Senator Christopher Dodd diagnosed with Prostate Cancer

Connecticut Senator Christopher Dodd announced today that he has been diagnosed with prostate cancer. The Senator states that he was diagnosed during his routine physical in June and that it was caught at an early stage. He further reports that he will undergo surgery in August (after the Senate adjourns), that his prognosis is very good, and that he plans to run for reelection in the fall.

 

What is the prostate?
The prostate is a walnut-sized gland between the rectum and anus of men. It’s function is to add fluid to support and nourish sperm in semen. The urethra, the tube through which urine flows out of the body passes through the prostate.

Prostate cancer is the number one cause of cancer (other than skin cancer) in American men. According to the American Cancer Society, about 1 man in 6 will be diagnosed with prostate cancer during his lifetime, but only 1 man in 35 will die ofit. The incidence increases with age, and it is estimated that up to 80% of men may have prostate cancer by age 80, although many are asymptomatic and are more likely to die of another cause.

The vast majority of prostate cancers develop from the prostate gland cells, and is called adenocarcinoma. Most cases are asymptomatic in the initial phases, but later symptoms may include:

  • A need to urinate frequently, especially at night
  • Difficulty starting urination or holding back urine
  • Weak or interrupted flow of urine
  • Painful or burning urination
  • Difficulty in having an erection
  • Painful ejaculation
  • Blood in urine or semen
  • Frequent pain or stiffness in the lower back, hips, or upper thighs.

It should be noted that these symptoms are not specific to prostate cancer and could also be due to other conditions; Benign prostatic hyperplasia (BPH) is a condition where the prostate gland enlarges, but no cancer cells are present. Prostatitis, an infection of the prostate gland is another possible cause. If these symptoms are present, then a workup must be done to determine whether prostate cancer or one of these other conditions is the cause.

Screening for prostate cancer is recommended to find asymptomatic tumors at an early stage, especially in men over 50. This is done with a combination of a blood test called PSA and with a digital rectal exam (DRE). PSA is a chemical produced by the prostate gland. A small amount of blood is drawn from the arm and the amount of PSA measured. Levels less than 4 ng/ml is considered “normal”, 4-10 ng/ml “intermediate”, and greater than 10 ng/ml “high.” It should be noted that a normal level does not mean that there is no cancer. Some studies suggest that obesity may artificially lower PSA levels to “normal” levels, and elevated levels may be found in noncancerous situations such as BPH and prostatitis. This is why PSA levels should be combined with a digital rectal exam (DRE). In a DRE, a gloved finger is placed in the rectum to feel the prostate gland for enlargement or for any lumps that may be present. Suspicious finding will lead to a biopsy of the prostate to get a definitive diagnosis.

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Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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