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Prostate Cancer: Causes, Diagnosis, Treatment and Prevention

Prostate cancer (a.k.a: prostatic carcinoma) is the second most common cancer in men.  Sometimes, it progresses very slowly and do not show any symptoms for years. Therefore, routine screening is necessary to detect prostate cancer in early stages.

What is Prostate Cancer?

In prostate cancer, cancer arises in the prostate gland. Prostate gland is located below bladder and in front of the rectum. It is an essential organ of male reproductive system. It secretes the seminal fluid (liquid in semen), that is necessary for survival and transportation of sperm. It also controls urine.

Prostate Cancer

What Causes Prostate Cancer?

Prostate cancer may occur due to mutations in the DNA of prostate cells. These mutations lead to uncontrollable growth resulting in formation of mass of cells caller tumor. These cancerous cells can invade nearby tissues or invade distant parts (metastasis).

Prostate Cancer Symptoms:

Usually early stages of prostate cancer do not have any symptoms, unless the cancer is located near the urethra (urinary tube), if the cancer grows near the urinary tube, it compresses the tube affecting normal urination. Symptoms of prostate cancer include:

  • Frequent urination
  • Painful or burning micturition
  • Decreased urine flow
  • Blood in the urine or semen
  • Urinary incontinence
  • Pain during ejaculation
  • Erectile dysfunction
  • Back pain
  • Bone pain (later stages)

Risk Factors:

There are few factors which can contribute to the growth of prostate cancer. The risk factors of prostate cancer are:

  • Men with age above 40 years
  • Family history of prostate cancer
  • Consuming diet with poor nutrition
  • Obesity
  • History of coronary artery disease
  • High cholesterol levels
  • Men with increased height > 6’ 2”
  • High intake of calcium
  • Decreased zinc levels in the body

Prostate Cancer Complications:

Prostate cancer and its treatment affect the reproductive capacity in men. Decreased semen production and erectile dysfunction are the common problems.

Diagnosis:

The healthcare provider performs a physical examination initially. Digital rectal exam can be performed by inserting gloved and lubricated finger into the rectum to examine prostate.

  1. Blood tests such as prostate-specific antigen (PSA) test can be recommended. PSA is produced by prostate gland and high levels may indicate cancer. But it may also other abnormalities of prostate such as benign prostatic hyperplasia (BPH).
  2. Imaging tests such as ultrasound is performed by inserting a probe into the rectum. This test helps to visualize the prostate gland and detect changes in it. Positron emission tomography (PET) scan is performed if metastasis is suspected. This test helps to identify spread of cancer to other organs.
  3. Biopsy also helps to confirm the diagnosis of prostate cancer. A sample of tissue is obtained with the help of a needle from the affected site. The cells are examined under the microscope to detect the malignancy.

Gleason score is given observing the biopsy of the sample. The sample is compared with normal tissue. Based on the histologic patterns in the patient cells, Gleason score is determined.

Pattern 1: Small and uniform glands

Pattern 2: More space between glands

Pattern 3: Infiltration of cells from glands

Pattern 4: Irregular masses of cancerous cells with few glands

Pattern 5: Lack of or occasional glands, sheets of cells

Grading of the prostate cancer based on Gleason score:

Grade 1: Gleason score ≤6; well differentiated and less aggressive

Grade 2: Gleason score 7; moderately differentiated and more aggressive than grade 1

Grade 3: Gleason score 8 – 10; poorly differentiated and aggressive

Prostate Cancer Treatments:

The treatment of prostate cancer depends on factors like the overall health of the patient, the extent of spread of the cancer and the speed at which the cancer is growing.

Treatment Options for Prostate Cancer Include:

Surgery: Surgery performed to remove prostate is called radical prostatectomy. In this procedure, prostate gland, surrounding tissue, and lymph nodes are removed. This procedure can be done manually or by robots. Robotic surgery is considered safe and effective when compared manual surgery.

Radiation therapy: High energy X-rays are directed towards the tumor to kill the cancer cells or interrupt with their growth. Linear accelerators are the machines used mostly for radiation therapy.

Brachytherapy: it is a type of radiation therapy. In this procedure, radioactive materials are inserted into the prostate gland. These materials exert low energy radiation gradually destroying the affected prostate tissue.

Stereotactic radiation therapy: High energy beams are targeted towards the tumor without any incision. It is highly advanced radiation therapy.

Cryosurgery: Extreme cold is used to freeze the cancer cells and destroy them. Liquid nitrogen, carbon dioxide, or argon can be used to freeze the cells.

Hormone therapy: This therapy is also called androgen deprivation therapy (ADT) or androgen suppression therapy (AST). Use of antiandrogens decreases testosterone levels in the body. Testosterone is necessary for growth of prostate cells. Therefore, deprivation of testosterone hormone can reduce the growth of tumor.

Chemotherapy: Medications are given orally or intravenously to interfere with the growth of cancer cells.

Immunotherapy: Medications are given to boost the immune system that helps in fighting against the cancer.

Prevention and Cure for Prostate Cancer:

Measures that help in prevention and cure of prostate cancer are:

  • Consume low-fat diet.
  • Increase the dietary intake of fruits and vegetables.
  • Eat fish as it contains omega-3 fatty acids.
  • Limit intake of dairy products or foods rich in calcium.
  • Avoid processed and canned foods.
  • Maintain normal weight.
  • Perform regular physical activity, at least 30 minutes per day.
  • Quit smoking.
  • Take vitamin and mineral supplements as recommended by healthcare provider.

FAQs:

1. Does prostate cancer spread to the brain.

Prostate cancer may spread to the brain. However, it is very rare.

2. Does prostate cancer cause fatigue?

Yes, prostate cancer may cause fatigue due to pain, stress, and anxiety experienced by the patient.

3. What are the side effects of hormone therapy for prostate cancer?

The side effects of hormone therapy for prostate cancer are libido (loss of interest in sex), insulin resistance, loss of muscle mass, and decreased muscle strength.

4. Can you ever be cured of prostate cancer?

Most of the prostate cancers are detected at early stages. Therefore, cure and survival rates are high. However, there is no permanent cure for this disease.

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