What is Prostate Cancer?
Prostate cancer is a disease affecting the male gland, it occurs when cells multiply and manifest into cancerous tissue.
It’s a disease which can be influenced by age, genetics or ethnic origin. Even your diet or weight has shown an indication towards contracting prostate cancer. (1)
Prostate cancer is the second most common form of cancer found in men in the United States. It’s estimated about one in nine men will be diagnosed with this condition during their lifetime. (2)
Symptoms
The prostate gland is a male organ which produces some of the fluid found in the semen. It is located behind the rectum, just under the bladder.
There are actually five types of prostate cancer which include: sarcomas, small cell carcinomas, neuroendocrine tumors, transitional cell carcinomas and adenocarcinomas.
Adenocarcinomas are the most common type of prostate cancer. The others only occur in rare cases. (3)
In cases of adenocarcinomas the cancer forms in the gland cells, which are what produce prostate fluid.
Prostate cancer is not aggressive which means its slow growing and doesn’t spread as fast as other types. In fact many men go years without even knowing they have the disease. (4)
The prostate has two types of possible precancerous conditions: prostatic intraepithelial neoplasia (PIN) and proliferative inflammatory atrophy (PIA).
PIN is where small changes are visible through a microscope of the prostate cells. It’s classified as low and high-grade. If you have high-grade PIN there’s a 20 percent chance you might have prostate cancer. (5)
PIA is when the cells are abnormally small and the area looks to be inflamed. This can lead to high-grade PIN or directly to prostate cancer.
However, it is not completely understood how they actually lead to the disease. (6)
Prostate cancer could be described as a silent condition, this is because symptoms during the early stages don’t tend to present themselves. It’s not until the disease has progressed do you start to encounter the telltale warning signs:
Urinary Symptoms
Most men affected by prostate cancer have issues with their waterworks. (7)
Problems urinating can show as a weak or slow flow of urine which can be troublesome to start off. Yet it can also give off a sense of urgency to ‘go’, especially during the night.
However, this can also be a sign of another condition known as urinary hesitancy, which occurs mainly in older men as their prostate becomes enlarged. (8)
Blood in Fluids
Blood in the urine or semen are clear signs the issue is in need of investigation.
It can be a indicator a tumor in the prostate. It could also be a clue of an infection or maybe even an STD. Either way blood in urine or other bodily fluids should not be taken lightly.
Erectile Dysfunction (ED)
ED makes it difficult for a man to achieve or sustain an erection.
It’s a normal part of ageing for men, but it could also be a sign of other conditions such as low testosterone levels, diabetes or even chronic kidney disease. (9)
It can happen to men affected by prostate cancer, both as a symptom and as a side effect of treatment. (10)
Painful Bones
If pain is experienced in the surrounding areas of the prostate it could mean the cancer has advanced into the bones. (11)
Weakness or Numbness
Any kind of weakness or tingling sensation which suddenly appears in the lower limbs or even causes a loss of bowel or bladder control, could be a hallmark sign that cancer is interfering with the spinal cord. (12)
Stages
Staging of cancer is an important part of finding the right treatment for you. Cancer is not analyzed in this manner to see how it progresses, it’s to determine severity and how far the cancer has grown in the body. (13)
Doctors determine the stage of prostate cancer by analyzing different test results about the extent of the main tumor, whether it has reached lymph nodes or if it has spread to other organs.
They will also test the level of prostate-specific antigen (PSA) in the blood and look at results from a gleason score test, which shows how aggressive the cancer is. It is rated from grade one to five, the higher the score the more aggressive the cancer is. (14)
With a combination of these results the cancer is ranked in the stages mentioned below. (15)
Stage I
During this stage the cancer has not spread and is still confined to one or both sides of the prostate.
It can be diagnosed through a biopsy or by having the prostate removed. The cancer is still in grade group one with a PSA level less than 10, which means it is not aggressive.
Stage IIA
The cancer is still a grade group one, but the PSA level is more than 10 but still under 20, so the cells are growing faster.
The tumor may or may not be felt during a digital rectal exam, but is diagnosed through a biopsy or by having the prostate removed.
Stage IIB
The cancer has now moved to grade group two, still with a PSA level of more than 10. However, as of yet not spread further to either lymph nodes or other body parts.
Stage IIC
The cancer is getting more aggressive and is now a grade group three or four with a PSA level less than 20. However, it is still confined to the prostate and hasn’t started to spread.
Stage IIIA
In this stage the cancer is still only in the prostate, within grade group one to four, but the PSA level is now 20 or more. The tumor is still small and so cannot be felt.
Stage IIIB
The cancer has now grown out of the prostate. It may also be present in the seminal vesicles or in other tissues like the muscle which controls urination, the rectum or the pelvis wall.
It has not spread to the lymph nodes yet, although PSA levels can be any rating, it’s still within grade group one to four.
Stage IIIC
In this stage the grade group is now five, however the cancer may or may not have outgrown the prostate. It still hasn’t spread any further into the body.
Stage IVA
The cancer has now spread to nearby lymph nodes and maybe into other nearby tissues, but has not gone any further into the body.
In the last stages the grade group and PSA levels can be of any value.
Stage IVB
At this stage the cancer could have spread to nearby tissues or lymph nodes. It has now also spread to other body parts such as bones, distant lymph nodes or other organs.
This is the most advanced stage of prostate cancer.
Treatment
There are various different treatments available for prostate cancer, in some cases treatment will be known as “watchful waiting” and “active surveillance”. This is generally only in cases where the cancer is in the early stages of older men. (16)
Other treatments include:
Surgery
Surgery is performed if it hasn’t spread beyond the gland. (17)
In these cases the prostate is likely removed and nearby lymph nodes are examined for cancer cells. However, if cancer has spread the prostate won’t be removed.
Radiation Therapy
Radiation therapy uses high-energy x-rays to kill the cancer cells. It can be used as a cure for low-grade cancer.
This type of treatment can be done externally or internally, where small beads are placed in the specific area. (18)
Cryotherapy
This kind of treatment freezes and kills the cancer cells within the prostate by inserting a long needle which passes cold gas to the area. It’s usually used if the cancer is in earlier stages.
However, if the man has large prostate glands doctors generally avoid this treatment. (19)
Hormone Therapy
Hormone therapy works to reduce the male hormones in the body. It has shown to slow down the growth of the cancer cells, but it does not cure the cancer. (20)
Chemotherapy
This treatment includes anti-cancer drugs which are injected into a vein or through the mouth. Chemotherapy is not commonly used in early stages of prostate cancer and is usually applied when hormone therapy fails to work.
Vaccine Treatment
This uses a cancer vaccine called sipuleucel-T (Provenge) which works to boost the immune system to help fight the cancer.
It is custom made for each man where doctors collect white blood cells to create the vaccine. (21)
Although this is not a cure, it has shown to help men with advanced stages of prostate cancer prolong their life expectancy.
These are general treatments of prostate cancer, if the cancer spreads other treatments may be applied.
FAQ
What is prostate cancer? It’s a type of cancer which develops in the prostate gland when the cells start to grow uncontrollably.
What are the signs of prostate cancer? Signs of prostate cancer can include: urinary issues, blood in either urine or semen, erectile dysfunction or weakness in limbs.
How do you develop prostate cancer? The exact causes are unknown, but belief is based around changes to cell structure within the prostate. Other reasons which could increase chances of developing the condition include: family history, ethnic background, age or even where you come from. (22)
How are you diagnosed for prostate cancer? A doctor will ask you about your medical history and perform a physical examination. Afterwards he/she will do a PSA blood test to see if the levels raise concern. Next will be a transrectal ultrasound (TRUS), followed by a prostate biopsy to determine which stage the cancer is at. (23)
What is the best treatment for prostate cancer? Treatment will be best determined depending upon which stage you are at. Your specialist will work out the best plan for you.
What are the long term complications of prostate cancer? Treatments of prostate cancer for example chemotherapy can be notorious for side effects. Others can lead to erectile dysfunction or urinary dysfunctions like incontinence.
Is prostate cancer considered a disability? It’s not considered a disability, but some cases can qualify for disability benefits.
Is there a cure for prostate cancer? Providing the disease is caught early enough the success rate of overcoming prostate cancer is considered to be very high. However, it does still lead to a number of deaths every year. (24, 25)
Is prostate cancer life threatening? Yes it can be if the cancer is in advanced stages and treatment has failed to work.
Summary
Prostate cancer can be described as abnormal cell growth within the prostate gland.
It’s a common type of cancer among men which grows slowly and doesn’t spread as easily as other types of cancers might would, yet it’s still crucial to be aware of the symptoms.
However, no matter how embarrassing it may seem to go and get checked out, early diagnosis will provide you with the best possible chance of recovery.