About Prostate Cancer

  • April 18, 2023

Prostate cancer is a type of cancer that affects the prostate gland, which is a small walnut-shaped gland in men that produces seminal fluid. Prostate cancer occurs when cells in the prostate gland grow abnormally and form a tumor.

Symptoms

Prostate cancer is a common cancer in men, especially in those over the age of 50. It is usually a slow-growing cancer and may not cause any symptoms for many years. However, in some cases, prostate cancer can be aggressive and grow and spread quickly, causing serious health problems.

The exact cause of prostate cancer is not known, but factors that increase the risk of developing prostate cancer include age, family history, race, and certain genetic mutations.

Here are some symptoms that could be related to prostate cancer. However, these symptoms can also be caused by other, less serious conditions such as benign prostatic hyperplasia (BPH) or prostatitis. Also, not all men with prostate cancer experience symptoms, and if you have prostate cancer and experience symptoms, your cancer may be at a very late stage.

  • Frequent Urination. Needing to urinate more frequently, especially during the night.
  • Difficulty Starting Urination. Trouble starting a urine stream or making more than a dribble.
  • Weak Flow. A weak or interrupted flow of urine.
  • Painful Urination. Pain or burning sensation during urination.
  • Blood in Urine or Semen. Hematuria or blood in semen may occur, though this is rare.
  • Painful Ejaculation. Discomfort or pain during ejaculation.
  • Difficulty Maintaining an Erection. Erectile dysfunction may be a symptom.
  • Hip, Back, or Pelvic Pain. Pain in the lower back, hips, or upper thighs.
  • Loss of Appetite and Weight. General fatigue, loss of appetite, and weight loss may also be associated with advanced stages of prostate cancer.
  • Difficulty Controlling the Bladder. Leaking urine when laughing or coughing, or a sudden urge to urinate.

If you’re experiencing any of these symptoms, consult your healthcare provider for an accurate diagnosis and appropriate treatment options.

It is important to diagnose prostate cancer in its earliest stages, so that it can be treated.  If you are over 50, or over 40 with a family history of prostate cancer, consult your healthcare provider about screening tests like the Prostate-Specific Antigen (PSA) test or a digital rectal examination (DRE).

 

Treatment

Treatment for prostate cancer may include surgery, radiation therapy, hormone therapy, chemotherapy, or a combination of these treatments, depending on the stage of the cancer and other factors. Early detection and treatment of prostate cancer can improve the chances of a successful outcome. Regular prostate exams and screening tests, such as a prostate-specific antigen (PSA) test, can help detect prostate cancer in its early stages.  Different treatments have different side effects, success rates, and risks, and these will be considerations in selecting treatment options.

 

How Common is Prostate Cancer?

Prostate cancer is one of the most common types of cancer among men worldwide. According to the World Health Organization (WHO), prostate cancer is the second most commonly diagnosed cancer in men and the fifth leading cause of cancer death in men globally.

The incidence of prostate cancer varies by region and age. In developed countries, such as the United States and Western Europe, prostate cancer is the most common cancer diagnosed in men, accounting for around 20% of all new cancer cases. The incidence of prostate cancer incidence is lower in developing countries, such as in Africa and Asia, where it accounts for less than 10% of all new cancer cases in men.

Age is also an important risk factor for prostate cancer. The incidence of prostate cancer increases with age, with the majority of cases diagnosed in men over the age of 65. However, prostate cancer can occur in younger men as well.

 

What is the Survival Rate with Prostate Cancer?

The survival rate for prostate cancer varies depending on the stage of the cancer at diagnosis, the age and overall health of the patient, and the effectiveness of treatment. It is generally considered to be one of the more treatable forms of cancer when detected early. Survival rates are often presented in terms of 5-year survival rates, which indicate the percentage of people who live at least 5 years after being diagnosed with cancer.

According to the American Cancer Society,

  • The relative 5-year survival rate for localized or regional stage prostate cancer (meaning it has not spread outside the prostate or has spread to nearby areas such as lymph nodes in the pelvic area) is nearly 100%.
  • The relative 5-year survival rate for distant stage prostate cancer (meaning it has spread to other parts of the body, like your bones or distant lymph nodes) is around 30%.

 

Clinical Guidelines for Prostate Cancer

The clinical guidelines for prostate cancer vary depending on the stage, grade, and other individual factors of the cancer. However, here are some general guidelines:

  • Screening. The American Cancer Society recommends that men discuss the potential benefits and risks of prostate cancer screening with their healthcare provider. Men should begin the discussion at age 50 if they are at average risk for prostate cancer. African American men and men with a family history of prostate cancer should start the discussion at age 45.
  • Diagnosis. Prostate cancer is typically diagnosed using a combination of a digital rectal exam (DRE) and a prostate-specific antigen (PSA) blood test. If these tests suggest the presence of cancer, a biopsy may be performed.
  • Staging. Once prostate cancer is diagnosed, imaging tests such as MRI, CT, or bone scans may be used to determine the stage of the cancer.
  • Treatment. Treatment options for prostate cancer may include surgery, radiation therapy, hormone therapy, and chemotherapy. The specific treatment plan will depend on the stage and grade of the cancer, as well as the patient’s overall health and preferences.
  • Follow-up. After treatment, patients will typically undergo regular monitoring to check for signs of recurrence or progression of the cancer. This may include regular PSA tests, imaging tests, and other exams.

It’s important to note that these guidelines are not one-size-fits-all, and healthcare providers may make individualized recommendations based on each patient’s unique circumstances.

 

Participating in a clinical study

As a prostate cancer patient, you may be interested in helping future cancer patients, and one way to do this is by participating in a clinical study. Some clinical studies (observational studies) will largely involve observations, testing, and imaging. They will not affect the course of your treatment, but will help us to understand the disease. Other clinical studies (clinical trials) may provide you with access to new treatment options while they are still in development, and may be an option for patients that are not responding well to treatments that are already on the market.

Joining a clinical trial could provide medical benefits to you, but there are also potential risks and uncertainties involved. You should carefully consider the study’s potential risks and benefits, and must be fully informed about the procedures, possible side effects, and potential outcomes before deciding to enroll. It is recommended that you discuss participation in a clinical trial with your doctors and that you make an informed decision based on your individual circumstances.

Note that even if you join a clinical trial, there is no guarantee that you will receive the new treatment.  If individuals are “randomized” to different groups, you may be assigned to a group that receives the “standard of care” or “usual care” for your type of prostate cancer, and not the experimental treatment.  It’s a matter of chance which group you will be assigned to.