Prostate cancer is the second leading cause of cancer deaths in men. It is the fourth leading cause of death among African American men over the age of 45.

Prostate cancer occurs when cells in the prostate gland start to grow in an uncontrolled way.

The prostate gland makes and stores seminal fluid, part of semen. It is as small as a walnut and is situated below the bladder and around the urethra, the tube through which men pass semen and urine. Some men get no symptoms at all, but signs of prostate cancer include: a weak urine flow; a need to urinate more often; difficulty in passing urine, pain or burning; leakage; pain in the lower back, hips or pelvis; and problems getting or keeping an erection.

More than 85 percent of cases are diagnosed in men over the age of 60, with the risk increasing with age. The average age of men at diagnosis is 72. More than 16 percent of American men are diagnosed with prostate cancer at some point in their lives. Eight percent will have serious symptoms and three percent will die of the disease.

Detection and survival rates for all stages of prostate cancer have steadily improved over the past 50 years. Today, more than three out of four men can expect to live at least five years from the time of diagnosis. For men whose cancer has not spread beyond the prostate gland, the survival rate is 99 percent.

Black men are three times more likely to develop prostate cancer. They not only tend to be diagnosed at a younger age but also experience more aggressive forms of the disease.

Prostate cancer also has a hereditary link. Men who have a father or brother who has had the disease are 2.5 times more likely to develop it. Diets rich in fat, dairy products and red meat increase the risk of the cancer. Regular physical exercise and healthy eating, with plenty of fruit and vegetables, are recommended.

There is as yet no definitive test for prostate cancer, but the PSA (Prostate Specific Antigen) test is currently the best available. PSA is a protein produced by the prostate gland. Its level is affected by age, infection, prostate problems and some medicines. The accepted normal PSA test result is up to 2.5 nanograms/ml for men in their 40s and 6.5 ng/ml for men in their 70s.

However some men with early prostate cancer can have a normal PSA the test alone cannot tell you whether or not you have prostate cancer. As the prostate enlarges with age, some men can also have changes which are not indicative of cancer. But the higher the level of PSA, the greater the chance this is due to prostate cancer.

Prostate cancer is slow growing cell changes can begin ten, 20 or 30 years before a tumour gets big enough to cause symptoms. More than half of all American men have some cancer in their prostate glands by the age of 80. For many the disease will never progress or require treatment. Early screening with PSA testing and regular Digital Rectal Examinations (DRE) are the key to catching any potential problems. Any biopsies should also be repeated, every two to three years.

The DRE involves a doctor inserting a lubricated, gloved finger into the rectum to feel the prostate gland through the wall of the back passage, checking for any hard or lumpy areas. The test lasts ten-15 seconds.

If the DRE gives cause for concern, the patient will be referred to a urologist. Hospital tests may include: a TRUS (Trans-Rectal Ultra Sound) guided biopsy, CT scan, MRI scan, or bone scan.

A pathologist will grade any cancer cells in a biopsy according to the 'Gleason' scale, adding together grades of the two most common types of cell, to give the Gleason score. A score of eight or more out of ten means the cancer is most likely to spread.

A team of doctors will decide on a treatment specifically tailored to the individual. This can include brachytherapy internal radiotherapy; radiotherapy; hormone therapy or surgery.

Side effects can include problems passing urine and erectile dysfunction.

Surgery may be recommended for early cancers contained within the prostate. Although the prostate gland is removed, nerve-sparing surgery can keep the nerves which control erections intact. Medicines, injection therapy and specialist devices can also help impotence in men.

Hormone therapy works by stopping testosterone from reaching the cancer, so causing it to shrink. There is ongoing research into other ways of testing for prostate cancer.

This includes the PCA3, also known as DD3, which picks up the high levels of RNA (ribonucleic acid) typically present in prostate tumour cells. A urine test for RNA is currently being developed.

For more information visit: www.prostate-cancer.org.uk or the Prostate Cancer Foundation at www.prostatecancerfoundation.org

To watch, listen to or read personal experiences of prostate cancer, go to: www.dipex.org.uk

The US National Cancer Institute has a Cancer Information Service on 1 800 422 6237, or log onto: http://cancer.gov/publications

The National Prostate Cancer Coalition can be found at: www.fightprostatecancer.org

The American Cancer Society's support group for men – the Man-to-Man Program, can be found at www.cancer.org or telephone 1 800 277 2345

Alternatively, try CancerCare at www.cancercare.org or The Wellness Community at: www.thewellnesscommunity.org

The Us TOO International Prostate Cancer Education and Support Network has chapters around the world. Call 1 800 80 USTOO or visit: www.ustoo.org.