What Is Prostate Cancer?

Prostate cancer occurs when a tumour forms in the prostate due to abnormal cell growth. The prostate is a gland that surrounds the urethra and is just below the bladder. It is shaped like a walnut and located in the lower abdominal region of a man. Its main function is to produce seminal fluid.

Types Of Prostate Cancer

There are two prostate cancer types: aggressive prostate cancer and non-aggressive prostate cancer. Aggressive prostate cancer is also known as fast-growing prostate cancer. In this type of cancer, the tumour proliferates and is highly likely to spread to other areas of your body, like your bones. In non-aggressive or slow-growing prostate cancer, tumour growth is much slower. In some instances, there is no tumour growth over time in non-aggressive prostate cancer.

Symptoms And Causes Of Prostate Cancer

Prostate cancer symptoms

The following are some of the most common signs of prostate cancer.

You might have trouble urinating. It is one of the most common symptoms of prostate cancer because the tumour can press on the urethra or the bladder when it grows. You might be unable to urinate, or you might find it difficult to urinate. You might feel like you need to urinate more often than normal, especially at night. Sometimes, you might notice that you are bleeding when you urinate. You might also feel a burning sensation when you urinate.

You might experience pain. For example, you might experience pain in your bones. You might start experiencing pain and discomfort in your pelvic area. You might feel discomfort and pain in your thighs, lower back, or hips. Sometimes, you might experience pain in your chest as well. Depending on where the prostate cancer has spread, you might feel pain in that area. If the cancer has reached your spinal cord, then you might feel pain and discomfort in your legs.

You might experience sexual problems when you have prostate cancer. You might notice bloody discharge in your semen when you ejaculate. You might experience erectile dysfunction caused by prostate cancer. You might have difficulty ejaculating as it is often painful. You might not ejaculate as you normally would. That is, the amount of semen that is ejaculated may be considerably lower.

There are some more symptoms of prostate cancer. You might have a feeling of pressure in your rectum. You might start to have trouble breathing. You might begin to feel very tired pretty quickly. You might experience your heart beating faster than normal. You might experience dizziness as well.

Note that sometimes you might not experience any symptoms of prostate cancer, especially in the beginning. However, when prostate cancer has advanced, you might start to notice the symptoms discussed above.

Prostate cancer causes

The exact cause of prostate cancer has not yet been conclusively diagnosed. However, doctors say that many factors can lead to prostate cancer. It is the cancerous cells' growth due to DNA mutations that cause prostate cancer in men. DNA mutations are responsible for the way that cancer cells grow abnormally. These cells keep dividing faster than your normal cells until a tumour forms in the prostate gland. One particular point to note is that these abnormal cells live longer, and when they metastasise, they can spread to your other body parts.

Are You At Risk For Prostate Cancer?

Here are the risk factors which make you more susceptible to prostate cancer.

If people in your family have had prostate cancer or breast cancer, then you have a higher chance of having prostate cancer.
The chances of developing prostate cancer increase as you age. Prostate cancer seldom affects young men. It is more common in older men.
·If you are an African American male, then you have a higher chance of developing prostate cancer. Men in some races are more prone to prostate cancer than others.
Sometimes, it is the genetic changes that occur in your body that can lead to you becoming more prone to having prostate cancer.
Research shows that those men who do not get enough vitamin D may be at a higher risk of having prostate cancer than other men.
If you are obese, then your chances of developing prostate cancer are increased manifold. Mostly, obese men's prostate cancer is tougher to treat.
Some studies have reported that men who eat high-fat dairy products and red meat more often are more likely to develop prostate cancer.

Prostate Cancer Diagnosis And Screening

It is essential to get a periodic preventative screening for prostate cancer as the symptoms are not very apparent at the initial stages. When you go for your annual health examination, you might want to speak to your doctor about prostate cancer screening. If you are 40 years old, then doctors recommend that you get yourself screened, especially if one of your close family members has prostate cancer.

Doctors say that if you are 45, if you are African American, and you have someone close to you who was diagnosed before they were 65, then you should get a screening done for prostate cancer as you have a high statistical risk.

The following tests are used for screening and diagnosing prostate cancer.

1. History and physical exam

Your doctor will first ask you for your medical history to determine any medical conditions you have had and your overall health record. Then, your doctor will ask you about your habits. Finally, your doctor will examine your body using a physical exam to gauge your overall health.

2. Transrectal ultrasound

This type of ultrasound uses a probe, a finger-sized device inserted in the rectum to check the prostate. The probe creates echoes through ultrasound of your organs and internal tissues, helping create a sonogram that clearly shows your body tissues.

3. Digital rectal exam

This prostate cancer test is used to examine your rectum. Your doctor will use lubrication on their glove and insert it into your rectum. It enables him to feel the state of your prostate. If there are any lumps, the doctor can feel them through your rectal wall. If anything else is out of the ordinary, then your doctor will be able to diagnose it through this test.

4. Transrectal magnetic resonance imaging (MRI)

This test is done to see whether the cancer has spread to other nearby tissues besides the prostate. It uses radio waves, a magnet, and a computer to create pictures of your body's internal parts. A probe is inserted inside your rectum, letting your doctor see your prostate and the nearby tissues.

5. Prostate-specific antigen (PSA) test

The prostate is in charge of producing PSA in the body; hence, the level of PSA can reveal the health of your prostate. This test measures how much PSA is present in your blood. Men who have prostate cancer usually have high amounts of PSA in their blood, which is why this test is conducted. Note that just because the levels of PSA are high doesn't mean it has to be prostate cancer. Other conditions can cause high PSA levels, too.

6. Transrectal biopsy

Your doctor can perform this procedure to diagnose prostate cancer. A thin needle is inserted through your rectum and into your prostate. The tissue is removed from the prostate, and this is viewed by a pathologist who analyses it under a microscope to see any signs of cancerous cells. A transrectal biopsy can be done using transrectal MRI or transrectal ultrasound.

When the pathologist can find cancer cells, a grade will be given. This grade describes the abnormality of the cancer cells and the likely rate at which they will spread. This grade is called the Gleason score. If your score is lower than six, it means that your risk of prostate cancer is low. If the score is higher, your doctor will analyze the cells with the help of your score and the PSA level.

Prostate Cancer Treatment

If you are diagnosed with prostate cancer, then various types of treatments are available. Which treatment is best depends on factors such as age, cancer stage, and health. The following are the standard treatment procedures for prostate cancer.

Bisphosphonate therapy

In this type of treatment, bisphosphonate drugs are given. These include zoledronate. This treatment is given when prostate cancer has spread to your bones. Men who get treated with treatment options such as orchiectomy or antiandrogen therapy have a high risk of losing their bones. In such cases, bisphosphonate therapy decreases the chances of breaking bones. These drugs can prevent cancer from spreading in the bones, but this is currently being researched.

Chemotherapy

This type of treatment involves using drugs to stop the cancer cells from growing further or to kill them. These drugs are given as medications that you can eat or inject so that they can enter your bloodstream. This type of chemotherapy is called systemic chemotherapy. Another type of chemotherapy is known as regional chemotherapy, and in this, the drugs affect only those areas. Your doctor will determine which type of chemotherapy needs to be given depending on your cancer specifics.

Hormone therapy

Glands make hormones, which are present in the bloodstream. Hormone therapy consists of either blocking hormones from working or removing hormones from the body to inhibit cancer cells from dividing and growing further. Hormone therapy can include estrogens, abiraterone acetate, antiandrogens, luteinising hormone-releasing hormone agonists, orchiectomy, and drugs. There are various side effects of hormone therapy, such as weak bones, nausea, hot flashes, and itching.

Biologic Therapy

An example of biologic therapy is Sipuleucel-T, which is used to treat prostate cancer that has spread to various areas of your body. Biologic therapy is a treatment procedure in which your immune system is used to fight prostate cancer. Your body is prepared to use its defences against cancer in this type of treatment. Substances made in the lab or the ones that your body makes are used to do this.

Radiation therapy

In this type of treatment, radiation is used to kill the cancer cells so that they cannot grow anymore. There are three different types of radiation therapy: internal radiation therapy, external radiation therapy, and radiopharmaceutical therapy. Men who are treated with radiation therapy usually experience a few problems, such as urinary problems and impotence. The method by which the treatment is given depends on many factors, such as the stage of prostate cancer.

Active surveillance

This type of treatment is generally for older men who have medical conditions but do not show any symptoms of prostate cancer. It is for those people who show signs of prostate cancer during the screening test. This type of treatment means monitoring you closely until signs of prostate cancer appear. Treatment is then given to you depending on the symptoms that you exhibit. There are various tests and exams that you need to go through as your doctor will need to see whether the cancer is growing or not.

Surgery

If you are a healthy person and your doctor has found a tumour in your prostate, then one of the treatment options is prostate cancer surgery. There are various types of surgery. One such surgery is radical prostatectomy, which consists of two different types of prostate surgeries: perineal prostatectomy and retropubic prostatectomy. Other types of surgeries are transurethral resection of the prostate (TURP), pelvic lymphadenectomy, and nerve-sparing surgery. Many complications and risks are associated with prostate surgery, such as impotence or urinary incontinence.

Prostate Cancer Stages And Survival Rate

The prostate cancer survival rate depends on which stage you are at when the diagnosis is done. When a diagnosis is made early, and cancer hasn't spread to other parts of your body, then you can expect a positive result because treatment can be started immediately. However, if the cancer has advanced to different parts of your body, then it depends on how much the cancer has metastasised in your body.

The prostate cancer stage indicates how far your cancer has advanced, helping your doctor determine the right course of action for your treatment. The prostate cancer stages are 1, 2, 3, and 4, where stage 1 is considered early while stage 4 is regarded as the most advanced stage of cancer. The Grade Group depends on the Gleason score; this information and PSA levels help determine the prostate cancer stage.

Stage 1

In the first stage of prostate cancer, the cancer is only in the prostate. Your doctor might feel the cancer growth during the digital rectal exam, usually on the part of one side of the prostate. Otherwise, your doctor can find cancer through a needle biopsy that was done due to high PSA levels. In stage 1, PSA levels are below ten, and the Grade Group is 1.

Stage 2

In the second stage, the cancer is relatively advanced but is still limited to the prostate. This stage is further divided into three stages: stages 2A, 2B, and 2C.

Stage 2A is when the PSA level is ten or more but below 20, and cancer found is part of a side of your prostate, and the Grade Group is 1. Otherwise, it is when both sides of the prostate or more than one-half of one side of your prostate has cancer, and the Grade Group is 1.

Stage 2B is when the cancer is on either one side of the prostate or both sides of your prostate. The Grade Group is two in this stage, and the PSA level is less than 20.

Stage 2C is when the cancer is on both sides of the prostate or one side of the prostate. The Grade Group is 3 or 4, and the PSA level is less than 20.

Stage 3

In the third stage of prostate cancer, cancer may be in the prostate only or may have spread to other parts of your body. This stage is further divided into three sub-stages.

Stage 3A is when the cancer is still in the prostate only. Cancer can be on both sides of your prostate or only one side. The PSA level is below 20, and the Grade Group can be 1, 2, 3 or 4.

Stage 3B is when cancer has advanced and spread to the seminal vesicles. It may have spread to nearby organs or tissues. The PSA level can be anything, and the Grade Group is 1, 2, 3 or 4.

Stage 3C is when the cancer is in one or both sides of your prostate and has spread to nearby organs such as the rectum and bladder. The PSA level can be anything, and this stage's Grade Group is 5.

Stage 4

In this stage, prostate cancer has advanced further. This stage is divided into two sub-stages.

Stage 4A is when the cancer is on one or both sides of your prostate, has spread to nearby organs, and has spread to lymph nodes, too. The PSA can be at any level, and the Grade Group can be anything from 1 to 5.

Stage 4B is when the cancer has spread to other parts of the body, such as lymph nodes that are further away or bones.

How To Prevent Prostate Cancer?

There are two main ways to ensure prostate cancer prevention.

Certain foods, such as soy, tomatoes, fish, omega-3 fatty acids, rich oils, and cruciferous vegetables, can reduce the risk of prostate cancer. Having a variety of fruits, whole grains, and vegetables will do wonders, and this is an easy way to avoid prostate cancer.

You should avoid certain foods, such as red meat, dairy products, products containing a high amount of saturated fats, and grilled meat.

Obesity increases your chance of prostate cancer, so exercising regularly can help you lose weight and become healthy. Regular exercise will decrease your chances of developing prostate cancer. Aim to exercise at least five days a week. You should always start slow, listen to your body, and slowly increase your exercise intensity.

Prostate Cancer And Your Sex Life: What You Should Know

While sex might not be the first thing on your mind when you are diagnosed with prostate cancer, it is something that you need to know about, especially if you lead a sexually active life. You might feel awkward talking about your sex life with your doctor, but it is important to do so.

When you get treated for prostate cancer, it can affect your sex life in various ways. You might lose interest in sex, or you might just feel discomfort when you think of sex. Some men feel pain during ejaculation as well. All of these can hinder your ability to enjoy sex, and this can affect your self-image and self-confidence.

You need to ask your doctor about the treatment that you will be receiving and how it will affect your sex life. You can ask questions such as the safety measures that you can take, which sex positions you should avoid, whether you can have sex with your partner daily, etc.

Whatever questions you have, just ask your doctor to be on the safe side. If you cannot do that, you might want to speak to your counsellor first and then to your doctor so you don't feel awkward.

Road To Recovery And Aftercare

Often, prostate cancer treatment ensures that cancer has been destroyed or removed. For some men, the cancer might not be removed entirely and may come back, but in other parts of the body. In such cases, men might need to get treated again so that cancer doesn't spread further.

Your doctor will continue monitoring you after treatment, and you should ensure you are clear about follow-up care. You should attend all the appointments, as your doctor might want to test you to ensure you are not suffering from any side effects due to the treatment.

You should immediately call your doctor whenever you feel something is wrong. It can indicate that your cancer might be back or another medical condition. Exercise is important, and many studies have shown that regular exercise can speed your recovery. From the moment you are diagnosed with prostate cancer to the period after treatment, you must stay emotionally strong. It can be stressful, so seeking the help of a family or professional counsellor is recommended so you feel emotionally stable.