What is Prostate Cancer?

Cancer is a disease in which cells in the body grow out of control. When cancer starts in the prostate, it is called prostate cancer. 

What Is the Prostate?

The prostate is a part of the male reproductive system, which includes the penis, prostate, and testicles. The prostate is located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). It produces fluid that makes up a part of semen. As a man ages, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow. This is called benign prostatic hyperplasia, and it is not the same as prostate cancer. Men may also have other prostate changes that are not cancer.

What Are the Risk Factors?

Research has found risk factors that increase your chances of getting prostate cancer. These risk factors include:

  1. Age: The older a man is, the greater his risk of getting prostate cancer.
  2. Family history: Certain genes (the functional and physical units of heredity passed from parent to offspring) that you inherited from your parents may affect your prostate cancer risk. Currently, no single gene is sure to raise or lower your risk of getting prostate cancer. However, a man with a father, brother, or son who has had prostate cancer is two to three times more likely to develop the disease himself.
  3. Race: Prostate cancer is more common in some racial and ethnic groups than in others, but medical experts do not know why. Researchers are trying to determine the causes of prostate cancer and whether it can be prevented. They do not yet agree on the factors that can influence a man’s risk of developing the disease, either positively or negatively.
  4. Some drugs lower the risk of getting prostate cancer, but whether they can help lower the risk of dying from prostate cancer is still unclear. Regular use of multivitamins has not been proven to increase or decrease the risk of early or localized prostate cancer. Talk to your doctor about multivitamin use.

What Are the Symptoms of Prostate Cancer?

Different people have different symptoms of prostate cancer. Some men do not have symptoms at all. Some symptoms of prostate cancer are:

  1. Difficulty starting urination.The weak or interrupted flow of urine.
  2. Frequent urination, especially at night.
  3. Difficulty emptying the bladder completely.
  4. Pain or burning during urination. Blood in the urine or semen.
  5. Pain in the back, hips, or pelvis that doesn’t go away.
  6. Painful ejaculation. If you have any symptoms that worry you, be sure to see your doctor right away. 

Keep in mind that these symptoms may be caused by conditions other than prostate cancer.

Should I get screened for Cancer Prostate? Informed Decision Making - Most urologists support informed decision making. Informed decision making occurs when a man:

  1. Understands the nature and risk of prostate cancer.
  2. Understands the risks of, benefits of, and alternatives to screening.
  3. Participates in the decision to be screened or not at a level he desires.
  4. Makes a decision consistent with his preferences and values. We need better ways to screen for and treat prostate cancer. 

Until we make these discoveries, and even when we do, men and their families will turn to trusted health care professionals to help them make informed decisions.

How Is Prostate Cancer Diagnosed?

If your prostate-specific antigen (PSA) test or digital rectal exam (DRE) is abnormal, doctors may do more tests to find or diagnose prostate cancer. 

  • Transrectal ultrasound: A probe the size of a finger is inserted into the rectum, and high-energy sound waves (ultrasound) are bounced off the prostate to create a picture of the prostate called a sonogram. This test may be used during a biopsy.
  • Biopsy: A small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells.
  • Gleason score: This score is determined when the biopsy is looked at under the microscope. If there is cancer, the score indicates how likely it is to spread. The score ranges from 2–10. The lower the score, the less likely it is that cancer will spread.

Staging: If prostate cancer is diagnosed, other tests are done to find out if cancer cells have spread within the prostate or to other parts of the body. This process is called staging. Whether the cancer is only in the prostate, or has spread outside the prostate, determines your stage of prostate cancer. The stage of prostate cancer tells doctors what kind of treatment you need.

How Is Prostate Cancer Treated?

Different types of treatment are available for prostate cancer. You and your doctor will decide which treatment is right for you. 

Some common treatments are:

  1. Active surveillance - Closely monitoring prostate cancer by performing prostate-specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms.
  2. Surgery - A prostatectomy is an operation where doctors remove the prostate. Radical prostatectomy removes the prostate as well as the surrounding tissue. 
  3. Radiation therapy - Using high-energy rays (similar to X-rays) to kill the cancer. There are two types of radiation therapy—External radiation therapy. A machine outside the body directs radiation at the cancer cells or Internal radiation therapy (brachytherapy). Radioactive seeds or pellets are surgically placed into or near the cancer to destroy the cancer cells. Brachytherapy is not available in India
  4. Hormone therapy - Blocks cancer cells from getting the hormones they need to grow.Other therapies used in the treatment of prostate cancer that is still under investigation include
  5. Cryotherapy - Placing a special probe inside or near the prostate cancer to freeze and kill the cancer cells. Not available in India.
  6. Chemotherapy - Using special drugs to shrink or kill the cancer. The drugs can be pills you take or medicines given through your veins, or, sometimes, both.
  7. Biological therapy - Works with your body's immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments.
  8. High-intensity focused ultrasound. This therapy directs high-energy sound waves (ultrasound) at cancer to kill cancer cells.
  9. Many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. 

Talk to your doctor before you start any kind of complementary or alternative medicine.

Which Treatment Is Right For Me? Choosing the treatment that is right for you may be hard. Talk to your cancer doctor about the treatment options available for your type and stage of cancer. Your doctor can explain the risks and benefits of each treatment and their side effects. Sometimes people get an opinion from more than one cancer doctor. This is called a “second opinion.” Getting a second opinion may help you choose the treatment that is right for you.