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What is Prostate Cancer and Who Has It?
Prostate cancer is the most common and leading cancer diagnosis and the second most common tumor diagnosed worldwide among men after lung cancer. It is to men what breast cancer or cervical cancer is to women and began when abnormal cells in the prostate part of the male organ start growing uncontrollably. It has the potential to grow and spread quickly, but for most men, it is a relatively slow-growing disease, often causing no symptoms until it is in an advanced stage.
A black man is 70 percent more likely to develop prostate cancer than a white man and nearly 2.3 times more likely to die. And as men increase in age, the risk of developing prostate cancer increases exponentially. About 6 in 10 cases are found in men over the age of 65. That is why it is important and recommended that men aged 40 and above get screened for prostate cancer.
What Causes Prostate Cancer?
It is still unclear to medical scientists as to what causes prostate cancer, but do understand it usually occurs when cells in the prostate begin to develop changes in their DNA. Yet, some risk factors have been discovered to cause prostate cancer among men. These risk factors are both non-modifiable (unchangeable) and modifiable (have the tendency to be changed).
Non-Modifiable Risk Factors
Age: As a man increases in age, same does the risk of having prostate cancer increases. The risk of having prostate cancer before the age of 45 years is very rare but increases after the age of 50 years. About 60% of cases of prostate cancer are found in men older than 65.
Ethnic Groups or Race: There is an increased chance of having prostate cancer if a man is racially black than being white. Although the reason for this racial difference is still very much unclear.
Family Background / History: An individual tends to have an increased risk of prostate cancer if there is a family history of prostate cancer. Some prostate cancer may still occur without a family history. The risk is much higher for men with several affected relatives, particularly if their relatives were young when the cancer was found.
Diet: Men who eat a lot of red or high-fat foods, and fewer fruits and vegetables have a higher chance of getting prostate cancer. Consuming a lot of calcium-based food or supplements can also increase the risk of developing prostate cancer.
Obesity: Although not fully proven, some medical studies have proven that obese men may be at a greater risk of having more advanced prostate cancer and also dying from it.
Smoking: Smoking increases the risk of getting prostate cancer.
Chemical Exposures: Exposure to certain chemicals especially by firefighters might increase their risk of getting prostate cancer.
Prostatitis (Inflammation of the Prostate): It has been suggested that Prostatitis (inflammation of the prostate gland) may have a connection to an increased risk of prostate cancer, but it hasn’t been proven as to how it does increase prostate cancer risk. Inflammation is often seen in samples of prostate tissue that also contain cancer.
Sexually Transmitted Infections (STI): It has been suggested that some sexually transmitted diseases such as gonorrhea, chlamydia which causes inflammation of the prostate might cause prostate cancer in some men
What are the Symptoms of Prostate Cancer?
Prostate cancer may cause no signs or symptoms at its early stages until when it has advanced. At this stage the symptoms might include:
Early Detection of Prostate Cancer
Detecting or diagnosing prostate cancer is very important for men, i.e., screening for prostate cancer possibilities before they can cause major symptoms and spread, starting treatment early, and surviving the disease. Tests commonly used for screening include the following:
Prostate-Specific Antigen (PSA) Test: A prostate-specific antigen (PSA) test is used to measure the level of PSA in the blood. The PSA is a type of protein released by prostate tissue that is a man's blood, i.e., a blood sample is drawn from a vein in the arm and analyzed for PSA. It's normal for a small amount of PSA to be in your bloodstream. However, if a higher-than-normal level is found, it may indicate prostate infection, inflammation, enlargement, or cancer. The normal level is 1 to 4.
Digital Rectal Examination (DRE): This is inserting a gloved, lubricated finger into a man’s rectum, which is adjacent to the rectum to feel the prostate for any abnormalities in the shape or size of the gland; and therefore, prescribing further tests.
Imaging Tests: This is the use of x-rays, sound waves / radioactive substances, and magnetic fields to create images of the internal part of the man’s body. This is done to look for cancer in the prostate; help the doctor see the prostate during prostate biopsy or other types of prostate cancer treatment; or probably check if the prostate cancer hasn’t spread to other parts of the man’s body.
The common types of imaging tests devices used include:
Biopsy: A biopsy is a procedure that can be used to diagnose prostate cancer. This is when a small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. This is because the specimens for biopsy are usually taken from several areas of the prostate (this is done to ensure that a better sample is taken for proper examination).
Preventing Prostate Cancer
Theoretically, there is no sure way in preventing prostate cancer because many risk factors such as age, race, and family history can’t be controlled but men with an average risk of prostate cancer can make choices that benefit their overall health. These include:
Primary Preventive Method for Prostate Cancer
Healthy Lifestyle: Some particular lifestyles that an individual can adopt or stop their addiction to reduce or increase the chance of prostate cancer. Exercises like walking, running, bicycling, and swimming improve overall health, help maintain weight, and improve mood. Being overweight or obese is linked to an increased risk of aggressive prostate cancer, in which regular exercise can help you maintain a healthy weight. The benefits of exercise include increased muscle mass and better metabolism.
Prostate cancer patients who smoke or are heavy alcohol drinkers are more likely to have a recurrence of the disease. Therefore, it is advisable to quit smoking and reduce the numbers of alcohol taken per day.
Choosing a Healthy Diet: It has been observed and recommended that having a healthy diet could help reduce the risk of prostate cancer among men. A diet that includes tomatoes, fruits, and vegetables can lower prostate cancer.
Frequent Ejaculation: Whether it’s from sex, masturbation, or wet dreams, men who ejaculate more appear to be less likely to get prostate cancer. Although not yet proven as to how it helps, frequent ejaculation, especially through sex can potentially help move irritating substances out of the prostate.
Secondary Preventive Method for Prostate Cancer
Frequent Screening with PSA
At age 40, years, it is important to frequent screening for prostate cancer is important (especially for an individual who has a family history of cancer). Screening for prostate cancer aims to identify high-risk, localized prostate cancer that can be successfully treated, thereby preventing the morbidity and mortality associated with advanced or metastatic prostate cancer. It is recommended that men talk to their doctor before having a test to check for prostate cancer. Men need to understand the risks and benefits of testing before proceeding with a PSA (prostate–specific antigen test (a blood test that can screen for prostate cancer) and digital rectal exam. For men aged 55 to 69 years, the decision to undergo periodic prostate-specific antigen (PSA)–based screening for prostate cancer should be an individual one.
Managing Prostate Cancer
The process of managing prostate cancer can take different methods, solemnly depending on the physical and biological characteristics of the disease such as the stages, size of the tumor, and how far cancer may have spread; the patient’s age; and the overall well-being of the patient.
This is why medical doctors (oncologists) need to analyze and advise prostate cancer patients on the best and most appropriate way to manage their disease. Also, the suitable treatment options available and various preventive methods.
Treating Prostate Cancer
Prostate cancer patients have several treatment options available to them, and most choices are succinctly affected by their personal preferences and other viable information they might have regarding prostate cancer. These choices are usually affected by:
Prostate cancer treatment options include:
Active Surveillance
This is usually done when prostate cancer is at a low-grade, and treatment is not needed right away. In this process, regular follow-up blood tests, prostate biopsies, and rectal examinations are performed to monitor the progress of cancer.
Surgery
This is the removal of the prostate and some surrounding lymph nodes during an operation. The type of surgical operation used depends on the overall health status of the patient, the age of the patient, the stage of the disease, and several other factors. There are different types of surgical operations used for prostate cancer including:
Radical or Open Prostatectomy: This is the surgical removal of the entire prostate and the seminal vesicles. Sometimes the lymph nodes in the pelvic area may also be removed.
Laparoscopic Prostatectomy: A less invasive surgical operation than a radical prostatectomy. A special long instrument is inserted through the abdominal wall to remove the prostate.
Bilateral Orchiectomy: This is the surgical removal of both testicles. This is done in advanced prostate cancer.
Transurethral Resection of the Prostate: This is a surgical operation used to treat men with benign prostatic hyperplasia (BPH), a non-cancerous prostate enlargement. It can sometimes be used for men with advanced prostate cancer to help relieve symptoms such as trouble urinating, but not treat prostate cancer. Here, the inner part of the prostate gland that surrounds the urethra (the tube through which urine pass through) is surgically removed.
Radiation Therapy
This is the use of high-powered energy and other particles to kill cancer cells in the body. It is typically done using a large machine that aims energy beams toward the cancer location at the body (external beam radiation). Also, it can be done inside the body by placing radioactive materials inside the body i.e., brachytherapy.
Ablative or Focal Therapy
This is the use of cold, heat, and other methods to treat prostate cancer. They are a less-invasive treatment that is used to destroy small prostate tumors without treating the rest of the prostate gland.
Cryoablation or Cryotherapy: This is using a very cold gas to freeze cancer cells. It is done using a metal probe instrument inserted through a small incision in the area between the rectum and scrotum.
High-Intensity Focused Ultrasound (HIFU): This is a heat-type of focal therapy where concentrated ultrasound energy is used to heat the prostate tissue, causing them to die.
Hormonal Therapy
This is a treatment that uses medication to stop the production of the male hormonal androgen called testosterone. Since prostate cancer cells rely on the androgens to grow, blocking the supply of testosterone can cause these cancer cells to die or grow slowly. Also, in hormonal therapy, orchiectomy can be used to reduce the testosterone level in the body once the testicles have been removed.
Chemotherapy
This is the use of drugs to kill the abnormal cancer cells that rapidly grow in the prostate. It can be administered intravenously, in pill form, or both. It is a treatment option for prostate cancer that might have spread to another part of the body, or cancer cells that do not respond to hormonal therapy.
Immunotherapy
This is the use of the body’s natural immune system to fight cancer by improving the immune system’s ability to attack cancer cells. The body's disease-fighting immune system may not attack cancer because the cancer cells produce proteins that blind the immune system cells but immunotherapy works by interfering with that process.
Targeted Therapy
This treatment focuses on specific abnormalities that are present in the cancer cells. Through this therapeutic method, those abnormalities are blocked thus causing the cancer cells to die. Targeted therapy may be recommended to treat advanced or recurrent prostate cancer if hormonal therapy is not working.
