What you need to know about prostate cancer

Prostate cancer is a prevalent and potentially curable form of cancer that affects the prostate gland in men. In this comprehensive guide, we will explore the key aspects of prostate cancer, including its causes, risk factors, symptoms, diagnosis, treatment options, and living with the disease. Whether you or someone you know has been diagnosed with prostate cancer, understanding the condition is crucial for making informed decisions and managing your health effectively.

What is Prostate Cancer?

Prostate cancer is a type of cancer that develops in the prostate gland, a small walnut-shaped organ located below the bladder and in front of the rectum. The prostate gland produces seminal fluid, which nourishes and transports sperm. When cells in the prostate gland start to grow uncontrollably these abnormal cells accumulate, which can lead to the development of prostate cancers. A cancer that begins in the prostate and spreads to another part of the body is known as metastatic prostate cancer.

Prostate cancer is one of the most common cancers in men, ranking second after skin cancer. According to the American Cancer Society, about 1 in 8 men will be diagnosed with prostate cancer in their lifetime. It predominantly affects older men, with the majority of cases occurring in individuals over the age of 65.

Understanding the prostate gland

The prostate gland is a walnut-sized gland situated just below the bladder and in front of the rectum. It surrounds the urethra, which is the tube responsible for carrying urine and semen out of the body. The primary function of the prostate gland is to produce a fluid that mixes with sperm to create semen. This fluid helps in nourishing and protecting the sperm, enabling them to travel through the female reproductive system.

Causes and risk factors

The exact cause of prostate cancer is unknown, but several risk factors have been identified. Age is the most significant risk factor, with the incidence of prostate cancer increasing as men get older. Other risk factors include:

• Ethnicity: Black men have a higher risk of developing prostate cancer compared to men of other races. They are also more likely to be diagnosed at an advanced stage and have a higher mortality rate
• Family history of prostate cancer: Having a close family member, such as a father or brother, with prostate cancer increases the risk of developing the disease
• Genetics: Certain inherited gene mutations, such as BRCA1 and BRCA2, have been linked to an increased risk of prostate cancer
• Obesity: Studies suggest that obese men may have a higher risk of developing aggressive forms of prostate cancer

It’s important to note that having one or more risk factors does not guarantee the development of prostate cancer. Conversely, individuals without any known risk factors can still develop the disease. Understanding these risk factors can help guide screening and prevention efforts.

Signs and symptoms of prostate cancer

In its early stages, prostate cancer often does not cause noticeable symptoms. As the disease progresses, the following signs and symptoms may occur:

• Urinary symptoms: Difficulty urinating, weak urine flow, frequent urination (especially at night), and the sensation of incomplete emptying of the bladder
• Hematuria and Hematospermia: Blood in the urine or semen
• Erectile dysfunction: Difficulty achieving or maintaining an erection
• Pelvic discomfort: Pain or discomfort in the pelvic area
• Bone pain: Advanced prostate cancer may metastasize to the bones, causing pain, particularly in the lower back, hips, and thighs
• Unexplained weight loss: Sudden and unintentional weight loss without changes in diet or physical activity

It’s important to note that these symptoms are not exclusive to prostate cancer and can be caused by various other conditions. If you experience any of these symptoms, it’s crucial to consult with a healthcare professional for an accurate diagnosis.

Screening and diagnosis

If you experience any of these symptoms, it is important to consult a healthcare professional for further evaluation. They will conduct various tests to diagnose prostate cancer. These tests may include:

• Digital Rectal Examination (DRE): During a DRE, the doctor inserts a gloved finger into the rectum to feel for any abnormalities in the prostate gland
• Prostate-Specific Antigen (PSA) blood test: A PSA test measures the level of PSA, a protein produced by the prostate gland. Elevated PSA levels can indicate the presence of prostate cancer, but further testing is required for a definitive diagnosis
• Imaging scans: Scans such as ultrasound, MRI, or CT scans may be performed to visualize the prostate gland and determine the extent of the cancer
• Biopsy: A prostate biopsy involves taking a small sample of prostate tissue for examination under a microscope. This is the most accurate way to diagnose prostate cancer

Accurate diagnosis is crucial for determining the appropriate treatment options and developing an individualised care plan.

Understanding prostate cancer staging

Once a diagnosis of prostate cancer is confirmed, the next step is to determine the stage of the cancer. Staging refers to the extent or spread of cancer in the body. The most commonly used staging system for prostate cancer is the TNM system, which evaluates the size of the tumour (T), the involvement of nearby lymph nodes (N), and the presence of metastasis (M) or spread to distant organs. Staging plays a crucial role in determining the appropriate treatment approach and prognosis for an individual with prostate cancer.

Prostate cancer treatment options

The treatment options for prostate cancer depend on various factors, including the stage of cancer, the aggressiveness of the tumour, the age and overall health of the individual, and their personal preferences. Treatment modalities may include:

• Active surveillance or watchful waiting: In cases where the cancer is low-risk and slow-growing, closely monitoring the cancer’s progression may be the preferred approach
• Surgery: A radical prostatectomy involves the surgical removal of the entire prostate gland and surrounding tissues. This procedure may be recommended for localised prostate cancer
• Radiation therapy: External beam radiation therapy uses high-energy beams to target and destroy cancer cells in the prostate. Another form of radiation therapy is brachytherapy, where small radioactive seeds are implanted directly into the prostate gland
• Hormone therapy: Prostate cancer cells often rely on male hormones, such as testosterone, for growth. Hormone therapy, also known as androgen deprivation therapy (ADT), aims to reduce the levels of these hormones to slow down cancer growth
• Chemotherapy: Chemotherapy utilizes powerful drugs to kill cancer cells. It may be recommended for advanced prostate cancer or when other treatment options have not been successful
• Immunotherapy: Immunotherapy works by stimulating the body’s immune system to recognize and attack cancer cells. This treatment approach is still being researched for prostate cancer and may be used in specific cases

The choice of treatment depends on the individual’s specific circumstances and should be discussed thoroughly with a healthcare professional.

Clinical trials

Clinical trials offer access to novel treatments and therapies that are still being researched. Participation in clinical trials can contribute to advancing medical knowledge and potentially provide access to cutting-edge treatments.

It’s important to discuss the potential benefits and risks of each treatment option with a healthcare team to make an informed decision based on individual circumstances.

Managing side effects

Treatment for prostate cancer can be accompanied by side effects that may impact quality of life. These side effects can include:

• Urinary incontinence: Difficulty controlling urine flow
• Erectile dysfunction: Difficulty achieving or maintaining an erection
• Bowel problems: Changes in bowel function, such as diarrhoea or constipation
• Fatigue: Persistent tiredness and lack of energy
• Hot flashes: Sudden feelings of warmth and sweating

It’s important to communicate openly with healthcare providers about any side effects experienced, as there are various strategies and interventions available to manage and alleviate these symptoms.

Regular screening and early detection

Regular prostate cancer screenings are crucial, especially for men over a certain age or those with risk factors such as a family history of the disease. Early detection allows for prompt intervention and potentially curative treatment. It is important to have open and honest discussions with healthcare providers about the benefits and limitations of screening, considering individual circumstances and preferences.

Support and coping strategies

A prostate cancer diagnosis can be emotionally challenging, and it’s essential to seek support from loved ones, support groups, or mental health professionals. These resources can provide emotional support, advice, and coping strategies to help navigate the journey of living with and managing prostate cancer.

Lifestyle modifications for prevention

While the exact cause of prostate cancer is unknown, adopting a healthy lifestyle can potentially reduce the risk of developing the disease. Lifestyle modifications that may help prevent prostate cancer include:

• Healthy diet: Incorporating a diet rich in fruits, vegetables, whole grains, and lean proteins
• Regular exercise: Engaging in regular physical activity to maintain a healthy weight and overall well-being
• Smoking cessation: Quitting smoking, it is associated with an increased risk of developing aggressive types of prostate cancer
• Moderate alcohol consumption: Limiting alcohol intake to moderate levels
• Routine check-ups: Regular medical check-ups and screenings can help detect any potential health concerns, including prostate cancer, at an early stage

Advances in prostate cancer research

Ongoing research and advancements in the field of prostate cancer are continuously improving our understanding of the disease and treatment options. Clinical trials, genetic testing, and precision medicine are rapidly evolving areas of research that hold promise for personalized and targeted therapies in the future.

Prognosis and survival rates

The prognosis for prostate cancer varies depending on various factors, including the stage of cancer at diagnosis, the aggressiveness of the cancer cells, and the overall health of the individual. With early detection and appropriate treatment, the five-year survival rate for localized prostate cancer is extremely high, with 99% of patients living five years or longer.

Conclusion

Prostate cancer is a significant health concern for men worldwide, but with early detection and appropriate treatment, the outlook can be positive. Understanding the risk factors, symptoms, screening methods, and treatment options is essential for effectively managing prostate cancer. By adopting a proactive approach to healthcare, seeking support, and staying informed about advances in research, individuals can navigate the journey of prostate cancer with confidence and hope.

Remember, if you have any concerns or questions about prostate cancer, it is crucial to consult with a healthcare professional for personalised advice and guidance. Stay informed, take charge of your health, and prioritise regular check-ups for early detection and prevention.

Sources

• Prostate cancer – Symptoms and causes – Mayo Clinic
• Basic Information About Prostate Cancer – CDC
• Prostate Cancer – Prostate Cancer Information and Overview
• Top 10 Things You Should Know About Prostate Cancer – Prostate Cancer Foundation
• Prostate cancer – Cancer Research UK