Are you aware of prostate cancer? Let's talk about it!

Have you ever heard of prostate cancer ? Maybe you have heard a friend or relative talk about it. This is a disease that only affects men and requires some attention. But don't worry, once you know about it, a lot of things will become clear. Let's talk about it in detail, very simply. The prostate is a small gland that only men have. To be precise, it is about the size of a small walnut. It is located below the bladder, in front of the anus. It secretes a secretion that combines with sperm and helps keep the sperm healthy to conceive a child. So, when the cells in this prostate gland start to grow abnormally and uncontrollably, we call it prostate cancer. This is a rather serious disease. It can also be seen more commonly among men. Just think, about 13 out of 100 men will develop this condition at some point in their lives. But the good news is that in most cases it can be detected before it spreads beyond the prostate gland . If treated early, the cancer can be completely cured. However, in some cases, it can also cause death. For example, in the United States alone, nearly 35,000 people die from it every year.

What are the types of prostate cancer?

If you are diagnosed with prostate cancer, it is most likely a type of adenocarcinoma. Adenocarcinoma is a type of cancer that starts in the cells of glands that secrete substances, such as your prostate. Very rarely, prostate cancer develops from other cell types. There are other rare types:

• Small cell carcinomas
• Transitional cell carcinomas
• Neuroendocrine tumors
• Sarcomas

What are the symptoms of prostate cancer?

In the early stages, prostate cancer often has very few symptoms. This means that you may not notice any changes at first. However, as the cancer progresses, you may start to notice some changes. If you have any of these symptoms, it is important to see a doctor for advice :

• Frequent, sometimes urgent, need to urinate , especially at night .
• Weak urine stream, or urine that starts to flow and then stops.
• Feeling pain or burning when urinating (we call this dysuria ).
• Inability to control urination (this is called urinary incontinence).
• Inability to control bowel movements (fecal incontinence).
• Pain during ejaculation and sexual dysfunction ( erectile dysfunction - ED).
• Seeing blood in the semen or urine .
• Pain in your lower back, hips, or chest.

What are the causes of prostate cancer?

In fact, experts still don't know exactly how prostate cells become cancerous. Like any cancer, prostate cancer starts when cells start dividing faster than normal. Just think, normal cells in our bodies die after a while. But cancer cells don't die that way . Instead, they keep multiplying and forming a tumor. As these cells continue to divide, pieces of the tumor can break off and spread to other parts of the body (this is called metastasis). Fortunately, prostate cancer usually grows slowly . Most of the time, these tumors are detected before the cancer has spread outside the prostate gland. At that point, prostate cancer has a much better chance of being cured.

Who is most at risk for this? (Risk factors)

There are several main risk factors that contribute to the development of prostate cancer:

• Age : This risk increases as you get older. If you are over 50, you are more likely to be diagnosed with this disease. About 60% of prostate cancers occur in men over 65.
• Race and ethnicity : If you are black or of African descent, your risk is higher. This is especially true for aggressive cancers that spread quickly and cancers diagnosed before age 50.
• Family history of prostate cancer : If someone in your immediate family (such as a father or brother) has had the disease, your chances of developing it increase by two to three times.
• Genetics : If you have a condition called Lynch syndrome, or if you have inherited gene mutations (BRCA1 and BRCA2) that increase the risk of breast cancer, your risk is higher.

Some studies have identified several other risk factors, but the evidence is not yet conclusive. Other possible factors include:

• Smoking.
• Inflammation of the prostate gland (prostatitis).
• Body mass index (BMI) greater than 30 (which means obesity).
• Sexually transmitted infections (STIs).
• Exposure to Agent Orange (a chemical used during the Vietnam War).

How do doctors diagnose this disease?

Doctors use several tests to diagnose prostate cancer. These include physical exams, scans, and sometimes a biopsy . Most people start getting screening tests around age 55. However, if you are at high risk, you can start getting these tests earlier. These tests are usually stopped after age 70. If these test results show anything unusual, you may need more tests. However, if your doctor thinks the cancer is slow-growing and not causing any major problems, he or she may wait a while before doing more tests. However, if the cancer is growing rapidly or has spread outside the prostate, a biopsy is definitely needed to confirm the diagnosis .

What tests are used?

These screening tests will help you decide if you need further testing:

• Digital Rectal Exam (DRE) : In this test, your doctor inserts a gloved, lubricated finger into your rectum and feels your prostate gland. If there are any lumps or hard areas, it could be a sign of cancer.
• Prostate-Specific Antigen (PSA) blood test : The prostate gland produces a protein called prostate-specific antigen (PSA). An elevated PSA level in the blood can be a sign of cancer. However, PSA levels can also be elevated in other non-cancerous conditions, such as benign prostate hyperplasia (BPH) or prostatitis. Therefore, an elevated PSA does not always mean cancer .
• Imaging : An MRI or transrectal ultrasound can take pictures of your prostate. These pictures can identify areas that may be suspicious for cancer. The results of these imaging tests can help your doctor decide whether to do a biopsy.
• Biopsy : In this test, the doctor uses a small needle to remove a sample of tissue from the prostate gland and examine it for cancer cells. This is the only way to definitively confirm whether you have prostate cancer.. It can also tell how severe the cancer is and how fast it is spreading. Sometimes this sample is subjected to genetic testing to help plan treatment.

What are the grades and stages of prostate cancer?

Doctors use things like Gleason score and cancer staging to determine how serious the cancer is and what treatment you need.

What is the Gleason Score?

The Gleason score allows your doctor to classify how abnormal your cancer cells are. The more abnormal the cells, the higher the Gleason score. This score determines the grade of the cancer, or how quickly it is likely to spread.

Staging of cancer

Cancer staging allows your doctor to determine how far your cancer has grown or spread. The cancer may be confined to the prostate gland (local), have invaded nearby tissues (regional), or have spread to other organs (metastasized). Prostate cancer most commonly spreads to the bones and lymph nodes . It can also grow in the liver, brain, lungs, and other organs.

How is prostate cancer treated?

Your treatment depends on several factors. These include your overall health, whether the cancer has spread, and how quickly it is spreading. Depending on your treatment, you may need to work with a variety of specialists (for example, urologists, radiation oncologists, and medical oncologists) . Most prostate cancers that are detected early can be cured with treatment .

Specific medications and treatments

Surveillance

If your cancer is slow-growing and hasn't spread, your doctor may decide to observe it without treating it right away.

• Active Surveillance : In this, you will have regular screenings, scans and biopsies – about once every one to three years – to monitor the progress of the cancer. This is best for early-stage, low-risk cancers that are asymptomatic. Treatment is only started if the cancer gets worse.
• Watchful Waiting : This approach is used for older people or those with other health problems. It involves fewer tests and focuses more on relieving symptoms rather than eliminating the cancer.

Surgery

Radical prostatectomy is a surgical procedure that removes the diseased prostate gland.This surgery can successfully remove prostate cancer that has not spread. If your doctor thinks you would benefit from this surgery, he or she will recommend the most appropriate removal method for you.

• Open Radical Prostatectomy : In this procedure, the doctor makes a single incision in your abdomen and removes the prostate gland. This procedure is no longer used as commonly as other less invasive procedures.
• Robotic Radical Prostatectomy : In this procedure, the doctor can perform the surgery through a few very small incisions. He operates a robotic system via a console.

Radiation Therapy

You can have radiation therapy for prostate cancer as a single treatment or in combination with other treatments. Radiation therapy can also relieve symptoms.

• Brachytherapy : This involves placing radioactive seeds inside your prostate gland. This destroys cancer cells while sparing the surrounding healthy tissue.
• External Beam Radiation Therapy (EBRT) : A machine directs a powerful beam of X-rays at the tumor. Advanced methods like IMRT can target only the cancer while sparing healthy tissue.

Systemic Therapies

If the cancer has spread beyond your prostate, your oncologist may recommend systemic treatments. These treatments travel throughout the body and kill cancer cells or stop them from growing.

• Hormone Therapy : Testosterone is a hormone that helps prostate cancer grow. In hormone therapy, medications block or reduce testosterone. Some men may also have surgery to remove the testicles (orchiectomy) to stop testosterone production.
• Chemotherapy : This treatment uses drugs to kill cancer cells. For advanced cancer, it may be given alone or with hormone therapy. If the cancer has spread beyond the prostate gland, you may be given chemotherapy alone or with hormone therapy.
• Immunotherapy : This stimulates your immune system to help it find and fight cancer cells. It is often used for advanced or recurring cancer.
• Targeted Therapy : These treatments target genetic mutations that cause cancer. They work best for cancers with BRCA mutations.

Focal Therapy

Focal therapy is a new treatment that destroys cancer cells inside your prostate gland. Your doctor may recommend this treatment if your cancer is low-risk and hasn't spread. Most of these treatments are still experimental.

• High-Intensity Focused Ultrasound (HIFU) : High-intensity sound waves generate intense heat and kill cancer cells in your prostate.
• Cryotherapy : Cold air freezes the cancer cells in your prostate, destroying the tumor.
• Laser Ablation : Intense heat directed at the cancerous tumor kills cancer cells in the prostate gland and destroys the tumor.
• Photodynamic Therapy : Drugs make cancer cells more sensitive to certain wavelengths of light. A doctor then exposes the cancer cells to those wavelengths of light, killing them.

What are the side effects of prostate cancer treatment?

There are several side effects that can occur from treatment:

• Incontinence : You may leak urine when you cough or laugh. Or you may feel the sudden need to urinate even when your bladder is not full. This condition usually gets better without treatment within 6 to 12 months .
• Erectile Dysfunction (ED) : Surgery and other treatments can affect the ability to have an erection during sex. You may notice a difference in your sex life for a year or two. Medications such as Sildenafil (Viagra®) or Tadalafil (Cialis®) can help with this by increasing blood flow to the penis.
• Infertility : Treatment may affect your sperm production or ejaculation. If you are hoping to have children, consider sperm banking before starting treatment . Later, the sperm can be retrieved and implanted in your partner's uterus.

If you have these side effects, be sure to let your cancer care team know . Often, they can recommend medications and treatments that can help.

What questions should I ask my doctor?

If you have prostate cancer, you may want to ask your doctor questions like these:

• Has the cancer spread outside my prostate?
• What is the best treatment for my stage of prostate cancer?
• What are the risks and side effects of treatment?
• Is there a risk of prostate cancer in my family? If so, should we get genetic tests?
• What follow-up care do I need after treatment?
• Should I watch out for signs of complications?

What kind of hope can a person with prostate cancer have?

If prostate cancer is found early, you can expect a much better outcome . Ninety-nine percent (99%) of men who are diagnosed before the cancer has spread – that is, they will live for at least five years after diagnosis . In most cases, cancer that is only in the prostate gland can be completely removed with treatment. However, if the cancer has spread (metastatic prostate cancer), the survival rate is not as good – only 32% of men with metastatic prostate cancer will be alive five years after diagnosis. When you find out you have prostate cancer, you may have a range of emotions – and many questions. But the good news is that if it is found early, prostate cancer can often be treated very well . Many people live full, cancer-free lives for many years after treatment. However, in some cases, it can be more severe and spread quickly. Your cancer care team will explain your options and provide you with the support and guidance you need through every decision, from testing to treatment.

Final Take-Home Message

Prostate cancer is a common and potentially serious disease in men. But don't panic . The most important thing is to be aware of the symptoms and get screened at the right age . It is very important to get tested for prostate cancer, especially if you are over 50 or if someone in your family has had the disease. If detected early, treatment methods that can completely cure this disease have been developed today . Therefore, if you have any doubts, do not be shy or afraid to see a doctor. You are the one who should take the most care of your health. Remember, maintaining a healthy lifestyle (no smoking, balanced diet, exercise) also helps to protect yourself from such diseases to some extent .

---

` Prostate Cancer, prostate cancer, PSA, DRE, cancer symptoms, cancer treatment, men's health