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Home » Genitourinary » Prostate Cancer

Prostate Cancer

Introduction

Prostate cancer is one of the most common types of cancer in men. It is defined as the uncontrolled growth of abnormal cells in the prostate gland. The prostate gland is a male reproductive organ that helps in the production of semen. It is situated just under the bladder and in front of the anal passage or rectum. Prostate cancer may be confined within the gland or may be aggressive and spread to other parts of the body and cause serious complications.

Prostate cancer incidence increases with age, with the majority of prostate cancers diagnosed after the age of 65. Prostate cancer is highly treatable if discovered in the early stages.  Therefore, screening for prostate cancer at earlier stages is extremely important so that effective treatment can be provided. Treatment for prostate cancer mainly depends on the type and stage of cancer.

Causes and Risk Factors

It is not known what exactly causes prostate cancer. Doctors believe it could occur as a result of several factors such as:

  • Family history
  • Exposure to certain chemicals
  • Advanced age
  • Genetic changes
  • Ethnicity or race – African American males have a higher risk of developing prostate cancer

 

Signs and Symptoms

Prostate cancer causes no signs or symptoms in its early stages. Symptoms may show once the cancer grows and spreads to other parts of the body.  Advanced prostate cancer may cause symptoms such as:

  • Painful urination
  • Frequent urination
  • Difficulty urinating
  • Weak urine flow
  • Blood in the semen or urine
  • Weight loss
  • Erectile dysfunction
  • Bone pain

 

Diagnosis

Screening of the prostate can be done by:

  • Digital Rectal Exam: In this method, the doctor inspects your prostate gland for any lumps by inserting a lubricated gloved finger into your rectum.
  • Prostate-Specific Antigen (PSA) Test: Prostate-specific antigen is a protein produced by the prostate gland. A PSA test measures the blood levels of this protein. Elevated levels of PSA imply the possibility of prostate cancer. However other tests should also be performed in order to confirm the diagnosis because PSA levels may be elevated in other conditions too.
  • Prostate Biopsy: A prostate biopsy may be a more dependable screening method for prostate cancer. Tissue from the prostate is excised and viewed under a microscope for any abnormalities. If cancer is detected, the cancer will be graded or staged, with the higher grade indicating a more severe, advanced cancer.

 

Treatment

Several treatment options are available for treating prostate cancer. The standard approaches may include:

  • Active Surveillance: Also known as watchful waiting, this is a process where a patient is observed over a period of time. Various tests such as blood PSA, digital rectal examinations, imaging studies, and biopsies may be performed at various intervals to document the progress of the disease.
  • Radiation Therapy: Radiation therapy is a procedure where high-energy rays are used to destroy cancer cells.  This can be delivered from outside of the body (external beam radiotherapy), or using radioactive seeds placed into the prostate gland (brachytherapy).
  • Hormone Therapy: Prostate cancer cells require testosterone (male hormone) to grow. Without testosterone, cancer cells die or grow more slowly. Hormone therapy reduces the levels of testosterone in the body. This can be administered by injection every 3 months or through surgery to permanently remove the testosterone producing cells in the testicles.
  • Chemotherapy: Chemotherapy involves the use of anti-cancer drugs. These drugs are either given intravenously (through the veins) or orally (by mouth). This type of treatment is extremely useful in cases where the cancer has spread to different parts of the body. These drugs work against the cells that divide quickly thereby slowing down the growth of cancer and its associated symptoms.
  • Surgery to Remove the Prostate – Radical Prostatectomy: This surgery involves removing the prostate and seminal vesicles and then reconnecting the bladder to the urethra, the tube through which urine is passe. The surgeon may elect to preserve the nerves around the prostate gland in order to preserve erectile function in suitable patients with prostate cancer that is localized within the prostate gland. In patients with more aggressive prostate cancer, the nerves and tissues surrounding the prostate gland are also removed to ensure complete removal of all cancer cells. The procedure can be performed as an open, laparoscopic, or robotic-assisted surgery.

 

Summary

Prostate cancer is the second leading cause of cancer death in men, yet it is highly curable if discovered while still confined to the prostate gland. Many treatment options are available for prostate cancer. Prostate cancer treatment is tailored to the patient’s needs, taking into account the aggressiveness of the cancer, the degree to which the cancer has spread and the general health of the patient.


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