Prostate Cancer

When cancer starts in the prostate, it is called prostate cancer.

Prostate cancer is the uncontrolled growth of cells in the prostate, a gland in the male reproductive system just below the bladder.

Prostate is a small walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm.

Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.
As the tumor grows, it can damage nearby organs causing erectile dysfunction, blood in the urine or semen, and trouble urinating. Some tumors eventually spread to other areas of the body, particularly the bones and lymph nodes. There, tumors cause severe bone pain, leg weakness or paralysis, and eventually death.

Difference between benign and malignant tumor

A benign tumor is made up of cells that don’t threaten to invade other tissues. The tumor cells are contained within the tumor and aren’t abnormal or very different from surrounding cells.
WHILE
Malignant tumors are made of cancer cells that can grow uncontrollably and invade nearby tissues. The cancer cells in a malignant tumor tend to be abnormal and very different from the normal surrounding tissue.

SYMPTOMS

1. Frequent urination
2. Trouble urinating
3. Decreased force in the stream of urine
4. Blood in the semen and urine
5. Erectile dysfunction
6. Bone pain
7. Discomfort in the pelvic area
8. Discomfort or pain when sitting, caused by an enlarged prostate.

CAUSES

Prostate cancer is caused by the accumulation of genetic mutations to the DNA of cells in the prostate. These mutations affect genes involved in cell growth, DNA damage repair, and cell death. Changes to these genes can cause cells in the prostate to grow uncontrollably, resulting in a tumor. (american cancer society, may 2023).
Some abnormal cells can break off and spread (metastasize) to other parts of the body.

RISK FACTORS

1. Older age
2. Family history of prostate or breast cancer
3. Race
4. Obesity

COMPLICATIONS

1. Erectile dysfunction
The nerves that control a man’s erectile response are located very close to the prostate gland. A tumor on the prostate gland or certain treatments such as surgery and radiation can damage these delicate nerves. This can cause problems with achieving or maintaining an erection. Medications, vacuum devices that assist in achieving erection and surgery are available to treat erectile dysfunction.

2. Incontinence
Prostatic tumors and surgical treatments for prostate cancer can also lead to urinary incontinence. Someone with urinary incontinence loses control of their bladder and may leak urine or not be able to control when they urinate. The primary cause is damage to the nerves and the muscles that control urinary function. Treatment for incontinence depends on the type you have, how severe it is and the likelihood it will improve over time. Treatment options may include medications, catheters and surgery.

3. Metastasis (cancer that spreads)
Metastasis occurs when tumor cells from one body region spread to other parts of the body. The cancer can spread through tissue and the lymph system as well as through the blood. Prostate cancer cells can move to other organs, like the bladder. They can travel even further and affect other parts of the body, such as the bones and spinal cord. Prostate cancer that metastasizes often spread to the bones. This can lead to complications such as fractured or broken bones, severe pain, stiffness in the hip, thighs, or back, weakness in the arms and legs and higher-than-normal levels of calcium in the blood (hypercalcemia), which can lead to nausea, vomiting, and confusion.

STAGES

Staging typically describes how much cancer is present in the body and how serious the cancer is. Knowing the stage of prostate cancer can help a person understand what to expect and will inform decisions about treatment.
Stages may include:
1. Stage I: Cancer is only present in the prostate gland.

2. Stage II: Cancer has not yet spread from the prostate, but a person will have a higher PSA level.

3. Stage III: Cancer may have spread to nearby tissues.

4. Stage IV: Cancer may have spread to distant parts of the body.

TESTS AND DIAGNOSIS

Screening for prostate cancer
Prostate cancer screening searches for tumors in those without symptoms. Screening aims to separate men with high-risk cancers who would benefit from treatment, from those whose tumors are slow-growing and unlikely to impact health. This is typically done through blood tests for levels of the protein prostate-specific antigen (PSA), which are elevated in those with enlarged prostates, whether due to prostate cancer or benign prostatic hyperplasia.

Diagnosis for prostate cancer
A diagnosis of prostate cancer requires a biopsy of the prostate. Prostate biopsies are typically taken by a needle passing through the rectum or perineum, guided by transrectal ultrasound imaging, magnetic resonance imaging (MRI), or a combination of the two. Ten to twelve samples are taken from several regions of the prostate to improve the chances of finding any tumors. Biopsies are examined under a microscope by a pathologist, who determines the type and extent of cancerous cells present. Cancers are first classified based on their appearance under a microscope. Over 95% of prostate cancers are classified as adenocarcinomas (resembling gland tissue), with the rest largely squamous-cell carcinoma (resembling squamous cells, a type of epithelial cell) and transitional cell carcinoma (resembling transitional cells).

PSA testing

The blood test, called a prostate-specific antigen (PSA) test, measures the level of PSA and may help detect early prostate cancer. PSA is a protein produced by both cancerous and noncancerous tissue in the prostate, a small gland that sits below the bladder in males.
It’s normal to have a low level of PSA in your blood. A high PSA level may be caused by:
• Prostate cancer
• An enlarged prostate (BPH) (benign prostatic hyperplasia)
• Other common prostate problems
•Taking certain medicines.

TREATMENT OF PROSTATE CANCER

Your prostate cancer treatment options depend on several factors, such as how fast your cancer is growing, how much it has spread and your overall health, as well as the benefits and the potential side effects of the treatment.

1. Active surveillance
For men diagnosed with very early-stage prostate cancer, treatment may not be necessary right away. Some men may never need treatment. Instead, doctors sometimes recommend active surveillance.
In active surveillance, regular follow-up blood tests, rectal exams and possibly biopsies may be performed to monitor progression of your cancer. If tests show your cancer is progressing, you may opt for a prostate cancer treatment such as surgery or radiation.

2. Radiation therapy
Radiation therapy uses high-powered energy to kill cancer cells. Prostate cancer radiation therapy can be delivered in two ways:
● Radiation that comes from outside of your body (external beam radiation): During external beam radiation therapy, you lie on a table while a machine moves around your body, directing high-powered energy beams, such as X-rays or protons, to your prostate cancer. You typically undergo external beam radiation treatments five days a week for several weeks.
● Radiation placed inside your body (brachytherapy): brachytherapy involves placing radioactive seeds inside your prostate. This approach kills cancer cells while preserving surrounding healthy tissue.

3. Hormone therapy
The hormone testosterone boosts cancer cell growth. Hormone therapy uses medications to combat testosterone’s role in fueling cancer cell growth.  Cutting off the supply of hormones may cause cancer cells to die or to grow more slowly.

4. Surgery to remove the prostate
Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes. 

5. Chemotherapy
Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form or both.
Chemotherapy may be a treatment option for men with prostate cancer that has spread to distant areas of their bodies. Chemotherapy may also be an option for cancers that don’t respond to hormone therapy.

LIFESTYLE AND HOME REMEDIES

You can reduce your risk of prostate cancer if you:

1. Choose a healthy diet full of fruits and vegetables.
2. Exercise most days of the week
3. Maintain a healthy weight. 
4. Talk to your doctor about increased risk of prostate cancer.

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