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Prostate Cancer: Symptoms, Diagnosis and Treatment

Prostate Cancer is one of the most common types of cancer affecting men. It occurs in the prostate, a small, walnut-shaped gland that is responsible for producing the seminal fluid in men which nourishes and transports the sperm. The gland is located under the bladder surrounding the urethra. When an abnormal growth of cells occurs in the prostate, it is referred to as prostate cancer. Cancer grows slowly and is initially confined to the prostate gland, where it may not be very harmful. However, it tends to spread to other organs of the body, leading to serious health conditions. Hence, slow-growing cancers might need minimal or no treatment, but aggressive and quickly spreading prostate cancers will require immediate medical treatment to avoid health complications. A prostate cancer, if detected early, while it is in the prostate has higher chances of successful treatment than otherwise.

Causes of Prostate Cancer

There is no definitive cause of prostate cancer. However, it is believed that it occurs when certain cells of the prostate gland become abnormal and cause mutations in their DNA leading the cells to grow and divide more quickly than other normal cells. The abnormal cells continue to live even beyond their natural course and tend to accumulate forming a tumour, which has the potential to invade nearby tissues. Some abnormal cells can also spread to other body parts, leading to the aggressive growth of cancer.

Risk Factors of Prostate Cancer

Even though the exact cause of prostate cancer is not known, there are some factors which make some men more prone to the risk of developing prostate cancer than others. These risk factors include:

  • Increasing age, mostly in mean above the age of 65
  • Race, black race men are at higher risk than others
  • Family history
  • Obesity
  • Genetic changes

Symptoms of Prostate Cancer

Non-aggressive forms of prostate cancer have no signs or symptoms, especially in their early stages. However, advanced prostate cancer does tend to cause significant symptoms, such as:

Urinary Problems: Since the prostate is located beneath the bladder and surrounds the urethra, any abnormal growth in the prostate creates a pressure on the bladder or the urethra, leading to problems such as:

  • Frequent urge to urinate
  • Weaker urinary stream
  • Bleeding while urinating

Sexual Problems: Erectile dysfunction or impotence is also a symptom of prostate cancer. The condition makes one incapable of getting or keeping an erection.Moreover, blood in the semen post ejaculation is also a symptom of prostate cancer.

Pain and Numbness: For cases, where cancer has spread to other body parts and organs, it can cause pain in the below areas:

  • Pelvic
  • Back
  • Chest

Moreover, for cases, where cancer has spread to the spinal cord, the patient might lose the feeling of the legs and bladder.

Diagnosis of Prostate Cancer

Screenings of prostate cancer include:

  • Digital Rectal Exam (DRE)
  • Prostate-specific antigen (PSA) test

 A combined analysis of both screening tests helps to identify prostate cancer in their earliest stages. In case, abnormal cell growth is detected in these tests, the doctor will conduct further tests to know more:

  • Ultrasound
  • Biopsy through sample prostate tissue
  • MRI Fusion

In case, the presence of cancer is confirmed in the prostate, the next step is to determine the aggressiveness of cancer. For this purpose, a laboratory pathology exam is conducted to check for the difference in cancer cells from the healthy cells in the body. A higher grade of difference indicates an aggressive form of prostate cancer, which is more likely to spread to other body organs and parts.

In the case of aggressive cancers, it is also crucial to diagnose, how far cancer has already spread. In case, the doctors suspect cancer to have spread beyond the prostate, a few more imaging tests may be conducted, such as:

  • Bone scan
  • Ultrasound of the body
  • CT Scan
  • MRI
  • PET Scan

Once all the tests results arrive, the stage of the cancer is determined and the appropriate treatment is followed.

Treatment of Prostate Cancer

In some cases, where the cancer is low-risk, any form of treatment may not be required immediately. In some of these cases, the patient may never require any treatment and only a few cautionary measures would help manage cancer. However, continuous monitoring of health, regular blood tests, rectal exams, and biopsies may be recommended to keep an eye on the tumour. In cases, where the tests result show that the cancer is advancing, surgery or another form of treatment may be required.

The exact form of treatment depends on the severity and aggressiveness of prostate cancer, as well as the general health of the patient. In some cases, a combination approach involving more than one treatment method may be adopted. Some treatment options include:

Surgery: The surgery for prostate cancer will involve removing the prostate gland, as well as some of the surrounding tissues and lymph nodes. The surgery can be performed in several ways such as using a robot directed by the surgeon or by making an incision in the abdomen. Surgery carries a risk of urinary incontinence and can also cause erectile dysfunction.

Radiation Therapy: Radiation therapy involves usage of high-powered energy cells directed to kill the cancer cells. Radiation therapy for prostate cancer can be delivered in two ways:

  • External beam radiation: Involves using high-power energy beams directed at the prostate cancer from outside the body to help shrink the tumour size or eliminate the cancer cells.
  • Brachytherapy: In this form of radiation therapy, rice-sized radioactive seeds are placed in the prostate tissue to kill the cancer cells. These radioactive seeds emit low doses of radiation over time and eventually stop emitting.

Side effects of radiation therapy involve pain, frequent and urgent need to urinate, as well as rectal symptoms or a possible erectile dysfunction.

Hormone Therapy: This therapy involves using medications or surgery to stop the body from producing the male hormone testosterone, which is the basis for the growth of prostate cancer cells. Eliminating the supply of testosterone may cause cancer cells to die or to grow slowly. This is very useful to shrink large tumours before radiation therapy. The hormone therapy can cause erectile dysfunction, hot flashes, loss of bone mass, excessive weight gain and more.

Freezing Prostate Tissue: Also known as cryosurgery or cryoablation, this treatment involves freezing tissue via cold gas and then reheating the tissue to kill the cancer cells through this strenuous process. The complication rates and side effects of this method were high in the past but with recent medical advancements, the method has proven effective in shrinking the size of the tumour before radiation therapy.

Chemotherapy: This method uses drugs to eliminate the rapidly growing tissues including cancer cells. This is a very viable option for cases where cancer has spread to remote body locations or for cancers which do not respond to hormone therapy.

Biological Therapy: This form of treatment involves using the body’s immune system to fight the cancer cells. The cells are genetically engineered in a lab to fight prostate cancer and then are injected back into the body through a vein. This treatment is expensive and requires multiple sittings.

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