Prostate Cancer

Prostate cancer: what is it?

The prostate, a tiny, walnut-shaped gland that sits in front of the rectum and under the bladder in men, is where prostate cancer starts. The fluid secreted by this little gland combines with semen to maintain the health of sperm throughout conception and pregnancy.

A dangerous condition is prostate cancer. Thankfully, the majority of prostate cancer patients get a diagnosis prior to the disease spreading outside of their prostate gland. Cancer is often eradicated by treatment at this stage.

What kinds of prostate cancer are there?

An adenocarcinoma is most likely the cause of your prostate cancer diagnosis. The cells of fluid-secreting glands, such as your prostate, are where adenocarcinomas begin. Prostate cancer seldom develops from other cell types.
Prostate tumors of the small cell carcinoma type are less prevalent.
carcinomas of transitional cells.
malignancies of the nervous system.
Sarcomas.

What is the prevalence of prostate cancer?

The most frequent cancer in men is prostate cancer, which is second only to skin cancer. The majority will ultimately pass away from reasons unrelated to prostate cancer after leading regular lives. Some won’t need medical attention.

What signs of prostate cancer are present?

Prostate cancer in its early stages seldom exhibits symptoms. As the illness worsens, several problems might arise:

frequent, sometimes urgent urination, particularly at night.
weak urine flow or intermittent flow.
Dysuria is pain or burning during urinating.
incontinence, or loss of bladder control.
loss of intestinal control (incontinence of the feces).
Erectile dysfunction (ED) and painful ejaculation.
Blood in urine or semen (hematospermia).
discomfort in your chest, hips, or low back.

Do issues with the prostate usually indicate prostate cancer?

Prostate growths are not always cancerous. Prostate cancer symptoms may also be caused by the following other conditions:
Almost everyone who has a prostate will eventually develop benign prostatic hyperplasia (BPH). Although your prostate gland enlarges, this condition does not raise your chance of developing cancer.
Prostatitis: An enlarged prostate gland is most likely prostatitis if you are under 50. Your prostate gland becomes inflamed and swollen when you have prostatitis, a benign illness. Infections with bacteria are often the reason.

Prostate cancer: what causes it?

What makes the cells in your prostate turn into cancer cells is unknown to experts. Prostate cancer develops when cells divide more quickly than normal, much as cancer in general. Cancer cells do not ultimately die, but normal cells do. Rather, they proliferate and develop into a mass known as a tumor. Parts of the tumor may separate and move to other areas of your body (metastasize) as the cells continue to proliferate.

Fortunately, prostate cancer often progresses slowly. The majority of tumors are identified before the malignancy has progressed beyond the prostate. At this stage, prostate cancer is very curable.

Which variables increase the risk of prostate cancer?

Among the most prevalent risk factors are:

Age. As you age, your risk rises. If you are over 50, your chances of receiving a diagnosis are higher. People over 65 account for around 60% of prostate cancer cases.
Ethnicity and race. If you are Black or of African descent, you are more vulnerable. Prostate tumors that are more prone to spread are more likely to occur in you. Additionally, you have a higher chance of developing prostate cancer before the age of fifty.
Familial prostate cancer . If a close relative has prostate cancer, your chances of developing the disease are two to three times higher.
Genetics. Having Lynch syndrome or inheriting mutant (alter) genes linked to an elevated risk of breast cancer (BRCA1 and BRCA2) puts you at higher risk.

Testing and Diagnosis

How is a diagnosis of prostate cancer made?

Prostate cancer may be detected early with screenings. You will most likely get your first screening test at age 55 if your risk is average. If you belong to a high-risk population, you could need early testing. Typically, screenings end around age 70.

If screenings reveal that you could have prostate cancer, you might need further testing or treatments.

Prostate cancer screening tests : Screening tests may determine if you have prostate cancer symptoms that need further investigation.
Digital rectal examination: Your healthcare practitioner feels your prostate gland by putting a gloved, lubricated finger into your rectum. Hard spots or bumps might indicate malignancy.
Blood test for prostate-specific antigen (PSA): Protein-specific antigen (PSA) is a protein produced by the prostate gland. Elevated PSA levels might be a sign of cancer. Additionally, levels increase if you have benign illnesses like prostatitis or BPH.

Prostate cancer diagnostic techniques

Not all people with probable prostate cancer will need a conclusive diagnosis. For instance, your doctor could postpone more testing if they believe your tumor is not severe enough to need therapy and is developing slowly. If it’s more aggressive (growing quickly or spreading), you could need a biopsy and other procedures.

Imaging: Your prostate gland may be seen on an MRI or transrectal ultrasound, along with any questionable regions that could be cancerous. Your doctor may use the findings of your imaging tests to determine whether to do a biopsy.
Biopsy: In a needle biopsy, a medical professional takes a sample of tissue to be tested for malignancy in a lab. The only reliable method for diagnosing prostate cancer or determining its aggressiveness is a biopsy. The biopsied tissue may be subjected to genetic testing by your physician. Certain cancer cells contain traits (such as mutations) that increase their propensity to react to certain therapies.

Which stages and grades of prostate cancer exist?

To assess the severity of your cancer and the kinds of therapies you need, medical professionals utilize the Gleason score and cancer staging.

Gleason’s score

Your doctor may grade the abnormality of your cancer cells using the Gleason score. Your Gleason score increases with the number of abnormal cells you have. Your doctor may use the Gleason score to assess the aggressiveness of your cancer and its grade.

Prostate cancer staging

Your doctor may use cancer staging to assess the extent of your disease’s spread and its level of advancement. Prostate cancer may be local (just affecting your prostate gland), regional (invading surrounding tissues), or metastasized (spreading to other organs). Your bones and lymph nodes are where prostate cancer most often spreads. Your liver, brain, lungs, and other organs may also develop it.

Treatment

In what ways is prostate cancer treated or managed?

Your general health, whether the disease has spread, and how quickly it is progressing are some of the variables that will affect your course of therapy. You could collaborate with urologists, radiation oncologists, and medical oncologists, among other healthcare professionals, depending on your course of therapy. Treatment may cure the majority of prostate cancers found in their early stages.

Specific procedures used

Monitoring : If your cancer develops slowly and doesn’t spread, your doctor may choose to monitor your condition rather than treat it.
Active monitoring: Every one to three years, you have screenings, scans, and biopsies to track the progression of cancer. If the cancer is limited to your prostate, develops slowly, and is asymptomatic, active monitoring is most effective. Your doctor may begin therapy if your condition worsens.
Alert waiting: Similar to active monitoring, watchful waiting is more often employed for patients with cancer who are fragile and whose condition is unlikely to improve with therapy. Testing is also much less common. Treatments often concentrate on controlling symptoms rather than removing the tumor.

Operation

Radical prostatectomy : A damaged prostate gland is removed during a radical prostatectomy. Prostate tumors that haven’t spread may often be effectively removed using it. If your doctor thinks you will benefit from this procedure, they may suggest the optimal removal technique.
- Open radical prostatectomy: Your doctor removes your prostate gland by making a single incision in your abdomen, which runs from your belly button to your pubic bone. Compared to less invasive procedures like robotic prostatectomy, this treatment is less popular.
- Robotic radical prostatectomy: This procedure enables your doctor to operate via several small incisions. They use a console to control a robot system rather than working directly.
Radiation treatment : Radiation therapy may be used alone or in conjunction with other therapies to treat prostate cancer. Additionally, radiation may alleviate symptoms.
- Brachytherapy: Brachytherapy is a kind of internal radiation therapy in which radioactive seeds are implanted within the prostate. This method destroys cancer cells while protecting the healthy tissue around them.
- Radiation treatment using an external beam: Strong X-ray beams are delivered straight to the tumor by a machine in external beam radiation treatment (EBRT). Certain types of EBRT, such as IMRT, may target the tumor with high radiation doses while avoiding damage to healthy tissue.
Systemic treatments : In the event that cancer has progressed beyond your prostate gland, your doctor could suggest systemic therapy. Systemic treatments use chemicals that go throughout your body to either kill or stop the development of cancer cells.
- Hormone therapy: Testosterone promotes the proliferation of cancer cells. Medication is used in hormone treatment to counteract testosterone’s ability to promote the development of cancer cells. The medications either lower your testosterone levels or stop testosterone from getting to cancer cells. As an alternative, your doctor can suggest surgical orchiectomy, which would remove your testicles and stop them from producing testosterone. For those who would rather not take medicine, this procedure is a possibility.
- Chemotherapy: Chemotherapy kills cancer cells using medications. If your cancer has migrated outside of your prostate, you may be treated with hormone therapy or chemotherapy alone.
- Immunotherapy: Immunotherapy boosts your immune system’s capacity to recognize and fight cancerous cells. Immunotherapy could be suggested by your doctor to treat advanced cancer or recurrent cancer, which is cancer that disappears but then comes back.
- Targeted treatment: Targeted therapy stops healthy cells from proliferating by focusing on the genetic alterations (mutations) that cause them to become cancerous. Prostate cancer is treated with targeted treatments that kill cancer cells that have mutations in the BRCA gene.

Focal treatment

A more recent therapeutic option that eliminates prostate tumors is focal therapy. If the cancer is low-risk and hasn’t spread, your doctor could suggest this therapy. Several of these therapies are currently regarded as experimental.

High-intensity focused ultrasound (HIFU): This procedure uses intense sound waves to produce potent heat that destroys prostate cancer cells.
Cryotherapy: The tumor is removed by freezing the prostate’s cancerous cells using cold gases.
Laser ablation: The tumor is destroyed by intense heat that destroys cancer cells within your prostate.
Photodynamic therapy: Drugs increase the sensitivity of cancer cells to certain light wavelengths. When a medical professional exposes cancer cells to certain light wavelengths, the cancer cells are killed.

What adverse effects might therapy for prostate cancer cause?

Possible adverse effects consist of:

Incontinence: When you cough, laugh, or have an urgent desire to urinate even when your bladder isn’t full, you may leak urine. Without therapy, this issue often gets better throughout the first six to twelve months.
ED, or erectile dysfunction: Your ability to get or sustain an erection may be impacted by damage to the erectile nerves in your penis by surgery, radiation therapy, and other therapies. Regaining erectile function usually takes a year or two, although sometimes it happens sooner. Meanwhile, drugs that increase blood flow to your penis, such as tadalafil (Cialis®) or sildenafil (Viagra®), may be helpful.
Infertility: Treatments that interfere with sperm production or ejaculation might cause infertility. Before beginning therapy, you may store sperm in a sperm bank if you desire children in the future. You could have your sperm removed after therapy. Sperm are extracted straight from testicular tissue and placed into your partner’s uterus during this surgery.

If you’re having adverse affects from your therapy, speak with your doctor. They may often suggest helpful medications and treatments.

Prevention of prostate cancer

How may prostate cancer be avoided?

Prostate cancer cannot be prevented. However, following these guidelines might lower your risk:

Get screened for prostate cancer on a regular basis. Based on your risk factors, find out from your healthcare professional how often you should be checked.
Keep your weight in check. Find out from your healthcare professional what a healthy weight means to you.
Engage in regular exercise. A little over 20 minutes a day, or 150 minutes a week, of moderate-intensity exercise is what the CDC advises.
Consume a healthy diet. Although there isn’t a single diet that helps prevent cancer, eating well can help you stay healthier overall. Consume entire grains, fruits, and veggies. Steer clear of processed meals and red meats.
Give up smoking. Steer clear of tobacco products. To stop smoking, collaborate with your healthcare professional to develop a smoking cessation program.

Prognosis and Outlook

What is the outlook (prognosis) for individuals with prostate cancer?

If your doctor finds prostate cancer early, you have a very good prognosis. After being diagnosed with cancer that hasn’t gone outside of their prostate, 99 percent of people survive for at least five years.

When your prostate cancer spreads, or spreads outside of your prostate, your chances of survival are reduced. Five years later, thirty-two percent of patients with metastatic prostate cancer are still living.