Prostate cancer

Prostate cancer: signs & symptoms, diagnosis and treatment options


What Is Prostate Cancer?

A man’s prostate, the walnut-sized gland located behind the bladder and responsible for producing some of the fluid in semen, develops prostate cancer. After skin cancer, it is the most prevalent type of cancer in men. Prostate cancer frequently progresses very slowly and may not seriously impair the body. However, some strains are highly contagious and can spread swiftly if left untreated.


40% of all malignancies in men are prostate cancer, which is also the second-leading cause of cancer-related death in males. Prostate cancer is the most common kind of cancer in men. Even while nearly 100% of men, if they live long enough, have prostate cancer cells (typically undiscovered), just 3% of men ultimately pass away from the disease.

In the US, the lifetime risk of acquiring prostate cancer is 20%, compared to a lifetime risk of developing breast cancer of 24%. Prostate cancer has a 3.5% lifetime mortality rate, compared to a 3.6% mortality rate from breast cancer. 2 Switzerland has the highest prostate cancer mortality rate in the world. China has the lowest death rates. All racial and ethnic groupings have a similar rate of latent prostate cancer. Identification of progression variables is so obviously therapeutically useful. Men who emigrate from low incidence nations have an increased incidence after immigration to countries with higher incidence, particularly the US, therefore environmental variables must be at play.


Sign of prostate cancer

Men may not initially exhibit any symptoms. However, metastatic cancer can result in severe back, hip, or upper thigh pain.

Prostate cancer in advanced stages and urinary symptoms

The passage of urine through the prostate may become blocked in more advanced prostate tumors because the cancer may spread from the prostate’s edge toward its center. This can produce urinary symptoms like:


  •     Burning or pain during urination
  •     Difficulty urinating, or trouble starting and stopping while urinating
  •     More frequent urges to urinate at night
  •     Loss of bladder control
  •     Decreased flow or velocity of urine stream
  •     Blood in urine (hematuria)
  •     Blood in semen
  •     Erectile dysfunction
  •     Painful ejaculation


Other signs of prostate cancer in its advanced stages

Prostate cancer in men who have advanced stages may have extra symptoms. This is due to the cancer’s metastasis, or spread, from the prostate to the bones or lymph nodes.

Among the warning signs of metastatic prostate cancer are:


  • Swelling in legs or pelvic area
  • Numbness or pain in the hips, legs or feet
  • Bone pain that persists or leads to fractures


Recurrent prostate cancer

Recurrent prostate cancer is cancer that comes back after treatment. When it returns to the area around the prostate, the disease is classified as a local recurrence. Recurring cancer is regarded as metastatic if it is discovered in another area of the body. Most likely, if the cancer extends outside of the prostate, it starts in the lymph nodes and bones. The liver and lungs are less frequently affected by metastatic prostate cancer.


PSA levels are anticipated to reduce significantly during the first course of treatment for prostate cancer. An increase in the PSA level detected by a blood test may be the first indication of recurrent prostate cancer. Depending on whether and where the cancer has spread, there may be additional signs of recurrent cancer. These signs include:


  •     Blood in the urine
  •     Difficulty urinating
  •     Lower back pain
  •     Fatigue
  •     Difficulty breathing
  •     Jaundice


Patients should discuss any symptoms with their doctor and ask about scheduling regular PSA tests after treatment.


Myths Concerning Prostate Cancer


The following items won’t result in prostate cancer: masturbation, a vasectomy, and too much sex. You are not always more likely to develop prostate cancer if you have an enlarged prostate (BPH). Alcohol consumption, STDs, and prostatitis are still being investigated as potential risk factors for prostate cancer.



Risk Elements You Can Manage


Prostate cancer appears to be influenced by diet and is significantly more prevalent in nations where meat and high-fat dairy products are staples of the diet. It’s unclear why this connection was made. Dietary fat, particularly animal fat from red meat, may raise male hormone levels. And that could encourage the development of malignant prostate cells. A diet that is too lacking in fruits and vegetables could also be a factor.


Risk Elements You Cannot Manage


The biggest risk factor for prostate cancer is becoming older, especially after age 50. Studies indicate that between 31% and 83% of men over the age of 70 have some kind of prostate cancer, even though there may be no overt symptoms. A man is at an increased risk if his father or sibling has prostate cancer, which more than doubles the risk.



Examinations to identify prostate cancer.

It is possible to utilize the following techniques and tests:

Health history and physical examination: an examination of the body to look for general health indicators, including looking for disease indications like tumors or anything else that seems out of the ordinary. Additionally, a history of the patient’s health practices, illnesses, and treatments in the past will be recorded.

Digital rectal exam (DRE): A rectal examination. A greased, gloved finger is inserted into the rectum by the doctor or nurse to feel the prostate through the rectal wall for lumps or other abnormalities.

Prostate-specific antigen (PSA) test: An examination to assess the blood’s PSA concentration. At the blood of men with prostate cancer, PSA, a chemical produced by the prostate, may be present in higher than usual concentrations. Men with BPH, an infection, prostate inflammation, or high PSA levels may also exhibit these symptoms (an enlarged, but noncancerous, prostate).


Transrectal ultrasound: A finger-sized device called a transrectal ultrasonography probe is introduced into the rectum to examine the prostate during this operation. With the aid of the probe, interior tissues or organs are used to produce echoes from high-energy sound waves (ultrasound). Sonograms are images of the inside organs created by the echoes.


Transrectal magnetic resonance imaging (MRI): Using the MRI equipment, the prostate and adjacent tissue can be seen more clearly in photographs. To determine whether the cancer has moved outside of the prostate into surrounding tissues, a transrectal MRI is performed. A biopsy technique might involve the use of transrectal MRI and its known as Transrectal MRI guided biopsy.



To identify prostate cancer and determine its stage, a biopsy is performed (Gleason score).

Using a transrectal biopsy, prostate cancer is identified. A transrectal biopsy involves passing a tiny needle through the rectum and into the prostate to remove tissue. Transrectal ultrasound or transrectal MRI may be used during this surgery to help guide the location from which tissue samples will be obtained. To check for cancer cells, a pathologist examines the tissue under a microscope.


Prostate cancer patients might get a variety of treatments.


Active surveillance or vigilance


When a patient’s condition is being attentively watched, no therapy is given until new or different indications or symptoms develop. Treatment is administered to ease symptoms and improve quality of life.



Surgery to remove the tumor may be used to treat patients in good health whose tumor only affects the prostate gland.


Radiopharmaceutical therapy and radiation therapy

High-energy x-rays or other forms of radiation are used in radiation therapy, a cancer treatment, to either kill or stop the growth of cancer cells.


Hormone treatment

In order to inhibit the growth of cancer cells, hormone therapy either eliminates hormones from the body or limits their activity.



Chemotherapy is a form of cancer treatment that employs medications to kill cancer cells or prevent them from proliferating in order to stop the growth of cancer cells. Chemotherapy enters the bloodstream whether administered orally or through an injection into a vein or muscle, where it can reach cancer cells throughout the body (systemic chemotherapy).


Targeted treatment

A type of therapy called targeted therapy identifies and kills particular cancer cells using medicines or other chemicals. Compared to chemotherapy or radiation therapy, targeted therapies typically have a lower impact on healthy cells.



Immunotherapy is a form of cancer treatment that activates the patient’s immune system. The body’s natural defenses against cancer are boosted, directed, or restored using substances produced by the body or in a lab. Biologic therapy is a category of treatment for cancer. An immunotherapy called sipuleucel-T is used to treat prostate cancer that has spread (spread to other parts of the body).


Bisphosphonate medication


When cancer has spread to the bones, bisphosphonate medications like clodronate and zoledronate diminish bone disease. Bone loss is more likely in men who have orchiectomy or antiandrogen medication. Bisphosphonate medications reduce the risk of bone fracture in these men (breaks).



Clinical trials are being used to explore new treatment modalities.




A procedure called cryosurgery employs a device to freeze and kill prostate cancer cells. The area to be treated is located using ultrasound. Cryotherapy is another name for this kind of therapy.

Impotence, bladder or rectum leakage, and impotence are side effects of cryosurgery.


High-intensity–focused ultrasound therapy


High-intensity focused ultrasound therapy is a medical procedure that employs ultrasound to target and kill cancer cells. An endorectal probe is used to generate the sound waves in order to treat prostate cancer.


Proton treatment radiation


A form of high-energy external radiation therapy called proton beam radiation therapy employs streams of protons, which are small particles with a positive charge, to destroy tumor cells. The amount of radiation damage to healthy tissue close to a tumor can be reduced with this kind of treatment.


A photodynamic treatment


a method of treating cancer that kills cancer cells by using a medication plus a specific kind of laser light. A medicine is injected into a vein, but it does not become active until it is exposed to light. Compared to normal cells, cancer cells accumulate the medication more. The laser light is then sent through fiberoptic tubes to the cancer cells, where it activates the medication and kills the cancerous cells. Healthy tissue suffers little harm from photodynamic treatment. It is mostly used to treat malignancies in the lining of internal organs, on the skin, or immediately beneath the surface.


Key Points :

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A review article by

Dr Bhavana Kalvala

(Clinical Research Director @ IEEARC Tech)



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