Prostate cancer – causes, symptoms, treatment and prognosis

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Prostate cancer is one of the most common types of cancer that affects men. Detecting it at an early stage of the disease increases the chances of a cure and minimizes the risk of metastasis. What is prostate cancer? What are the diagnostic methods? What is the treatment?

Prostate cancer – what is the prostate?

Prostate, prostate or prostate are different names for the same male organ. It is about the size of a chestnut tree and forms a rim around the urethra. The prostate gland secretes a fluid which, together with the secretion of the seminal vesicles and with the sperm, forms semen and causes the semen to liquefy in the vagina.

After the age of 30, the prostate begins to grow in almost all men. For some it is faster, for others it is slower. Benign enlargement of the prostate gland increases its size, which can sometimes lead to a narrowing of the urethra, which in turn obstructs the outflow of urine.

Symptoms of urethral stricture are:

1. change in the strength of the urine stream, its weakening or interruption,
2. long duration of urine output,
3. a feeling of lagging behind after settling down,
4. dripping or incontinence.

When the bladder is irritated, pollakiuria occurs, nighttime urination, and sudden pressure on the bladder. In this case, you should always consult a urologist.

Although there are plenty of commercials for over-the-counter preparations on TV that are supposed to eliminate prostate problems, using them without consulting a doctor can only do harm, says Prof. Dutkiewicz. Most often they do not eliminate the causes of ailments or cure it. In addition, symptoms typical of prostate hyperplasia can be signs of other diseases that should be diagnosed and treated by a doctor.

Also read: Increased urination at night – what does it mean?

Prostate cancer – definition

Unlike benign prostatic hyperplasia, prostate cancer is much more dangerous. Prostate cancer has a slow development, because it may take several years from the onset of the first cancer cells to the appearance of symptoms.

The tests used to diagnose prostate cancer are palpation, blood PSA and prostate biopsy (more on that below). The main treatment used in prostate cancer is hormone therapy that blocks the development of male sex hormones, which in turn increase the development of prostate cancer.

See: Guide – prostate for years

Prostate cancer – statistics

Prostate cancer is the second most common malignancy (after lung cancer) in men worldwide – counting 1276106 new cases and causing 358 deaths (989% of all cancer deaths in men) in 3,8.

According to the National Cancer Registry, prostate cancer is the second most common cause of cancer in men in Poland. Most cases of malignant neoplasms of the prostate gland among Polish men occur in the seventh and eighth decades of life (87% of cases occur after the age of 60, over 50% of cases occur after the age of 70).

In turn, besides skin cancer, prostate cancer is the most common cancer in men in the United States. The U.S. prostate cancer estimate for 2020 is as follows:

1. approximately 191930 new cases of prostate cancer,
2. approximately 33,330 deaths from prostate cancer.

Prostate cancer is more likely in older men and in African-American men. About 6 in 10 are diagnosed in males 65 years of age or older, and rarely in males under 40. The mean age at diagnosis is approximately 66 years.

Check if you belong to the risk group. Do a genetic test for prostate cancer.

Read: Is it a prostate disease?

Prostate cancer – prognosis

The prostate cancer survival rate is exceptionally high. Because cancer grows very slowly and responds well to treatment, most patients are able to live long and healthy lives.

As with other cancers, prostate cancer has the most favorable survival rates when patients are diagnosed early. When prostate cancer is found before it has spread to the lymph nodes (or other organs), it is most sensitive to treatment and therefore easier to treat.

Prostate cancer – risk factors

Among the factors influencing the occurrence of prostate cancer are:

1. nation (prostate cancer is more common in black men),
2. age (the average age at which prostate cancer appears is 71 years),
3. positive family interview result.

Genetic factors play a role in the development of prostate cancer. It is said that if a first-degree relative develops prostate cancer, the other men in the family are twice as likely to develop the disease. They have discovered 6 sites in the human genome, the mutations of which can cause prostate cancer.

Prostate cancer – symptoms

Prostate cancer is one of the most common cancers faced by men. While prostate cancer is rarely obvious in its early stages, there are several signs that could signal something is wrong with the prostate.

Here are five potential warning signs of prostate cancer:

1. painful or burning sensation when urinating or ejaculating
2. frequent urination, especially at night
3. difficulty stopping or starting urination
4. sudden erectile dysfunction,
5. blood in urine or semen.

Other possible early symptoms of prostate cancer include unusually poor urine flow and unexplained pain around the prostate while sitting. If the cancer has spread beyond the prostate gland, men may experience lower body swelling, pain in the back or hip, abnormal bowel movements, or unexplained weight loss.

It should be noted that the symptoms of prostate cancer also appear in many other, less serious conditions. If you show one or more of these symptoms, it does not necessarily mean you have prostate cancer. Likewise, a man diagnosed with prostate cancer may not have any of these symptoms.

Advanced prostate cancer has the following symptoms:

1. pain in the lower abdomen,
2. blood in the urine,
3. burning when urinating,
4. problems with incontinence,
5. problems with erection,
6. pain in the anus,
7. rectal bleeding
8. sperm with blood,
9. pain in the perineum and lumbar region.

The advanced form of prostate cancer often metastasizes to other organs, therefore the symptoms include: paralysis of the limbs, bone fractures and pain, enlarged lymph nodes, problems with blood clotting, pressure on the spinal cord.

Any worrying symptoms should prompt you to see a doctor. You can make an appointment for a consultation with a specialist via the website clinics.pl.

Prostate cancer – types

Almost all prostate cancers are adenocarcinomas (prostate adenocarcinoma). This form of cancer grows out of glandular cells (cells that produce prostate fluid that is added to semen).

Other types of cancer that can develop in the prostate include:

1. small cell tumors,
2. neuroendocrine tumors (other than small cell tumors)
3. transitional cell carcinomas,
4. sarcomas.

The above-mentioned forms of prostate cancer are quite rare.

Some prostate cancers grow and spread fairly quickly, but most develop slowly. In fact, autopsy studies show that many older men (and even some younger men) who died from other causes also had prostate cancer, which never gave clear signals. In many cases, neither they nor their doctors even knew that the patient was struggling with him.

Prostate cancer – PSA value

Finding prostate cancer at an early stage increases the chances of a cure. – That is why every man over 45 (and the family has a history of prostate cancer after 40 !!!), should see a urologist at least once a year – encourages Dr. Wolski.

Before that, it is worth taking a blood test to determine the PSA value. Its elevated level indicates pathological changes in the prostate. The diagnosis of an increased concentration of PSA is not the same as cancer. It may be the result of a benign enlargement or inflammation of the prostate.

You can buy a Home Prostate Test for the detection of PSA in your blood at Medonet Market. You will do it yourself at home, and then you will be able to consult the results with your doctor.

The concentration of PSA increases after ejaculation, after the use of certain medications, exercise, in urinary tract infections, and also after prostate examinations. It should be remembered that each diagnosis of an abnormal PSA value is a signal to undertake further diagnostic tests. – It is worth noting that low PSA does not exclude cancer – says prof. Dutkiewicz. Therefore, this examination does not exempt you from visiting a urologist.

Want to know more about the PSA test – read on here.

Prostate cancer – diagnosis

After the PSA test is done in the laboratory, you need to go to the urologist one by one with the result. The urologist checks the condition of the prostate by palpating the gland through the rectum (DRE) with a finger. The doctor may also perform an ultrasound.

We also recommend performing the cancer e-packet for men – extended genetic tests, where the level of PSA (prostate cancer marker) is also determined. The price of comprehensive examinations also includes consultation with a doctor or diagnostician.

Prostate cancer – biopsy

The suspicion of cancer is verified by biopsy. It consists in taking specimens from the prostate gland under transrectal ultrasound (TRUS) control.. Of course, a biopsy does not mean that we definitely have prostate cancer, and nothing will change that, sometimes cells are taken that are not cancerous, or too few cells are not used to definitively diagnose prostate cancer.

In some cases, the development of prostate cancer is very slow and immediate treatment is not always needed. Each case requires an individual approach.

Prostate cancer – metastases

Theoretically, prostate cancer cells can spread anywhere in the body. In practice, however, most prostate cancer metastases occur in the lymph nodes and bones.

Prostate cancer metastasis occurs when cells detach from the tumor in the prostate. Cancer cells can travel through the lymphatic system or bloodstream to other areas of the body.

More often, prostate cancer metastasis can occur in:

1. bones,
2. lymph nodes,
3. lungs
4. liver,
5. the brain.

Rare sites of prostate cancer metastasis include:

1. adrenal glands
2. breasts
3. eyes,
4. kidneys,
5. muscles,
6. pancreas,
7. salivary glands,
8. spleen.

Also check: What can an enlarged spleen show?

Prostate cancer – stage four

Metastatic prostate cancer is an advanced form of cancer (stage 4) in which cancer cells have spread from the prostate to other areas of the body. Grade 4 prostate cancer can be classified as either local or distant.

With localized metastasis, the cancer has spread to nearby pelvic organs, such as the pelvic lymph nodes. In distant metastasis, the cancer has spread further and can be found in the bones, liver, lungs, or other part of the body.

Prostate cancer that has progressed to this stage often causes symptoms such as difficulty urinating, painful urination, erectile dysfunction, and blood in the urine or semen. You may also experience general weakness, fatigue, and unexpected weight loss. If you are experiencing any of these symptoms, it’s important to see your doctor as many other conditions can cause similar symptoms.

Prostate cancer – treatment

The choice of prostate cancer treatment depends on how advanced the disease is. New treatments require consultation with more doctors who work in different fields. This is because doctors want to choose the best treatment option.

Prostate cancer that is not very advanced can undergo surgery, which consists in removing the (completely) prostate gland. However, this method is associated with certain complications. The patient should be informed that urinary incontinence and problems with potency may occur after the procedure.

Another method of treating prostate cancer is radiation, or radiotherapy. For this purpose, both classical and newer methods, which use radioactive elements for irradiation, can be used. However, irradiation can also lead to side effects, such as: diarrhea, impotence disorders, urinary incontinence problems, ulcers around the rectum.

One of the new treatment options is cabazitaxel for patients with advanced forms of prostate cancer. Combination treatment with this medicine ora prednisone has been shown to reduce the risk of cancer choking by around 28% in patients with metastatic disease that does not respond to hormone treatment. The life span was extended by 15,1 months.

Another drug for prostate cancer is abiraterone, the intake of which inhibits the production of testosterone and the action of the enzyme involved in its secretion. As is known, testosterone is of great importance in the development of prostate cancer – it has a stimulating effect, therefore its inhibition also inhibits tumor growth. In patients treated with this preparation, it has been shown to inhibit tumor growth and prolong life by about 4 months.

In addition, the first was registered in 2010 sipuleucel-T cell vaccine, which is used to treat metastatic prostate cancer that is refractory to hormone treatment. Clinical trials (IMPACT) have shown that administration of the vaccine prolongs the lives of patients with prostate cancer by 4,1 months. Unfortunately, this type of treatment is very expensive.

Another drug used to treat the symptoms of prostate cancer is denosumab. It is a human monoclonal protein that is responsible for regulating the activity of osteoclast cells. Patients taking this drug have a reduced risk of bone complications. They show a similar effect to this preparation zolendronic acid.

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