Definition

Prostate cancer is cancer that occurs in the prostate gland. The prostate is a small, walnut-shaped gland found only in men. It is located below the bladder (a sac that holds urine) and plays a role in transporting and nourishing sperm.

Prostate cancer is one of the most common types of cancer in men. The growth of prostate cancer is usually slow and initially remains confined to the prostate gland, causing no serious symptoms. However, some prostate cancers can be aggressive and spread quickly to other organs.

Causes

Prostate cancer begins with mutations in the DNA of prostate cells. DNA contains instructions for cells to function properly. Cells have a definite lifespan and will die at the appropriate time. When genetic mutations occur, changes in DNA can cause uncontrolled cell growth.

Mutated cells do not die like normal cells. This accumulation of abnormal cells continues to increase in number, forming a tumor. Malignant tumors can also spread to surrounding tissues. Over time, these abnormal cells can metastasize to other organs.

There are several types of prostate cancer based on the type of cell mutation. Prostate cancer can also vary in growth rate, being either aggressive (rapid growth) or non-aggressive (slow growth).

Risk Factor 

Several factors are thought to increase the risk of prostate cancer:

• Old age: The risk of prostate cancer increases with age, typically occurring in men over 50.
• Certain ethnicities and races: Black men have a higher risk of prostate cancer than men of other races, although the exact reason is unknown.
• Family history: Prostate cancer is more common in families with close relatives, such as parents, children, and siblings who have had the disease. Having a family member with a history of breast cancer also increases the risk.
• Obesity: Obese individuals have a higher risk compared to those with a normal weight. Obesity can increase the risk of cancer recurrence and aggressiveness, although this requires further research.
• Smoking: Heavy smokers face an increased risk of developing prostate cancer and are also more likely to die from it.

Symptoms 

Prostate cancer symptoms usually appear in advanced stages when the tumor is large enough to press on the bladder. Early-stage prostate cancer often has no symptoms. Possible symptoms include:

• Difficulty urinating despite increased urge
• Decreased urine stream strength
• Feeling that the bladder is not completely empty after urinating
• Blood in urine or semen
• Pain in the lower back or upper thighs
• Bone pain
• Loss of appetite
• Significant and unexplained weight loss
• Erectile dysfunction or trouble starting/maintaining an erection

Diagnosis 

Doctors will interview the patient and perform examinations. They may ask about symptoms, personal and family medical history, and regular medications.

Most medical organizations recommend that men over 50 consult a doctor about prostate cancer risk factors. Screening tests may include:

• Digital rectal exam: The doctor inserts a lubricated, gloved finger into the anus to feel for abnormalities in the prostate.
• Prostate-specific antigen (PSA) test: This test uses a blood sample taken from a vein to detect PSA produced by the prostate gland. Normally, only a small amount of PSA is present in the blood. Higher PSA levels indicate a greater likelihood of prostate gland disorders.

If abnormal results are found during the screening, the doctor will recommend further examination. Additional supporting tests that may be conducted include:

• Transrectal ultrasound: An ultrasound is performed using a device that is gently inserted into the anus. It uses sound waves to produce images of the prostate gland.
• MRI: Imaging to give a more detailed view of the prostate.
• Prostate biopsy: A biopsy is an examination that involves taking samples of prostate tissue. These samples are then analyzed in a laboratory to determine if cancer cells are present.

If the screening results indicate prostate cancer, the doctor will perform additional tests to assess the cancer's aggressiveness and stage. The choice of tests will depend on the doctor’s preference and decision.

Management

The management and treatment of prostate cancer are influenced by several factors, including the speed of cancer growth, the spread of cancer cells, patient's health, and the potential side effects of the treatment. For early-stage, non-aggressive prostate cancer, patients will undergo regular check-ups and monitoring to assess the cancer's progress.

Here are some treatment options for prostate cancer, including:

• Surgical removal of the prostate: There are several surgical options depending on the type of cancer, such as radical prostatectomy, which involves the removal of the entire prostate gland, some surrounding tissue, and possibly some lymph nodes. Surgery is typically performed in the early stages of prostate cancer that has not spread, but it can also be used in advanced stages in combination with other therapies.
• Radiation therapy: This treatment kills cancer cells using energy from outside the body. The radiation can be delivered externally using X-rays or protons. Alternatively, radiation therapy can be administered internally by inserting a device that emits radiation directly into the prostate gland.
• Freezing or heating prostate tissue: This includes ablation therapy, which involves either cooling the prostate gland or heating the prostate tissue. This type of treatment may be considered for very small prostate cancers when surgery is not an option.
• Hormone therapy: Hormonal therapy for prostate cancer targets the hormone testosterone. By stopping the production of this hormone, the growth of prostate cancer is inhibited, as cancer cells rely on testosterone for their growth.
• Chemotherapy: Chemotherapy aims to kill rapidly growing cells, including cancer cells. It can be administered via an infusion directly into a vein or through oral medication.
• Immunotherapy: Immunotherapy is a treatment that aims to enhance the immune system's ability to fight cancer.
• Targeted drug therapy: This therapy targets the abnormal conditions of cancer cells with the goal of causing their death. It is used when other therapies cannot eliminate the cancer or when the cancer recurs. Some types of therapy are effective only against cancer cells with specific genetic mutations.

Complications

Complications that can occur with prostate cancer include:

• Cancer spread (metastasis): Cancer cells often spread to nearby organs, such as the bladder. They can also travel through the blood vessels or lymphatic system to reach the bones and other organs. Bone metastasis can cause pain and fractures. Advanced prostate cancer is harder to cure but can respond to treatment.
• Urinary incontinence: Prostate cancer and its treatments can cause urinary incontinence. Treatments that can cause this condition typically include the use of catheters (urinary tubes), surgery, and certain medications.
• Erectile dysfunction: Erectile dysfunction may occur as a symptom of prostate cancer or develop after prostate cancer treatment. Treatments associated with this condition include surgery, radiation therapy, and hormone therapy. However, erectile dysfunction can still be managed and treated.

Prevention

Preventing prostate cancer involves managing and reducing risk factors. Some ways to achieve this include:

• Healthy diet: Improve your diet by eating more fiber-rich vegetables, fruits, and whole grains. These foods are packed with vitamins and nutrients that support overall health. Although fruits and vegetables cannot definitively prevent cancer, they can help reduce the risk of its occurrence.
• Exercise: Try to exercise every day. Regular exercise will improve your overall health, help maintain your weight, and boost your mood. Aim to exercise at least three times a week.
• Maintain ideal weight: Lose weight if you are overweight or obese, as obesity can be a risk factor for prostate cancer. Consult your doctor if needed.
• Consult a doctor: Seek medical advice if you have risk factors that could increase your likelihood of developing prostate cancer. Your doctor can provide early treatment and establish a schedule for regular check-ups.

When to See a Doctor?

See your doctor immediately if you have any of the above symptoms or risk factors. Prostate cancer detected at an early stage has a higher chance of being cured. If you have higher risk factors for prostate cancer, make sure to get regular check-ups.

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