Prostate Cancer: causes, symptoms, risks, and treatment

Prostate cancer occurs when normal cells in the prostate gland alter to form a mass of cancer cells, creating a tumour. How these cells react and affect the operation of the prostate, will differ for each individual. In some men the cells may grow very slowly and they may not develop symptoms from their prostate cancer.

For others the cancer cells will grow quickly, requiring treatment to kill the cells and prevent spread to other areas. The risk of developing prostate cancer rises with age.

It is most often diagnosed in the early stages, before it has begun to spread beyond the prostate gland.

In many cases prostate cancer can be cured or kept under control.

Doctors do not have a clear picture of what causes prostate cancer. It is known that prostate cancer starts when cells in the prostate undergo alterations in their DNA that prompt the cells to grow and divide more quickly than usual. The abnormal cells persist, whereas other cells would perish.

The cause of prostate cancer is unknown. But With that, there are some factors that might increase your risk of developing it.

• Age: Your risk increases as you get older. 60% of prostate cancer diagnosed in men over 65.
  
  
• Family history: Men whose brother or father developed prostate cancer at a young age have an increased risk.
  
  
• Race: African-American and African-Caribbean men are 70% more likely to develop prostate cancer than other ethnic groups.
  
  
• Diet: Men who eat a diet high in saturated fat and not enough green vegetables may have a raised risk of getting prostate cancer.
  
  
• A previous cancer: Men who have had other cancers in the past may have an increased risk of getting prostate cancer.

There are three stages of prostate cancer, determined by how large the tumour is and how far it has spread. By determining the stage the cancer is at doctors decide which treatment is most appropriate.

Tests and scans used to diagnose cancer give some information about the stage. Sometimes it’s not possible to determine the stage until after surgery.

Locally advanced prostate cancer is where the prostate cancer has spread through the prostate gland and into the surrounding tissues but has not yet spread to other parts of the body.

It may have spread into the:

• tissue around the prostate
• the tubes that carry semen (seminal vesicles)
• body organs nearby such as the back passage (rectum) or neck of the bladder
• lymph nodes close to the prostate gland

Treatment options will depend on how far the prostate cancer has spread.  Treatment may focus on eradicating the cancer or keeping it under control.

In the advanced prostate cancer stage, the cancer has spread from the prostate to other parts of the body, most commonly the lymph nodes or to the bones. In some cases it can also spread to other organs.

The cancer cells spread to other parts of the body through the bloodstream or lymphatic system.
It is not possible to cure advanced prostate cancer but there are treatments that can help control it.

Because early prostate cancer does not usually cause any symptoms, it is often identified through prostate cancer screening. This involves a doctor checking for the possibility of prostate cancer even when no symptoms are displayed. There isn't one specific, conclusive test for prostate cancer. Your doctor will go over the advantages and disadvantages of the different tests with you to help minimize unnecessary worry.

Men experiencing prostate urinary symptoms attending their doctor will initially undergo a general health exam and screening, where the doctor will enquire about the man’s general health, any symptoms and any family history of prostate cancer.

The first tests for assessing the prostate gland are the PSA blood test and a digital rectal examination.

In the early prostate cancer stage a prostate tumour may be so small it cannot be felt by the doctor during a digital rectal examination.

A raised PSA indicates that a man may have a problem with his prostate gland which merits investigation.  A high proportion of  men with a raised PSA who do proceed to prostate biopsy do not have prostate cancer.

Generally recommended for men whose prostate cancer may be caught early, contained or not causing symptoms. Men are monitored for changes in their cancer and tested regularly.

Uses high-energy X-rays aimed at a cancer to cure or control it.

There are two primary types of radiotherapy. External beam radiation and internal radiation (brachytherapy).

Prostate cancer depends on the male hormone testosterone to grow. By reducing the amount of testosterone via hormone therapy, the growth of cancer cells can be slowed or stopped.

Some men with advanced prostate cancer may be given chemotherapy in combination with hormone therapy.

Anti-cancer drugs designed to stop the growth of cancer cells are administered.

Radical Prostatectomy is the other option of definitive therapy next to Radiation therapy -- the choice is largely a matter of patient preference.

The options include open abdominal surgery and minimally invasive laparoscopic surgery (both performed “nerve sparing”) which is associated with a significantly lower rate of complications that would impact the patient’s quality of life.

The above techniques can also be performed as Robotic surgery.

Both Radiation therapy and Prostate surgery can have the undesired complications of urinary incontinence and erectile dysfunction.

Receiving a diagnosis of prostate cancer is shocking. It can be difficult to remember and understand all the information given by the doctor, or to know what questions to ask. Many men find it useful to ask the doctor to write down the information and record the details of biopsy results and treatment options for referring to another time.