Kate Halim
Prostate cancer develops in a man’s prostate, the walnut-sized gland just below the bladder that produces some of the fluid in semen.
It’s the most common cancer in men after skin cancer. Prostate cancer often grows very slowly and may not cause significant harm. But some types are more aggressive and can spread quickly without treatment.
Symptoms of Prostate Cancer
According to Dr. Gabriel Omonaiye, in the early stages, some men may have no symptoms. But later, symptoms can include frequent urination, especially at night and difficulty starting or stopping urination. “Other symptoms are weak or interrupted urinary stream, painful or burning sensation during urination or ejaculation and blood in urine or semen.” Omonaiye added that advanced cancer can also cause deep pain in the lower back, hips, or upper thighs.
Enlarged Prostate or Prostate Cancer?
The prostate can grow larger as men age, sometimes pressing on the bladder or urethra and causing symptoms similar to prostate cancer. This is called benign prostatic hyperplasia (BPH). It’s not cancer and can be treated if symptoms become bothersome.
“A third problem that can cause urinary symptoms is prostatitis. This inflammation or infection may also cause a fever and in many cases is treated with medication, stated Omonaiye.”
Risk factors you can’t control
Growing older is the greatest risk factor for prostate cancer, particularly after age 50. After age 70, studies suggest that anywhere from 31% to 83% of men have some form of prostate cancer, though there may be no outward symptoms.
Family history increases a man’s risk: having a father or brother with prostate cancer more than doubles the risk.
Risk factors you can control
According to a Dietitian, Ifeoma Onyebuchi, diet seems to play a role in the development of prostate cancer, which is much more common in countries where meat and high-fat dairy are mainstays.
Onyebuchi said that dietary fat, particularly animal fat from red meat, may boost male hormone levels. And this may fuel the growth of cancerous prostate cells. A diet too low in fruits and vegetables may also play a role.
Myths about prostate cancer
Too much sex, a vasectomy, and masturbation doesn’t cause prostate cancer. If you have an enlarged prostate (BPH), that doesn’t mean you are at greater risk of developing prostate cancer.
Can prostate cancer be found early?
Screening tests are available to find prostate cancer early, but the tests may find cancers that are so slow-growing that medical treatments would offer no benefit. And the treatments themselves can have serious side effects.
According to Omonaiye, men should talk with a doctor about screening tests, beginning at age 50 for average-risk men who expect to live at least 10 more years, at age 45 for men at high risk; this includes those with a father, brother, or son diagnosed before age 65.
Screening test should also be carried out on men who are 40 with more than one first-degree relative diagnosed at an early age.
It is advised that men talk to their doctors to discuss the potential risks and benefits of being tested.
Screening: DRE and PSA
Your doctor may initially do a digital rectal exam (DRE) to feel for bumps or hard spots on the prostate. After a discussion with your doctor, a blood test can be used to measure prostate-specific antigen (PSA), a protein produced by prostate cells. An elevated level may indicate a higher chance that you have cancer, but you can have a high level and still be cancer-free. It is also possible to have a normal PSA and have prostate cancer.
PSA test results
A normal PSA level is considered to be under 4 nanograms per milliliter (ng/mL) of blood, while a PSA above 10 suggests a high risk of cancer. But there are some exceptions.
Men can have prostate cancer with a PSA less than 4. A prostate that is inflamed (prostatitis) or enlarged (BPH) can boost PSA levels, yet further testing may show no evidence of cancer. Some BPH drugs can lower PSA levels, despite the presence of prostate cancer, called a false negative. If either a PSA or DRE test are abnormal, your doctor will likely order other tests.
Prostate cancer biopsy
If a physical exam or PSA test suggests a problem, your doctor may recommend a biopsy. A needle is inserted either through the rectum wall or the skin between the rectum and scrotum. Multiple small tissue samples are removed and examined under a microscope. A biopsy is the best way to detect cancer and predict whether it is slow-growing or aggressive.
Biopsy and Gleason Score
A pathologist looks for cell abnormalities and grades the tissue sample from 1 to 5. The sum of two Gleason grades is the Gleason score. These scores help determine the chances of the cancer spreading.
Gleason grades of 1 and 2 are not usually given in biopsies, so 6 is typically the lowest score for a prostate cancer. Cancer with Gleason scores of 8 to 10 is called high-grade, and can grow and spread more quickly.
Gleason scores help guide the type of treatment your doctor will recommend.
Prostate cancer imaging
Some men may need additional tests to see if the cancer has spread beyond the prostate. These can include ultrasound, a CT scan, or an MRI scan. A radionuclide bone scan traces an injection of low-level radioactive material to help detect cancer that has spread to the bones.
Prostate cancer staging
Staging is used to describe how far prostate cancer has spread or metastasized and to help determine the best treatment.
Stage I: Cancer is small and still within the prostate.
Stage II: Cancer is more advanced, but still confined to the prostate.
Stage III: Cancer is a high grade or it has spread beyond the outer part of the prostate or into nearby tissues such as seminal vesicles, the bladder, or rectum.
Stage IV: Cancer has spread to lymph nodes or distant organs such as bones or lungs.
Prostate cancer survival rates
The good news about prostate cancer is that it usually grows slowly. And 9 out of 10 cases are found in the early stages.
Overall, the 5-year relative survival rate is 100% for men with disease confined to the prostate or nearby tissues, and many men live much longer. When the disease spread to distant areas, the figure drops to 29%.