Prostate Cancer

What is Prostate Cancer?

Prostate cancer is a form of cancer that develops in the prostate gland of men. It is a malignant growth of cancerous cells. Typically, the tumour shows slow growth of cells that are restricted to this region for many years. In this stage, patients do not show any signs or symptoms that would indicate prostate cancer. Nevertheless, all cancers of the prostate do not behave in a similar manner. Some types of this cancer can grow and spread more speedily than some others. This type will significantly shorten the life expectancy of the affected patients. The cancer gradually advances and have the tendency to spread to other tissues locally. It also has the ability to spread further or metastasise to other parts of the body like the lungs, bones and the liver.

Prostate-Picture2

  • Statistics
  • Causes
  • Signs and Symptoms
  • Screening Tests
  • Diagnosis
  • Treatment
  • Prevention
  • Conclusion

Statistics

Prostate Cancer is the most common type of cancer among men in the U.S.A and the second leading cause of death due to cancer; the first being lung cancer. The lifetime risk of being afflicted with the disease include 17.6% for Caucasians and 20.6% for African Americans. The risk of death from the disease is 2.8% and 4.7%. Statistics indicate that a significant number of men  will be affected by prostate cancer.

However, the death rates from prostate cancer have shown a turn down during the past few years. Presently, in the U.S.A more than 2 million men are reported to be still alive after prostate cancer being detected at a point in their lives. Experts have recommended screening tests for men at the beginning of the age of 40.

Causes

The exact cause leading to prostate cancer is still unknown. The risk factors include old age, genetics, hormonal impact and environmental factors such as toxins, chemicals, etc. The probability of being afflicted with this type of cancer increase with old age. Therefore,  incidence of prostate cancer under the age of 40 is uncommon and it is more common in men older than 80. Studies also have reported that 50%-80% of men over the age of 80 have prostate cancer. Most cases of this cancer have been diagnosed in men older than 65.

As mentioned afore, genetics is one form developing this cancer. It is seen that prostate cancer is common among the members of family of the patient. Thus, the risk of attaining prostate cancer is 2 0r 3 times higher in men with a family history of the cancer than in individuals who do not have a family history.

The growth of prostate cells is stimulated by the male hormone, testosterone. This hormone is said to play an important role in the development and growth of the cancer. Thus, inhibition of the growth of cancer cells can be achieved by reducing the levels of the hormone. Current studies also indicate that sexually transmitted disease or infections is another risk factor for prostate cancer.

Although, environmental influences like smoking and diets high in fat content are not still proven to generate prostate cancer but is thought to increase the chances of one getting afflicted with the disease. Another risk factor considered to increase the risk is obesity. Experts have suggested that obesity will lead to more aggressive and larger prostate cancer which will have poor treatment outcomes. The development of this type of cancer is also further promoted by exposure to industrial sources.  Geographical influences also affect the incidence of prostate cancer. Men residing in the North America and Scandinavian countries are at a higher risk of developing this type cancer than men living in Asian countries. 

Signs and Symptoms

As previously mentioned, in the early stages of prostate cancer no symptoms pertaining to this disease is exhibited. Therefore, many a times the cancer is detected initially by the use of blood tests like PSA or through physical examination. The health care professional may find a hard nodule during a rectal examination as the prostate is located directly in front of the rectum. However, in more advanced stages of the cancer, the nodule can grow further and press on to the urethra. This will result in  urine difficulties and the urine flow will reduce significantly. Patients in this stage of the cancer will also feel a burning sensation during urination or see blood in the urine. This can also lead to complete blockage of the urine passage which will result in obstructed and enlarged bladder that will be very painful.

It is important to note that these symptoms alone do not indicate prostate cancer as this can be found in other non cancerous enlargement of the prostate gland in men. Having said that, when one experiences any of these symptoms, he should immediately consult a doctor to eliminate the presence of cancer and to get appropriate treatment.

Moreover, in the later stages of prostate cancer, the cancerous cells will invade the surrounding tissue or the lymph nodes in this region called pelvic nodes. Metastasis, the phenomenon of the cancer spreading to other areas of the body, can also occur. Symptoms of metastasis include fatigue, uneasiness and loss of weight. The health care professional will sometimes detect this local spread during a rectal examination by feeling the tumour that will have extended away from the gland. Back or pelvic pain can be experienced too. This is due to the fact that the cancer first metastasises or spreads to the lower spine of pelvic bones initially. The cancer can then spread to other areas like the lungs and the liver. When the cancer has metastasised to the liver one can experience pain in the abdomen. It may also cause jaundice, although this is quite rare. Metastases to the lung area will indefinitely cause chest pain and coughing.

Screening Tests

Screening tests are performed regularly to detect cancer at its early stages. Prostate cancer is generally determined at its early stages with the help of a digital rectal examination or through a blood test called PSA (Prostate Specific Antigen). Digital rectal examination involves the use of a gloved index finger inserted into the rectum to check for any abnormalities present. The doctor will palpate the prostate gland with the index finger. Digital rectal examination for men is recommended for those who are aged 40 and above.

The PSA test is a blood test which is reproducible and specific. The PSA is a protein that is released into the blood by the prostate gland. The blood test detects this protein in blood and it is said to be higher than 4 ng/ml in people suffering from prostate cancer than in those who are not. PSA is elevated during inflammation, infections and in circumstances which gives rise to a large prostate size. The PSA is thus a useful screening tool for this type of cancer.

Diagnosis

Diagnosis of prostate cancer is accurately made by the help of a biopsy of the prostate gland. Prostate cancer is suspected when the rectal examination and PSA blood test render abnormal results. The doctor will then take a biopsy of the prostate gland which is performed trans-rectally and guided by the help of ultrasound images. A small tissue sample will then be taken with the use of a cutting needle. This is standard protocol to diagnose prostate cancer. Multiple samples are taken from the base, apex and mid gland from each of the glands. In larger glands, more cores may be taken for sampling to increase the yield.

 

Treatment

Deciding on treatment options that are available to you can be a difficult task. This is partially due to the fact that treatment are very advanced these days and accurate data on these treatment are not available. Doctors decide on the treatment for a patient by categorising the prostate cancer  into 3 specific groups:- organ confined, locally advanced and metastatic. Organ confined means the cancer is localised to the prostate gland where as locally advanced refers to a large tumor that only spread locally. Metastatic, on other hand, means that the cancer of the prostate has spread to other areas. Treatment available for organ confined and locally advanced include the use of surgery, radiation therapies, hormonal therapies, cryotherapy, combination of these therapies as well as watchful waiting. No cure is available for metastatic prostate cancer as of yet. The treatments for this stage of prostate cancer include hormonal therapy and chemotherapy.

Surgery

 Surgery for prostate cancer is commonly known as radical prostatectomy. This involved the removal of the entire prostate gland. This is the most common form of treatment given to organ confined or locally advanced stages of prostate cancer in the U.S.A. Statistics show that around 36% of patient having organ confined prostate cancer undergo this surgery. Additionally, the American Cancer Society has reported that 90% cure rate of prostate cancer when the prostate gland is removed. The complications associated with this type of surgery are the risks that arise due to anaesthesia, bleeding locally, impotence (30-70% of patients) and incontinence (3-10% of patients). If impotence does occur after surgery, the condition may be treated with medications, injections to penis, various devices or by a penile prosthesis. Incontinence, loss of control of urination, is said to get better in time, exercises and medications. However, at times patients require implanting an artificial sphincter which is made up of muscle or some other material that will help control urine flow.

Video of prostate cancer

Radiation Therapy

Radiation therapy aims to cause significant damage to cancer cells in order to stop their growth or kill them. Radiation therapy works on the principle that the rapidly growing cancer cells are more prone to attack by radiation than the normal cells. Clinical trials of radiation therapy performed on organ confined patients have proven that the survival rate at 10 years after treatment is similar to that of radical prostatectomy. Although, impotence and incontinence can occur as a result of radiation therapy, it is reported to be occurring less often when compared to radical prostatectomy.

A drawback of radiation therapy include swelling of the prostate. ALthough, this swelling is short lived, it can cause obstruction to urine flow and increase the symptoms of the condition. Side effects of the external beam radiation include burning of skin, irritation and loss of hair on the area  where the radiation beam was exposed to the skin. Other side effects include tiredness, diarrhoea and urine difficulties. The effects can only be temporary.Having said that, side effects associated with long term use of radiation is still to be proven and there is considerable concern over such practise. Studies have reported that the likelihood of being afflicted with bladder or rectal cancer increases due to long term radiation therapy.

Hormonal Therapy

The male hormone, testosterone, stimulates growth of the cancer cells in the prostate gland, as mentioned earlier. Hormonal therapy aims to reduce the stimulation of testosterone thereby decreasing cancer cell growth. This hormone is produced by the testes as a result of stimulation by another hormone called luteinizing hormone-releasing hormone (LH-RH). The LH-RH is produced in the hypothalamus in the brain and released into the blood which then travels to the testes. The LH-RH will stimulate the testes to release testosterone. Hormonal treatment can achieved surgically or medically. Surgical hormonal treatment involves the removal of the testes whereas the medical hormonal treatment involves targeting drugs which will inhibit release of LH-RH.

Cryotherapy

Cryotherapy is one of the newer treatments available for prostate cancer. The treatment involves killing the cancer cells by freezing. Freezing is achieved by the insertion of a freezing liquid through needles into the gland which is guided by ultrasound images.

 

Prevention

Currently, there are no steps that could be undertaken to prevent the development of prostate cancer. Therefore, prostate cancer progression can only be prevented by early detection and treatment. Early detection or diagnosis can be easily be made by PSA tests and through a digital rectal examination. Screening tests are undertaken with the sole purpose of detecting cancer at an early, tiny or even microscopic stage. Thereby, treatment can be administered which can stop the growth, stop the spread and in certain circumstances cure the cancer.

Conclusion

Prostate cancer is the second leading cause of death. Risk factors of the disease include ageing, family history of prostate cancer, etc. This type of cancer is found with the use of a PSA blood test and digital rectal examination. The disease is diagnosed by a biopsy. Prostate cancer can be life threatening in some men and in some others it can prevail without causing any health conditions. Treatment options for the disease include surgery, radiation therapy, hormonal treatment, cryotherapy, chemotherapy, combination of these therapies as well as watchful waiting. There no specific methods available to prevent prostate cancer.

 

We will be expanding on this important topic in future articles. While I recommend you to register to download an e-book: “Adult Prevention Guide” for better health, a FREE

 

 

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The Team Manager Web Diseases

 

 

 

 

 

 

 

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