The prostate gland is a walnut-shaped gland which is part of the human male reproductive system. The prostate gland produces the seminal fluid that nourishes and transports the sperms. Cancer of the prostate gland is called prostate cancer. It is one of the common cancers occurring in males. It progresses slowly and mostly remains confined to the prostate gland. Prostate cancer that is restricted to the gland itself and detected early, can be treated in the best possible way.
Prostate cancer symptoms
In the early stages, prostate cancer does not cause any symptoms. However, in its advanced stages, the following signs and symptoms may be more evident and similar to an enlarged prostate symptoms:
- Difficulty urinating
- Decreased force in the stream of urine
- Blood in the urine (hematuria)
- Blood in the semen (hematospermia)
- Weight loss without any efforts
- Bone pain
- Erectile dysfunction
- Urinating often, especially during night time (nocturia)
- Trouble voiding out the bladder fully
- Pain or burning during urination (dysuria)
- Painful ejaculation
- Loss of bowel control (fecal incontinence)
- Pain in low back, hip, or chest
Prostate cancer causes
Although the cause of prostate cancer is still unknown, there are several reasons that can contribute towards its occurrence. Some of these are listed as given below:
- Age: Advancing age in men makes the DNA or genetic material of prostate cells more susceptible to harm. Thus, men over 55 years of age are more likely to develop prostate cancer.
- Family history: Having a blood relative such as grandfather, father, or brother who has had prostate cancer, increases your chances of getting the disease as well. Even if you have family members with breast and ovarian cancer, your chances of getting prostate cancer is considerable higher.
- Weight: Being overweight in your 50s has also been cited as a risk factor for getting prostate cancer. Thus, it is important to keep your weight under control with advancing age.
Prostate cancer diagnosis
Your healthcare provider may ask you to undergo the following tests if he suspects you of having prostate cancer.
- Blood test: Prostate specific antigen (PSA) test is done to measure PSA levels in the blood. PSA are proteins which are made by both normal and cancerous prostate cells. This is not a conclusive test as men with prostate cancer often show normal PSA levels. Only 1 in 3 males with elevated PSA levels has prostate cancer.
- Digital rectal examination: This is a physical examination of the prostate gland in which your healthcare provider feels for changes in the prostate gland. During this test, consistency, abnormal shape, nodularity, and thickness of the gland is checked. The drawback of this test is that it cannot detect prostate cancer in its early stages. Along with PSA test, this examination can help detect prostate cancer early, before it spreads.
- Biopsy: During a biopsy, small fragments of tissue are taken out from different parts of the prostate using a rectal ultrasound and examined under the microscope. It helps in determining the stage of the disease, based on the Gleason score.
Prostate cancer stages
Before starting the treatment, your healthcare provider will determine the stage and grade of cancer in order to determine the right kind of treatment.
A.There are 4 stages of prostate gland:
(i) Stage I and II (Early stage): Also called the “localized” stage, it denotes early stage of prostate cancer, where the tumor is limited to the prostate gland itself.
(ii) Stage III (Locally Advanced stage): This stage happens when the cancer has spread outside the prostate, but only to the nearby tissues.
(iii) Stage IV (Advanced stage): This is the final stage where the cancer spreads outside the prostate to other parts of the body such as the lymph nodes, liver, bones, or lungs.
B.Gleason score: This is the most common grading system and measures how quickly the cancer cells can grow and affect other tissues. Samples with small, densely packed cells are graded lower. Samples with more dispersed cells are graded higher. The two most prevalent grades discovered in a biopsy sample are added together to determine the Gleason score. With the help of the Gleason score, your healthcare provider will be able to ascertain if the cancer is low-, intermediate-, or high-risk.
Prostate cancer treatment
The specific procedures used for treating prostate cancer include:
- Surveillance: As the name suggests, in this procedure your healthcare provider will only monitor your condition instead of providing treatment. This is applicable only if the cancer is not growing and doesn’t spread.
- Active surveillance: This involves monitoring cancer growth through screenings, scans, and biopsies every 1-3 years. Active surveillance is an option only if the cancer is not growing, is limited to the prostate, and is not showing any symptoms.
- Watchful waiting: This is similar to active surveillance but it’s more often used for people who become weak due to cancer that won’t go away even with treatment. Testing is not done so frequently but the focus is on managing symptoms.
- Surgery: Prostate cancer surgery is also called radical prostatectomy. This surgical procedure is done to remove the diseased prostate gland that hasn’t spread to surrounding tissues.
- Radiation therapy: With the help of radiation, cancer cells are killed without harming the surrounding healthy tissues.
- Systemic therapy: Using hormone therapy, chemotherapy, immunotherapy, and targeted therapy, certain substances are sent throughout the body to destroy cancer cells or prevent their growth. This procedure is useful for treating cancer that has spread (metastasized).
- Focal therapy: A relatively newer form of treatment, focal therapy utilizes high-intensity sound waves, intense heat or cold, or certain wavelengths of light to kill the cancer cells. This novel technique is useful for treating low-risk cancer, that has not spread so far.
With the right diagnosis of cancer stage and grade, prostate cancer can be treated with one of the many options mentioned above. Early diagnosis improves your chances of faster recovery. Undergoing regular prostate screenings can prevent prostate cancer from occurring in the first place. By following the advice of your healthcare provider, you can overcome the odds of prostate cancer and lead a normal, healthy life!
NU Hospitals is the best prostate cancer hospital in Bangalore, India. With its state-of-the-art facilities and team of dedicated doctors, NU Hospitals has carved a name for itself in the medical realm. If you or a loved one is showing any symptoms of prostate cancer, get yourself treated by the expert andrologists at NU Hospitals without further delay.
References:
- Prostate cancer. Cancer Council. https://www.cancer.org.au/cancer-information/types-of-cancer/prostate-cancer.
- Prostate cancer. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/8634-prostate-cancer.
- Prostate cancer. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087.
- What are the symptoms of prostate cancer? Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/cancer/prostate/basic_info/symptoms.htm.
- What is prostate cancer? Urology Care Foundation. https://www.urologyhealth.org/urology-a-z/p/prostate-cancer.
Author: Dr. Vinod Kumar P + Dr. Pradeepa M G
