Everything You Need To Know To Spot It Early & Treat It

Prostate cancer is cancer that is developed in the prostate. The prostate is a small walnut-shaped gland in the male reproductive system. It is located in front of the rectum directly under the bladder and produces seminal fluids that are essential for nourishing and transporting sperms. About one out of every seven men is diagnosed with prostate cancer. Older men are at a higher risk of developing this cancer as compared to younger men.

Prostate cancer does not cause serious harm initially as its growth is slow and is confined to the prostate gland. However, some types of prostate cancers can grow aggressively and metastasize quickly. Stage 1 prostate cancer treatments are more effective when the condition is detected while it is still restricted to the prostate gland in its initial stages.

As with any other cancer, prostate cancer develops when some cells in the prostate display abnormalities. Mutation of DNA in abnormal cells causes them to grow and divide at a rapid speed. These cells can survive where other cells would die. The accumulation of these abnormal cells forms a tumour and can penetrate nearby tissues.

Risk Factors

Although the cause of prostate cancer is unknown, there are several factors that increase your chances of developing the disease –

Prostate cancer is more commonly diagnosed in older men, especially after the age of 50. 80 percent of prostate cancer cases are diagnosed in men older than 65.

Familial prostate cancer, i.e., prostate cancer that runs in the family occurs about 20 per cent of the time. A combination of shared lifestyle or environmental factors, and shared genes leads to its development. Inherited or hereditary prostate cancer is a rare occurrence and accounts for about 5 per cent of the total cases. Although it is uncommon, prostate cancer is believed to be inherited if the man’s family history displays any of these characteristics –

  1. Three generations on the same side of the family developing prostate cancer
  2. Prostate cancer in three or more first-degree relatives, for e.g., father, brother or son, puts the man at a higher risk of developing prostate cancer
  3. Prostate cancer in close relatives on the same side of the family before the age of 55

For unknown reasons, black men are more susceptible to develop prostate cancer than white men. They are also more prone to develop the aggressive form of the disease at an earlier age. Non-Hispanic white men are at a higher risk of developing prostate cancer than Hispanic men. Prostate cancer occurs most commonly in northern Europe and North America. The cancer rates are also rapidly increasing in Asian men with an unhealthy diet and lifestyle.

You are at an increased risk of developing prostate cancer if your diet comprises heavy intake of refined sugars, alcohol, caffeine, and unhealthy fats. An unhealthy diet is the most common factor in most diseases and needs to be addressed immediately for disease avoidance and a healthy lifestyle.

Survival Rates In Prostate Cancer

92 per cent of prostate cancers are diagnosed when the disease is confined to the prostate and nearby organs. Most men with regional or local prostate cancer have a 100 per cent 5-year survival rate. 98 per cent live for a decade and 96 per cent survive up to 15 years. However, if the cancer has spread to other parts of the body, the 5-year survival rate drops to 29 per cent.

It is important to remember that these survival rates are estimates. Survival statistics are measured every five years by experts. Thus, the estimates will fail to capture results of better treatment options for less than 5 years. Although the statistics of survival rates seem scary, you can keep prostate cancer at bay by understanding the signs of the disease and taking proactive steps in preventing it.

Signs And Symptoms Of Prostate Cancer

It is important to identify the most common symptoms that can lead to the development of prostate cancer. Because the prostate gland is in close proximity to the urethra and the bladder, the disease is accompanied by many urinary symptoms like –

  • Difficulty in urinating, often accompanied by pain
  • Weak or interruptions in the urine flow and straining to empty the bladder
  • The frequent urge to urinate, especially at night
  • Blood in the urine (Haematuria)
  • Loss of bladder control
  • Experiencing burning sensation while urinating

Some of the other common signs and symptoms are –

  • Erectile dysfunction
  • Blood in the semen or seminal fluids
  • Painful ejaculation
  • Difficult in sitting due to discomfort caused by large prostate
  • Swelling and discomfort in the pelvic region
  • Bone pain that might lead to fractures
  • Pain or numbness in the feet, legs or hips

There are chances that men suffering from prostate cancer might not display these symptoms. It is also possible that these symptoms are caused due to other medical conditions that are not cancer. It is always advisable to consult with your medical practitioner and get appropriate tests done to determine the cause of the symptoms.

If the prostate cancer has spread to other parts of the body, the patient might experience –

  • Edema or swelling in the legs or feet
  • Severe pain in the shoulders, back, hips, thighs, or other bones
  • Fatigue
  • Unexplained weight loss
  • Changed bowel habits
  • Pain in the spine due to pressure on spinal nerves

How Is Prostate Cancer Screened?

Since a person suffering from prostate cancer might not always display symptoms, screening is used as a way of detecting the disease before any of the signs are evident. Researchers have developed various tests that are used to screen a person for any particular type of cancer. Screening helps in lowering the count of people who develop cancer, thus, lowering the count of people who die from cancer.

The two types of tests commonly used for screening prostate cancer are –

PSA (Prostate-Specific Antigen) blood test helps in detecting prostate cancer in its earlier stages, thus, allowing men to get the required treatment before the disease spreads. However, this test also finds conditions that may not be cancer and would endanger the man’s life. Hence, the man may end up getting surgery and treatments that are not required, and seriously affect his quality of life.

DRE (Digital Rectal Examination) is a screening process where the doctor inserts a lubricated gloved finger into the man’s rectum to feel the prostate’s surface for irregularities.

Treatment Options

A man suffering from prostate cancer needs to weigh his options before choosing an option to treat his condition. While making this decision, patients are encouraged to consider clinical trials as a potential treatment option. It is important for the patient to understand that treatments may have side effects like erectile dysfunction, and incontinence (inability to control the urine flow).

While treating prostate cancer, doctors create an overall treatment plan to suit the patient that may be a combination of different types of treatments. Here are some of the options for treating prostate cancer –

When prostate cancer is detected in its early stages, doctors and patients consider postponing treatment as the side effects of the treatment may alter the man’s quality of life. Hence, the cancer is closely monitored under this treatment option for signs that the condition is worsening. Active surveillance is, thus, the best treatment for prostate cancer in early stages. The following is advised under active surveillance –

  1. DRE test at least once a year
  2. PSA blood test every quarter
  3. A prostate biopsy within 6 months to a year, then a biopsy every 2 to 5 years

Surgery is a safe option for eliminating a tumour before it spreads beyond the prostate. There are two types of surgery options depending on the man’s age, his overall health, the stage of cancer, and other factors –

  • Radical Or Open Prostatectomy –

In this process, the entire prostate and the seminal vesicles are surgically removed. The lymph nodes in the pelvic region may be removed as well. This option, however, may interfere with the sexual function. However, men can receive penile implants, injections and also receive drugs to resume normal sexual function.

  • Laparoscopic Or Robotic Prostatectomy –

This surgery is less invasive than a radical prostatectomy and has a shorter recovery time. In this process, small incisions are made in the patient’s abdomen, and a camera and surgical instruments are inserted through it. The surgeon then proceeds to remove the prostate gland. A robotic prostatectomy causes less pain and less bleeding, however, the side effects can be similar to those of radical prostatectomy.

This therapy involves destroying cancer cells using high energy radiation rays. There are various types of radiation therapies that are used for treating prostate cancer –

  • External-Beam Radiation Therapy

This is the most common type of radiation therapy. In this treatment, a beam of x-rays is focussed on cancer affected body part. In some cases, conformal radiation therapy (CRT) is used, where the precise location and shape of cancer can be determined. CRT reduces the damage of radiation to healthy organs and tissues surrounding the tumour by focusing the radiation only on the tumour.

Brachytherapy is an internal radiation therapy. This treatment involves insertion of radioactive agents directly into the prostate. These agents, also known as seeds, give off radiation in the small radius where they are inserted. Depending on the dosage, they may be left in the prostate for a short duration (high-dose rate) or for a longer duration (low-dose rate). Low-dose rate seeds can be left in the prostate permanently and are effective up to 1 year once they are inserted. High-dose-rate brachytherapy should not be left in the body for more than 30 minutes; however, they might require to be administered more than once.

Proton therapy or proton beam therapy is an external-beam radiation treatment that replaces x-rays with protons. Protons can destroy cancer cells at high energy. There is no evidence that proton therapy is more beneficial to men with prostate cancer than traditional radiation therapy. This process is also more expensive compared to radiation therapy.

  • Intensity-Modulated Radiation Therapy

This is an external-beam radiation therapy. Before starting treatment, an intensity-modulated radiation therapy (IMRT) uses CT scans to produce a 3D image of the prostate. Details of the shape, size and location of the prostate cancer help in determining the amount of radiation required to destroy it. IMRT helps in directing high doses of radiation at the prostate while controlling the risk of damaging nearby organs.

  • Androgen Deprivation Therapy (ADT)

The growth of prostate cancer is driven by the male sex hormones known as androgens. Hence, if the levels of these hormones are lowered, it will result in slowing the growth of cancer. Testosterone is the most common androgen. The levels of testosterone in the body can be lowered either by –

  1. Surgical castration – where testicles are removed surgically
  2. Medical castration – where functions of the testicles are turned off by taking drug

ADT is used for treating locally advanced prostate cancer, metastatic prostate cancer (when cancer spreads to other parts of the body), and recurrent prostate cancer. ADT can be used a treatment option in these cases –

  1. It is administered to men who have undergone surgery and had microscopic cancer cells detected in the removed lymph nodes. Its main purpose is to eliminate remaining cancer cells and reduce the chances of recurrence.
  2. ADT should be given to men with intermediate-risk and high-risk prostate cancer who are undergoing definitive therapy with radiation therapy. Definitive therapy is a treatment administered with the intent of curing cancer. Men suffering from intermediate-risk prostate cancer should be administered ADT for 6 months.  Men suffering from high-risk prostate cancer should be administered ADT for two to three years.

Chemotherapy involves using drugs for destroying cancer cells. It helps in stopping the cancer cells from growing and dividing. This regimen needs to be followed as prescribed by an oncologist and may have a specific number of cycles over a period of time.             

Systemic chemotherapy enters the bloodstream in order to reach cancer cells in the body. Chemotherapy for prostate cancer is administered intravenously. It may help in treating patients suffering from advanced or castration-resistant prostate cancer.

An immunotherapy is designed to enhance the body’s natural defence in combatting cancer. With the aim to improve or restore the immune system function, immunotherapy makes use of materials that are either produced by the body or in a lab.

Sipuleucel-T (Provenge) is an immunotherapy and is adapted for each patient. Before commencing with the treatment, the patient’s blood is extracted in a process called leukapheresis. Certain immune cells are segregated from the patient’s blood. These cells are further modified in the laboratory and then injected back into the patient. This therapy helps the immune system in identifying and destroying prostate cancer cells. It is difficult to determine if the treatment is effective in treating prostate cancer. This is because treatment with Sipuleucel-T does not reduce PSA, shrink of the tumor, or keep the condition from getting worse. However, clinical trials results have shown that Sipuleucel-T treatment contributes towards increasing survival rate in men with metastatic prostate cancer with or without any symptoms.

Lifestyle Changes That Help To Prevent Prostate Cancer

While it is uncertain that maintaining a certain lifestyle can prevent a man from developing prostate cancer, research has concluded that men who lead healthy lives are a lower risk of getting the disease. Here’s what they need to do –

Replace high-fat foods with vegetables, fruits and whole grains. Vegetables and fruits are rich in vitamins and other nutrients that contribute towards your overall health.

Working out helps you maintain an ideal body weight and improves your overall mood. Men who do not workout tend to have higher PSA levels than men who exercise regularly. Hence, men who work out are at a lower risk of developing prostate cancer. It is advisable to exercise five times a week for 45 minutes each. If you are new to exercise, start slow and gradually work your way up.

  • Maintain An Ideal Body Weight –

If your current body weight is ideal, work on maintaining it by exercising and sticking to a healthy diet plan. However, if you need to lose weight, reduce your calorie intake and incorporate more exercises to your weight loss plan.

  • Replace Supplements With Healthy Food –

Choosing healthy foods that is rich in minerals and vitamins can help you lead a healthy life. Some men consider taking medications and other treatments to reduce their risk. No research has suggested that supplements play an important role in reducing the risks of prostate cancer. Always choose healthy foods over supplements.

It is not always possible to recover from cancer. While the diagnosis is stressful, it is important to have conversations with your health care team to express your concerns. If you or a loved one has combatted prostate cancer, tell us your story in the comments section.


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