign Prostatic Hyperplasia
PSA levels are elevated in benign prostatic hyperplasia (BPH). In "Current Medical Diagnosis & Treatment," Maxwell Meng, M.D., associate professor at the University of California, writes that this disorder is very common in men. Approximately 20 percent of men ages 41 to 50 have BPH, while the percentage increases to 50 percent in men ages 51 to 60. Ninety percent of men over 80 have BPH.
Meng explains that studies have determined that aging and dihydrotestosterone, a male hormone, are responsible for this disorder. An older prostate is more sensitive to male hormones, also called androgens. The prostate gets bigger because its cells increase. An increased prostate can press on the urethra, and symptoms can include difficulty with starting urination, decreased stream of urine and the feeling of not having finished urinating.
Prostate Cancer
Prostate cancer may be detected based on what is referred to as a digital rectal exam, or DRE. The exam sometimes will reveal nodules in the back part of the prostate that are hard and have an irregular shape. Meng writes in "Current Medical Diagnosis & Treatment" that most prostate cancers today feel normal on the rectal exam, and they are found by the elevated levels of PSA.
Many times, early cancer has no symptoms. If the cancer is large, the symptoms will be the same as the symptoms in BPH, including urinary hesitancy, decreased stream of urine and the feeling of not having finished. Sometimes, the first symptom is bone pain because the cancer has spread to the bone. If it has spread to the spinal cord, the symptoms will be back pain and possibly fractures.
References
- Centers for Disease Control and Prevention: Prostate Cancer
- "Current Medical Diagnosis & Treatment 2009"; Stephen McPhee, M.D., Maxine Papadakis, M.D.; 2009
- Merck Manuals: Prostatitis
