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Reviewed by

Dr. Madhav Sanzgiri

Consultant - Urology

Manipal Hospitals, Goa

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Prostate Cancer: The Causes and Management

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The prostate is the small walnut-shaped gland in men located in the pelvic region. It is located next to the bladder. Prostate cancer develops among men in the prostate gland and is known to be the second leading cause of cancer-causing death among men in the US region.

The prostate gland in men possesses different functions, such as producing fluid that nourishes and transports sperm, secreting prostate-specific antigen (PSA) that helps semen retain its liquid form and helps in controlling urination.

Approximately 161,360 men are diagnosed with prostate cancer every year, and around 1 in 7 men have undergone a diagnosis of prostate cancer in their lifetime. Around 26730 deaths are estimated due to prostate cancer. Also, 2.9 million men have survived prostate cancer due to early diagnosis.

Signs and symptoms

No particular symptoms are observed during the early stages of prostate cancer. But men usually involve the following symptoms in prostate cancer:

Trouble urinating
Blood in the urine
Blood in the semen
Decreased force in the stream of urination
Erectile dysfunction
Urge to urinate frequently, especially at night
Painful urination and ejaculation
Painful urination and ejaculation
Back, hip, and pelvic pain

The symptoms of advanced prostate cancer depend upon the tumour size and its metastasis, which includes:

Bone pain
Unexplained weight loss
Tiredness

Causes of Prostate Cancer

The exact cause of prostate cancer is not known. Studies have revealed that changes in the glandular cells cause a higher risk of developing prostate cancer. If prostate gland cells appear abnormal, the doctors reveal these changes to be prostatic intraepithelial neoplasia (PIN). Almost 50% of men aged 50 and older suffer from PIN. Initially, the changes will be slow and the cells will not be cancerous. But later on, with time, they become cancerous. Some of the risk factors tend to increase the risk of developing prostate cancer, which includes:

Age

People of older age develop a higher risk of prostate cancer, which is common after 50.

Racism

Black people are prone to a higher risk of developing prostate cancer when compared with people of other races.

Family history

The individual who have a family history of prostate cancer, that is, if their parents, siblings, or any blood relative have this cancer type, may have an increased risk of developing this cancer.

Obesity

Obese people have a higher risk of developing prostate cancer.

Stages of Prostate Cancer

Prostate cancer has four stage classifications, which are discussed below:

Stage I: The tumour is found only in the prostate gland.
Stage II: Cancer has not spread to other body parts, but the PSA level has increased.
Stage III: Cancer has spread to surrounding tissues.
Stage IV: Cancer has spread to other parts of the body.

Diagnosis of Prostate Cancer

Screening tests are done for the diagnosis of prostate cancer. The diagnostic approach includes:

Medical history and physical examination
PSA blood test
Prostate biopsy
Genetic testing: PCA3 test for identifying the PCA3 gene in the urine.
Imaging tests: Transrectal ultrasound
Lymph node biopsy
Gleason score (grading system)

Consult with the Oncologist in Goa to have insight on the tests involved in the diagnosis of Prostate Cancer.

Treatment of Prostate Cancer

The treatment of prostate cancer depends entirely on the particular stage and screening tests involving the estimation of PSA level and Gleason score. Visit Manipal Hospitals, Cancer Care Hospital in Goa to know more about the treatment options for Prostate Cancer. Early diagnosis of prostate cancer results in the recommendation of the following treatments:

Watchful monitoring

PSA blood levels are checked on a regular basis, and the side effects are monitored regularly.

Surgery

Radical prostatectomy is recommended for the removal of tumours from the prostate gland along with removal of surrounding tissue, seminal vesicles, and nearby lymph nodes. The procedure can be performed using open, laparoscopic, or robot-assisted laparoscopic surgery.

Radiation therapy

It uses radiation to kill the tumour by integrating external and internal radiation therapy.

The following treatments are recommended for advanced prostate cancer:

Chemotherapy
Hormonal therapy
Immunotherapy
Targeted therapy

Prevention of Prostate Cancer

The risk of developing prostate cancer can be reduced if the following precautions are taken by individuals:

Choosing a healthy diet of food sources of fresh fruits and vegetables that contain important vitamins and nutrients contributes towards good health.
Consumption of healthy foods over supplements is good for health as they are rich in vitamins and minerals.
Exercising regularly
Maintaining a healthy weight
Communicate with the doctor regarding the increasing risk of prostate cancer.