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Prostate Cancer Treatment:
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What is prostate cancer?
Prostate cancer is when a tumour forms in the prostate due to abnormal cell growth. The prostate is a gland which surrounds the urethra and is just below the bladder. It is shaped like a walnut and it is located in the lower abdominal region of a man. Its main function is to produce seminal fluid.
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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 grows rapidly 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 certain cases, there is no tumour growth over time in non-aggressive prostate cancer.
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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. This 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 be 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 start 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. The DNA mutations are responsible for the way that the cancer cells keep growing abnormally. These cells keep on dividing faster than your normal cells until tumour forms in the prostate gland. One particular point to note is that these abnormal cells live longer and when they metastasize, then they can spread to your other body parts.
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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 increases 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.
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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 and 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.
History and physical exam
Your doctor will ask you for your medical history first to determine any medical conditions that you have had in the past and your overall health record. Your doctor will ask you about your habits. Your doctor will examine your body with the help of a physical exam to gauge your overall health.
Transrectal ultrasound
This type of ultrasound makes use of a probe. A probe is a finger-sized device. It is inserted in your rectum to check your prostate. The probe is used to create echoes through ultrasound of your organs and internal tissues. This helps create a sonogram which is a clear picture of your body tissues.
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. This enables him to feel the state of your prostate. If there are any lumps then the doctor can feel them through your rectal wall. If there is anything else that is out of the ordinary then your doctor will be able to diagnose it through this test.
Transrectal magnetic resonance imaging (MRI)
This test is done to see whether the cancer has spread to other tissues that are nearby apart from the prostate. The test uses radio waves, a magnet, and a computer to create pictures of your body’s internal parts. This test uses a probe that is inserted inside your rectum. Through this test, your doctor can see your prostate and the tissues nearby.
Prostate-specific antigen (PSA) test
The prostate is in charge of producing PSA in your body, hence the level of PSA can reveal the health of your prostate. This test is used to measure 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.
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, then it means that your risk of prostate cancer is low. If the score is more than that then your doctor will analyze the cells with the help of your score and the PSA level.
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Prostate cancer treatment
If you are diagnosed with prostate cancer, then there are various types of treatments that are available. Which treatment is best for you depends on factors such as your age, cancer stage, and your 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 is used so that the chances of breaking bones decreases. These drugs can be used to prevent cancer from spreading in the bones but this is currently being researched.
Chemotherapy
This type of treatment involves the usage of drugs to stop the cancer cells from growing further or to kill them. These drugs are given as medications that you can eat or they can be injected 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 and these are present in the bloodstream. Hormone therapy consists of either blocking hormones from working or removing hormones from the body to inhibit the cancer cells from dividing and growing further. Hormone therapy can include estrogens, abiraterone acetate, antiandrogens, luteinizing 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. This 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. The substances that are 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. They are 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 among others. The method in which the therapy 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. This 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 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.
7.
Prostate cancer stages and survival rate
The prostate cancer survival rate depends on which stage you are at when the diagnosis was done. When a diagnosis is done 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 other parts of your body then it depends on how much the cancer has metastasized in your body.
The prostate cancer stage is used to indicate how far your cancer has advanced to and it helps your doctor determine the right course of action to take for your treatment. The prostate cancer stages are 1, 2, 3, and 4 where stage 1 of prostate cancer is considered in its early stage while stage 4 is considered the most advanced stage of cancer. The Grade Group is dependent on the Gleason score and this information along with 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 a part of one side of the prostate. Else, your doctor can find cancer through needle biopsy that was done due to high PSA levels. In stage 1, PSA levels are below 10 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; stage 2A, 2B, and 2C.
Stage 2A is when the PSA level is 10 or more but below 20 and cancer found is a 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. In this stage, the Grade Group is 2 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 the 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 rectum and bladder. The PSA level can be anything and the Grade Group of this stage 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 any level and the Grade Group is anything from 1 to 5.
Stage 4B is when the cancer has spread to other parts of your body. This can be lymph nodes that are further away or bones.
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How to prevent prostate cancer?
There are two main ways to ensure prostate cancer prevention.
You can add certain foods to your diet that are known to reduce the risk of prostate cancer such as soy, tomatoes, fish, omega-3 fatty acids rich oils, cruciferous vegetables. Having a variety of fruits, whole grains, and vegetables is going to do wonders and this is an easy answer to the question how to avoid prostate cancer risk.
You should stay away from certain foods such as red meat, dairy products, products that contain a high amount of saturated fats, and grilled meat.
Obesity increases your chance of prostate cancer and 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 5 days a week. You should always start slow, listen to your body, and then slowly increase your exercise intensity.
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Prostate cancer and your sex life: What you should know
While sex might not be the first thing in 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 are unable to do that then you might want to speak to your counsellor first and then to your doctor so you don’t feel awkward.
10.
Road to Recovery and Aftercare
Oftentimes, prostate cancer treatment ensures that cancer has been destroyed or removed. For some men, the cancer might not be completely removed 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 is going to 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.
Whenever you feel something is not right, you should immediately call your doctor. This can indicate that your cancer might be back or another medical condition. Exercise is important and many studies have shown that regular exercise can fasten your recovery. From the moment you are diagnosed with prostate cancer to the period after treatment, you must stay emotionally strong. All of it can be pretty stressful and so seeking the help of family or professional counsellor is recommended so you feel emotionally stable.
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Prostate cancer FAQs: All your concerns addressed
1. What isn’t a risk factor of prostate cancer?
Many people think that consuming alcohol increases the risk of prostate cancer. It does not. No studies have proven that alcohol consumption can lead to prostate cancer. Vasectomy does not affect the chances of prostate cancer either. It is just a myth. Another common myth is that high sexual activity can lead to prostate cancer but there is no such truth to it according to research.
2. When should I see a doctor if I am not sure about the symptoms?
If you experience any symptoms of prostate cancer, then it is best to contact your doctor and make an appointment right away. Even if you think it might be something minor, it is a good idea to get it checked to be sure about whether it is prostate cancer or not. While there is still debate about the problems that can occur during prostate screening, you should speak to your doctor.
3. What are the complications associated with prostate cancer?
One of the most common complications of prostate cancer is that it metastasizes. In this, the prostate cancer spreads to other parts of your body such as bladder and other organs. In such cases, you might be wondering can prostate cancer be cured. Unfortunately, most of the times it is difficult to cure prostate cancer after it metastasizes, although it can be controlled to an extent. Other complications of prostate cancer include erectile dysfunction and incontinence.
4. What is the outlook and prognosis of prostate cancer?
Most of the prostate cancer cases are non-aggressive and so the outlook is positive. Only in some cases, prostate cancer is advanced due to aggressive prostate cancer. The key is to get yourself checked the moment you think you have prostate cancer symptoms because early diagnosis means quicker treatment.
5. When should you start testing for prostate cancer?
There are benefits of getting tested for prostate cancer, and it’s highly recommended that family doctors discuss the risks and values that come with routine testing with all their male patients; doctors also have to keep into account the patient’s medical history when conducting these tests.
6. Should you see a urologist or oncologist for treatment?
The main specialists who deal with prostate cancer are Urologists, radiation oncologists, and surgical oncologists. A urologist is a specialist who treats diseases that affect the urinary and the male reproductive system, which includes the prostate. Radiation oncologists are doctors who treat cancer with radiation therapy. Surgical oncologists are doctors who treat cancer by removing tumors and infected tissues during surgery. Depending on your condition, you can choose one or a combination of these doctors.
7. Is radiation therapy an option for me?
Radiation therapy makes use of targeted energy, this energy is similar to X-rays, and they kill cancer cells, shrink tumors, while providing relief from specific cancer-related symptoms. Radiation can be used as an alternative treatment in men who are suffering from early stages of prostate cancer; especially if cancer has not spread to other parts of the body. It can also be used in a combination with surgery to ensure that all the infected tissues are eliminated. Radiation oncologists will make use of a variety of tools and therapies to deliver radiation doses to tumors and ensure minimum damage to healthy tissues and organs. When radiation is focused directly on tumors then they can reduce the risk of side effects as well. There is a range of radiation therapy that includes external beam radiation, stereotactic body radiation, and so on.
8. What causes prostate cancer?
There is no clear cause for prostate cancer. Doctors are aware that this cancer begins when some cells in your prostate become abnormal. The mutations in the affected cells’ DNA can cause rapid division and multiplication, even more than normal cells. Cancer gets more intense when the abnormal cells continue to grow, while the normal cells die.
9. Can you prevent prostate cancer?
There is no set or proven way to prevent prostate cancer. However, you can reduce the risk of prostate cancer by choosing healthy options like eating a clean diet and having a consistent workout routine. Doctors have recommended that men who are at risk of developing prostate cancer make life choices that will benefit their health. For those who are at high risk of developing prostate cancer, you should discuss the prevention techniques with your doctor so that they can offer some medication and better options for risk reduction as well.
10. Who is more vulnerable to prostate cancer?
The most common risk factor for prostate cancer is age. Men who are above the age of 55 are more at risk of developing this cancer. Statistically, African-American men are more vulnerable to prostate cancer; especially, if someone in their family has it as well.
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