WHAT IS PROSTATE CANCER?
Prostate cancer arises when some cells in the gland in the male reproductive system reproduce more quickly than normal, resulting in a tumor. Without treatment, such cells could migrate to other areas of the body, resulting in more tumors
Early detection of prostate cancer is vital, since treatment is far more challenging if the cancer migrates from the prostate. However, when cancer is limited to the prostate, its progression can be halted via treatment. Indeed, early detection and treatment can bring a 97 per cent success rate.
Unfortunately, the majority of prostate cancers arise without men having any symptoms. That’s why regular testing is important, even in younger men who may be statistically less likely to get prostate cancer.
WHO’S AT RISK OF GETTING PROSTATE CANCER?
One out of every six men in the United States will be diagnosed with prostate cancer at some point in their life. Indeed, prostate cancer is the most diagnosed cancer in men aside from skin cancer. Annually, nearly 30,000 U.S. men will die of prostate cancer, and nearly a quarter of a million new diagnoses will be made, according to the National Cancer Institute (NCI).
Though widely considered an “old man’s disease,” prostate cancer can arise in young men as well. About 3% of diagnoses are for men under 50 years old, and many men in their 50s are diagnosed. Still, the older the man, the more likely he’ll get prostate cancer.
Such likelihood doubles if a man has a brother or father who had prostate cancer prior to the age of 60. Also, African Americans are 2.5 times more likely to get prostate cancer. And all men who lack proper exercise and diet run a greater risk.
WHAT ARE PROSTATE CANCER SYMPTOMS?
Most prostate cancer lacks symptoms, particularly in its early stages. But advanced prostate cancer — especially when it’s migrated beyond the prostate gland — may be evident via urinary tract symptoms.
These include trouble beginning urine’s flow; a slow urine flow; need to urinate often or during nighttime hours; blood in urine or semen; and pain during ejaculation. However, while such symptoms may be indicative of prostate cancer, they also may stem from problems other than prostate cancer. Only testing can reveal the truth.
WHAT ARE PROSTATE CANCER TESTS?
Prostate cancer testing need not be limited to men who experience symptoms, but rather can be performed for any man who has risk factors. And, of course, simply being a male is a risk factor, since around 16 per cent of all men will be diagnosed with prostate cancer at some point in their lives.
However, not all men may need to be tested. A man should discuss testing and testing options with his physician.
The American Cancer Society (ACS) advises that, while early diagnosis can be a life-saver, “all prostate cancers are not the same” and many grow slowly and “do not cause any harm.”
The ACS said today’s tests often can’t distinguish between slow- and fast-growing cancers, resulting in some men with slow-growing cancers getting treatments they don’t need.
The ACS also says tests may give false diagnoses. Therefore, men “should make an informed decision” about whether or not to be tested.
The two principal tests for detecting prostate cancer early are a Prostate Specific Antigen (PSA) blood test and a Digital Rectal Exam (DRE).
A PSA test assesses the level of a protein produced by prostate cells — a protein which, when elevated, could signify prostate cancer exists in the gland. However, an inflamed or enlarged prostate also can produce elevated levels, so such levels don’t necessarily indicate the existence of prostate cancer.
A DRE test involves a physician placing a gloved finger in the anus to feel the prostate’s surface and note any lumps, hardening or swelling which may signify a cancer tumor. Such a test is incomplete, since the physician can’t feel the entire surface of the prostate gland.
When such tests reveal abnormalities, a biopsy may be ordered to determine if cancer does exist in the prostate. A specialist such as a urologist will conduct the biopsy, using a needle to remove tissue from the gland to assess whether cancer cells are present. If they are, the specialist can study the cells to determine the severity of the cancer and to plan treatment.
WHAT ARE PROSTATE CANCER TREATMENTS?
For men diagnosed accurately with prostate cancer, numerous treatments are available. You should learn about these treatments, get a second opinion and make a carefully considered decision on your treatment options.
Also consulted and part of the process should be a man’s partner, since prostate cancer treatments can cause such things as erectile dysfunction (trouble achieving and sustaining an erection) and incontinence (involuntary leaking of urine).
Most forms of prostate cancer are slow-growing and can be overcome without surgery or other invasive treatments. For many men with low-grade prostate cancer, the regular monitoring known as “active surveillance” may suffice. That means checking the cancer often and not launching treatment unless it gets worse.
Indeed, numerous males who are diagnosed with early-stage prostate cancer could choose active surveillance and live as long as men who have immediate surgery, according to a clinical trial published in the New England Journal of Medicine in 2012, as cited by the NCI. The important thing is for men to consult their physician and decide what’s best for them.
Beside active surveillance, such treatments can include radiation therapy, in which the radiation of x-rays are used to destroy cancer cells. Several different forms of radiation therapy are available, the most common being external beam radiation therapy, an outpatient process whereby brief beams of x-rays are directed into the prostate daily for a week or for several weeks.
Beyond radiation, another treatment is hormone therapy, also called ADT, or androgen-deprivation therapy. By this means, testosterone’s released is halted so that the hormone can’t provide fuel for the growth of prostate cancer cells. Men with local treatment as well as advanced treatment may use this approach.
However, not all prostate cancer cells may be affected by this approach, which is not curative.
One alternative is chemotherapy, which applies chemicals in drugs to destroy cancer cells or stop their growth. However, this can be arduous for the body to endure. Another option is cryosurgery or cryotherapy, which can treat early-stage prostate cancer by freezing it. the ACS says this isn’t a good option for men with large prostate glands.
Another treatment is a prostatectomy, which means surgically removing the entire prostate gland, or a part of it. This usually is done for men with cancer that’s still limited to the prostate or in an early stage. For men with advanced or recurring prostate cancer, alternative surgical procedures may be needed.