What is Prostate Cancer?
The prostate gland is a secretory gland situated around the bladder neck, and it releases seminal fluid to transport sperm.
Amongst malignancies that affect men, Prostate Cancer is one of the most common types.
Who Does Prostate Cancer Affect?
Prostate Cancer occurs only in men and is more common in men who are older than 50 years, but it can occur in men as young as 40. Therefore, testing for prostate cancer should begin at age 50, or from 40-45 years of age depending on risk factors.
A positive family history on the father’s side of the family (father, paternal uncles, brothers) is the main risk factor and are more likely to result in more advanced cases of the malignancy. Also, a strong family history of breast, ovarian or pancreatic cancer may indicate the presence of a BRCA gene defect which is also a risk factor.
The rate of prostate cancer also varies with race, with Asians having the lowest incidence, the Hispanics and Caucasians having higher incidence rates.
How Does Prostate Cancer Occur?
When the cells in the prostate gland become abnormal, this results in the uncontrolled division in the mutated cells, forming a tumour made up of the abnormal cells, which continue to grow and spread to surrounding tissues and potentially to the rest of the body.
Causes Of Prostate Cancer?
The causes of Prostate Cancer are still not fully understood. Genetic and racial factors play a role as do dietary factors such as a high-fat diet, and obesity.
Symptoms of Prostate Cancer
The symptoms don’t appear in earlier stages of the disease. Therefore, men should not rely on symptoms as a guide as to whether there is anything wrong. Only a PSA test and a prostate examination can indicate whether cancer is present.
As the malignancy progresses, it can cause the following symptoms:
- Difficulty in urination, the need to push harder
- A weaker stream of urine
- Pelvic discomfort
- Blood observed in ejaculation (semen)
- Erectile Dysfunction
Types Of Prostate Cancer
The most common type of prostate malignancy is adenocarcinoma, either acinar or ductal in nature (almost 98% of all cases).
Other rare types include small call cancers, sarcomas and others (roughly 1% of all cases).
Stages Of Prostate Cancer
The Prostate Cancer can be graded based on its aggressiveness and spread. Historically, a scale called Gleason score is used for this which gives a score out of 10. Oddly, the lowest possible number is a score of 6 which means the cancer is non-aggressive. A score of 7 indicates an intermediate cancer, and scores of 8-10 mean it’s very aggressive.
The Gleason Grade is confusing and it has now been replaced with the International Society of Uropathologists (ISUP) grade, which grades the cancer from 1-5. An ISUP grade of 1 is non-aggressive while an ISUP grade of 5 is the most aggressive.
How is Prostate Cancer Diagnosed?
There are certain medical institutes that recommend regular screening of healthy men over the age of 50, especially men with identified high-risk factors, as early prognosis is crucial in a more positive outcome.
Screening involves a
- (PSA) test.
The guidelines concerning screening are still not a universal standard. However, regular testing should start from age 50, or age 40 if there are risk factors. The exact age to stop PSA testing is unclear but is around 75 years.
If the or test yields an abnormal result, to confirm malignancy and its stage the doctor may conduct an:
- an and possibly
A is a new technique that is also proving useful for accurate diagnosis.
How is Prostate Cancer Treated?
The treatment of Prostate Cancer varies on a case to case basis. It depends on the
- general health of the patient,
- cancer’s progression,
- Patient’s age and
- What the overall benefit would be if treatment is provided.
The treatment options range widely from
- - monitoring the cancer
The patient is also recommended therapy for distress and depression that might result from this prognosis as well as group support.
In certain cases, the doctor may recommend simple active monitoring of cancer by routine follow-ups, if treatment is not yet needed.
The overall 5- year survival rate for this cancer is almost 99%, for all stages of cancer.
What If Prostate Cancer Is Untreated?
If left untreated, the results would vary from case to case.
In most cases, the Prostate Cancer remains confined to the prostate and no other symptoms other than those mentioned earlier are seen. However, in other cases, it may spread to the bladder and lymph nodes, resulting in further complications and making successful therapy more difficult.