What is Prostate Cancer?
The prostate is a small, walnut-shaped gland in males that produces seminal fluid that nourishes and transports sperms. Prostate cancer is one of the most common types of cancer in men. While some types of prostate cancer grow at a slow rate and may need minimal or no treatment, other types are aggressive and spread quickly. Additionally, early detection of prostate cancer, while it’s still confined to the prostate gland, has a high chance of cure.
Symptoms and Signs of Prostate Cancer
Early-stage prostate cancer rarely causes any symptoms. The symptoms that may occur as the disease progresses can be as follows:
Frequent, and sometimes the urgent need to urinate
Weak flow of urine or flow that stops and starts
Dysuria (burning sensation or pain during urination)
Urinary incontinence (loss of bladder control)
Faecal incontinence (loss of bowel control)
Erectile dysfunction or painful ejaculation
Hematospermia (blood in semen or pee)
Pain in the chest, lower back or hip (in advanced stages)
Prostate Cancer Causes
The causes of prostate cancer are not clear. However, prostate cancer begins when the cells in the prostate appear abnormal. A doctor may collectively refer to these changes as prostatic intraepithelial neoplasia (PIN).
Risk Factors for Prostate Cancer
Common risk factors for prostate cancer include:
Age: The risk of prostate cancer increases as a person ages. It's most commonly diagnosed after the age of 50.
Family history: If an individual with a blood relative, including a parent or sibling is diagnosed with prostate cancer, the risk may be higher. Also, having a family history of genes that increase the risk of breast cancer (BRCA1 and BRCA2) or a strong family history of breast cancer, may also increase the risk of prostate cancer.
Obesity: People who are overweight or obese are at a higher risk of prostate cancer as compared to individuals with a healthy weight. In overweight people, the cancer is more likely to be aggressive and may recur after initial treatment.
Prostate Cancer Diagnosis
There is no single test for prostate cancer diagnosis. All the tests used to diagnose prostate cancer have benefits and risks that a doctor will discuss with you. Prostate screening tests might include:
Screening Tests
Digital rectal exam (DRE): A digital rectal exam helps detect abnormalities in the size, shape and texture of the prostate gland.
Prostate-specific antigen (PSA) test: During this test, a blood sample is drawn from a vein in the arm and analysed for PSA (a substance naturally produced by the prostate gland).
Note: It's normal for a small amount of PSA to be detected in the bloodstream. However, if a higher than usual level is found, it may indicate an infection in the prostate, enlargement, inflammation or cancer.
Imaging Tests
If a screening test for prostate cancer detects an abnormality, additional tests may be recommended by a doctor to determine if an individual has prostate cancer. These tests may include:
Ultrasound: During a trans rectal ultrasound, a small probe is inserted inside the rectum to create a picture of the prostate gland using sound waves.
Magnetic resonance imaging (MRI): In some situations, a doctor may recommend an MRI scan of the prostate to create a detailed procedure and plan a procedure to remove a sample of prostate tissue.
Collecting a sample of prostate tissue (biopsy): To determine if cancer cells are present in the prostate, a doctor may recommend a procedure to collect a sample of cells from the prostate (prostate biopsy).
Determining if the Cancer Has Spread
If a doctor suspects that the prostate cancer has spread, one or more of the following tests may be recommended:
A doctor uses the information from these tests to assign a prostate cancer stage. The lowest stage indicates that the cancer is confined to the prostate and by stage IV, the cancer has grown beyond the prostate and may have spread to other parts of the body.
Prostate Cancer Treatment
Prostate cancer treatment options vary based on factors like, the pace at which the cancer grows, if it has spread and overall health.
Surgery for Prostate Removal
Surgery for prostate cancer involves the removal of prostate gland (radical prostatectomy), some surrounding tissue and lymph nodes.
Surgery is a treatment option for cancer that’s confined to the prostate. It’s sometimes also used in combination with other treatments to treat advanced cancer.
Radiation Therapy
Radiation therapy damages cancer cells using high-energy radiation. Radiation therapy for prostate cancer treatment may involve:
External beam radiation (radiation that comes from outside the body): This is an option for treating cancer that’s confined to the prostate.
Radiation placed inside the body (brachytherapy): Brachytherapy involves placing radioactive sources in the prostate tissue. It is also a treatment option for cancer that has not spread beyond the prostate.
Heating or Freezing Prostate Tissue
Heating prostate tissue: High-intensity transurethral microwave thermotherapy (TUMT) uses concentrated ultrasound energy to heat or destroy the excess prostate tissue.
Freezing prostate tissue: Cryotherapy for prostate cancer involves using a very cold gas to freeze the tissue in the prostate gland. The cycle of freezing kills the prostate cancer cells.
Note: These treatment options may be considered if surgery isn’t possible or other treatments like radiation therapy have not helped.
Hormone Therapy
Hormone therapy is a type of cancer treatment that stops the body from producing male hormone Testosterone. The hormone testosterone supports the growth of prostate cancer cells. Cutting off the testosterone supply causes cancer cells to die or grow slowly. Hormone therapy includes:
Medications that stop the production of testosterone
Medications that block the testosterone hormone from reaching cancer cells
Surgery to remove the testicles (orchiectomy)
Hormone therapy is often used for the treatment of advanced prostate cancer. It is sometimes used before radiation therapy to treat cancer that has not spread beyond the prostate and increase the effectiveness of radiation therapy.
Chemotherapy
Chemotherapy uses anticancer drugs to kill rapidly growing cancer cells. It can be administered through a vein in the arm, in the form of a pill or both. Chemotherapy can be a treatment option if the prostate cancer has not spread to other parts of the body. It may also be used as an option for cancer that does not respond to hormone therapy.
Immunotherapy
This type of treatment option uses the immune system of the body to fight cancer. A cancer patient’s immune system may not attack the cancer because the cancer cells produce proteins that help them hide from the immune system. Immunotherapy for cancer treatment works by interfering with this process.
Targeted Drug Therapy
Targeted drug therapy focuses on specific abnormalities present within the cancer cells. By blocking the abnormalities, targeted drug therapy causes the cancer cells to die.
Prostate Cancer Complications
Potential complications of prostate cancer can be as follows:
Cancer that metastasizes (spreads): Prostate cancer can spread to nearby organs, such as the bladder and travel through the lymphatic system or bloodstream into the bones and other organs.
Incontinence: Prostate cancer and its treatment can potentially cause urinary incontinence. Treatment for incontinence may include medications, catheters and surgery.
Erectile dysfunction: Prostate cancer or its treatment can result in erectile dysfunction. Medications and surgery is available for the treatment of erectile dysfunction.
Prostate Cancer Prevention
Preventing prostate cancer isn’t possible. However, taking these steps helps reduce the risk:
Get regular prostate screenings: Based on the risk factors, consult a doctor to get regularly screened for prostate cancer.
Maintain a healthy weight: If an individual’s current weight is healthy, maintain a healthy diet and exercise most days of the week. If there is a need to lose weight, consult a doctor for a healthy weight loss plan.
Exercise regularly: A consistent exercise routine and physical activity improves overall health, mood and helps maintain a healthy weight.
Quit smoking: To mitigate the risk of prostate cancer, avoid use of tobacco products and quit smoking.
FAQs
Can prostate cancer be 100% cured?
With early diagnosis and treatment, prostate cancer is mostly highly curable. Several people diagnosed with cancer that hasn’t spread beyond the prostate can lead normal lives for many years following treatment.
How long can I live with prostate cancer?
For prostate cancer, the 10-year relative survival rate is 98% and the relative 15-year prostate cancer survival rate is 95%.
What is stage I prostate cancer?
Stage I prostate cancer is found in the prostate only. This type of cancer is diagnosed during a needle biopsy for high prostate-specific antigen (PSA) level or in a sample of tissue removed during surgery.
Can I recover from prostate cancer?
Yes. If prostate cancer is diagnosed at an early stage, the chances of recovery and survival are generally high.
Is stage IV prostate cancer curable?
Treatments can shrink or slow down the spread of stage IV prostate cancer. However, a majority of stage IV prostate cancers can’t be cured. Treatments can increase lifespan and reduce cancer symptoms.
