Prostate Cancer | پروسٹیٹ کینسر

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Prostate Cancer


Prostate is a small gland, almost the size of a walnut, in the male reproductive system. It is located below the urinary bladder (the organ that collects the urine) around the tube called urethra that carries urine from bladder to the penis. As age progresses in men, prostate gland may increase in size. The main function of the prostate gland is to produce a thick whitish fluid that provides the nutrients to the sperms and also act as a medium for their motility.

Prostate - illustration

Prostate cancer is one of the most common types of cancer in men. It grows slowly, if diagnosed early can be treated and have higher chance of being successfully cured.

In older age men (over 50 years), prostate gland may become enlarge mainly due to one of the following reason:

1. Prostatitis (Inflammation of prostate gland due to infection). Prostatitis is not a cancer.

2. Benign Prostatic hyperplasia or hypertrophy (BPH) – BPH is a non-cancerous condition, which occurs in older age men when prostate gland becomes enlarge and starts to squeeze the urethra and urinary bladder causing problems in urination. BPH can be effectively managed without complications. Since symptoms of BPH are similar to prostate cancer, they should not be ignored.

3. Prostate Cancer – Cells become abnormal start dividing unstoppably causing enlargement in prostate gland.

It should be noted that most prostate changes are not prostate cancer

This leaflet focuses on Prostate Cancer

Prostate cancer usually does not show any signs or symptoms in the early stages and remains undetected. Almost all prostate cancers are classified as adenocarcinoma (cancer type that develops in a gland).

Prostate cancer symptoms are similar to BPH. The signs and symptoms may include:

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  • Difficulty in passing urine
  • Difficulty in starting and stopping the stream of urine
  • Increase in frequency and urgency of urine, many patients wake up in the night to pass urine
  • Pain or burning while passing urine
  • Difficulty emptying the bladder completely
  • Pain in the lower backbone and/or other bones of the body
  • Pain while ejaculating
  • Feeling tired and short of breath, dizziness or pale skin due to anemia

There are no specific causes when it comes to prostate cancer.  Although at the cellular level, there are changes (mutations) in the DNA code that may result in rapid multiplication of abnormal cells.

The risk factors for developing a prostate cancer include:

  • Older age – being old (above 50 years) is one of the major risk factor 
  • Family history of prostate or breast cancer – a family history of prostate cancer or having a breast cancer gene (BRCA1 & BRCA2) might as well increase the risk
  • Obesity –  men with higher Body Mass index (BMI) 
  • Risk may be more for men who eat high fat diet

Medical opinion is divided on whether a healthy person should be screened for the disease or not.  Some suggest that a person above 50 years of age or with any other risk factors must be screened while other organizations do not recommend prior screening.

The two most commonly used tests to screen and diagnose prostate cancer include:

  • Digital Rectal Examination (DRE) – Prostate gland is situated on the front side of the rectum. During this examination, the doctor would insert gloved, lubricated fingers through the anal canal into the rectum to feel the size, shape, texture and consistency of the prostate gland. The test usually takes 1-2 minutes
  • Prostate Specific Antigen (PSA) – A venous blood sample is withdrawn and checked for the levels of PSA which might be raised higher than normal in prostate cancer. PSA levels are not specific for the prostate cancer as they may also rise in the infection of prostate or the inflammation of the gland as well as in a patient with BPH (benign prostatic hyperplasia).

If any abnormality is detected in the above tests, the doctor may recommend an ultrasound and/or MRI of the prostate gland and might also suggest testing the tissue sample of the gland (biopsy) for confirming the presence of prostate cancer.  The details can also be used for staging and grading the cancer.

As the prostate cancer is a slow growing cancer, most patients do not require immediate treatment. Some do not require treatment at all.

The cancers which are detected at early stages and do not cause any symptoms are usually delayed for treatment and kept under active monitoring (surveillance) by the doctors. During this, a number of regular follow-up blood tests, DRE and biopsies may be performed to check the progression of the disease.

If the cancer is progressing, the patient might have to undergo surgery for the removal of the diseased gland and treatment with chemotherapy, hormone-therapy and/or radiotherapy maybe performed.

The cancer in the late stage which has already progressed beyond the prostate and spread in the body has a very low survival rate. Removal of the gland is usually not performed then and instead patient is treated with radiotherapy and hormone therapy.

Radical Prostatectomy – It is the surgical removal of the prostate gland in very early stages of the cancer along with some surrounding tissues and few lymph nodes.

Chemotherapy – They are the drugs that kill the rapidly growing cancerous cell. They can be prescribed in tablet form or through the IV route into the veins.

Radiotherapy – It is the use of highly powered radiation energy to kill the rapidly dividing cancerous cell in the body.

Hormone-therapy – Prostate tissue rely on male testosterone for growth and cutting down the production of testosterone is what hormone therapy all about.

All of these treatment methods have considerable number of side effects, including erectile dysfunction and urinary incontinence (losing control on holding urine), but are only performed if the advantages outweigh their side effects.

The major complication is the progression of cancer to the advanced stage where it spreads (metastasize) to other parts of the body.  Metastasis occurs if the cancer seed to the neighboring organs or travels through blood stream or lymphatic system. Usually, prostate cancer spread to the bones of the body, and cause intense bone pain and broken bones. It is very less likely for a cancer to be cured once it has metastasized.

Along with that, other complications include urinary incontinence (losing control on holding urine) and erectile dysfunction in the patient suffering from prostate cancer.

The cancer progress very slowly and one can live years without any noticeable symptom or the need of treatment.

Nonetheless, all diseases have some effect on life. The patient may suffer from physical problems such as erectile dysfunction and urinary incontinence which may affect the complete lifestyle. Apart from that, many people suffer from anxiety, fear and severe depression when a disease such as cancer, become part of their life.

It is always beneficial to discuss the illness with family members, friends and prostate cancer survivors.

The risk of prostate cancer can be reduced by healthy diet and life-style changes

• Healthy diet (fruits and vegetables)

• Prefer healthy diet over supplements

• Regular exercise

• Maintaining a normal weight with a healthy BMI

• Talking to your doctor if you have family history of prostate or breast cancer or any other risk factors.

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