Cancer is a dreadful condition to suffer from. It does not discriminate between individuals, however well you have led your life.
There has been a wealth of research published that describes the various types of cancer and the newer treatments that are currently available. However, the primary focus these days is early detection and even prevention. Cancer research groups are many, and are all involved in reaching a common goal – having a cancer free world.
Among the common cancers in the general public, prostate cancer remains the most common type of cancer in men. In this article, we shall take a look at this problem and what can be done to treat and prevent the problem.
What is Cancer?
Cancer is basically the overgrowth of unhealthy cells. It can affect any part of the body, though the prostate, breast, colon and lung are commonly involved. Cancer can occur in one part of the body, and can go on to spread to other parts.
There are a number of reasons for cancer to develop. I will not go into too much detail about that here, but later in the article we shall look at the reason why prostate cancer develops.
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The Prostate Gland:
The prostate gland is a walnut shaped gland that is present at the base of the urinary bladder in men. It serves the purpose of releasing secretions required to keep semen healthy, thus helping in reproduction.
After a particular age, the prostate begins to enlarge in men. While this is a normal phenomenon, sometimes the enlargement may not be just age related. It could be due to prostate cancer.
In the early stages, prostate cancer may be difficult to differentiate from age related enlargement. However, the rapid rate of growth, the spread of the cancer and certain tests can differentiate between the two and help reach a diagnosis fast.
In other words, the earlier it is detected, the better it can be treated.
What Causes Prostate Cancer?
The reason why prostate cancer occurs is still poorly understood. It is believed that it occurs due to changes in the basic structure of the cells within the prostate gland. This change is called mutation.
When a mutation occurs within a cell, it begins to divide and multiply in an uncontrolled manner. The rapid increase in the number of cells is accompanied by an increase in the size of the gland.
Not only this, the unhealthy ‘bad’ cells can outgrow the healthy ‘good’ cells. The good cells die eventually, while the bad cells keep growing and increasing in number.
But these bad cells don’t just like to stay confined to the prostate. As they grow more and more, they can break away and spread to nearby structured through the blood. This is called metastasis.
There is a higher chance of prostate cancer in older men. It appears to be more prevalent in the African-American population group, though it is also seen in Indian men (less commonly).
Those who have a family history of prostate cancer or any other cancer for that matter are at a greater risk of this problem. Being overweight is also a risk factor.
Unfortunately, a large number of men who have prostate cancer have no idea about it until they get a routine test done.
Those who do have symptoms often have advanced disease. A common symptom seen is difficulty passing urine.
Another symptom is trouble beginning a urinary stream. Men may stand for a few minutes in front of a toilet in an attempt to pass urine. When the stream does start, it might be thin and have low flow velocity.
Occasionally, men with prostate cancer may notice blood in the semen. Blood in the urine may be seen though this is less common.
Prostate cancer usually spreads to the bone. This means that in advanced disease, patients may experience hip pain or back pain. In other words, bone pain in someone with suspected prostate cancer is indicative of advanced disease.
Some men may experience problems achieving and sustaining an erection. This is called erective dysfunction.
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A diagnosis of prostate cancer is usually made during a routine health check-up. As I mentioned earlier, many men do not experience any symptoms at all. However, there is no clear guideline as to whether we should be screening patients routinely for this problem.
As most patients who develop prostate cancer are above the age of 50 years, screening may be of some value. Speak to your doctor about whether it is necessary.
The best initial test to diagnose prostate cancer is an ultrasound scan of the prostate. This is a painless test which will detect how large the prostate is and whether it is placing any pressure on the urinary bladder.
If a large prostate is determined, the next step is to get a blood test called prostate specific antigen, or PSA. If the value of this test is greatly elevated, it could indicate prostate cancer. This would prompt further investigation.
If prostate cancer is suspected, then the best doctor to see would be a urologist. They would perform a test called ‘digital rectal examination’, where a gloved finger is inserted through the anus to feel the prostate. This test is only slightly uncomfortable but provides a wealth of information to the doctor.
To confirm a diagnosis of prostate cancer, a biopsy is needed. This is where a small piece of prostate tissue is removed and analysed by a pathologist under a microscope. Certain characteristic changes can be seen which are typical if there is prostate cancer.
Staging of the cancer and determining how aggressive it is also determined through biopsy.
Once a diagnosis is made, treatment is begun.
If it is believed that prostate cancer has spread, then additional investigations such as CT scans and bone scans may be conducted to determine if the cancer has spread.
Treatment of Prostate Cancer:
In the early stages of prostate cancer, no treatment may be needed. Some people will just be monitored by their doctor and their PSA levels will be checked frequently. A biopsy may also be repeated.
This process of regular follow up is called active surveillance. However, not many doctors prefer to just wait and watch, and instead opt to being treatment.
The treatment of prostate cancer is through radiation and surgery. Surgery involves removal of the entire prostate gland and some surrounding tissues. This ensures that all the prostate gland is removed, and no unhealthy cancer cells are left behind.
Removal of the prostate gland could lead to urinary incontinence and trouble achieving erections.
Once surgery is done, some patients require radiation therapy. The type of therapy and the duration of treatment will be decided by the treating cancer specialist.
Finally, some patients may even need hormone therapy. This is a way to stop excessive testosterone production which would normally help prostate cells grow. Sometimes, hormone therapy may be given before radiation therapy to shrink the prostate gland.
Other therapies that are available are chemotherapy and biological therapies. The former involves the use of powerful medicines, while the latter involves using immune cells.
Preventing Prostate Cancer:
The best way to prevent prostate cancer (or any cancer for that matter) is to follow a healthy lifestyle. Eat a diet that is rich in fresh fruits and veggies. Make sure you exercise on a regular basis. Keep a healthy body weight this way.
Speak to your doctor about your risk and whether you need testing.
Prostate cancer is the most common type of cancer in men. Advances in the medical field mean that many patients can be cured of the problem. Speak to doctor today about getting yourself tested.