Prostate Cancer

Prostate cancer

Something on health for the men too. Ladies can pick one or two for our fathers, Husbands, Brothers and Male figures in our lives.

Have you ever heard of prostate cancer?

If yes, that’s awesome but if your answer is No then let’s talk about it briefly….

What is a Prostate Gland?

It is a small walnut-shaped gland in men that produces the seminal fluid that nourishes and transports sperm. The prostate is just in front of the rectum and the urethra runs through the center of the prostate, from the bladder to the penis, letting urine flow out of the body.

Functions of Prostate Gland

The prostate secretes fluid that nourishes and protects sperm. During ejaculation, the prostate squeezes this fluid into the urethra, and it’s expelled with sperm as semen.

The vasa deferentia (singular: vas deferens) bring sperm from the testes to the seminal vesicles. The seminal vesicles contribute fluid to semen during ejaculation.

Symptoms of Enlarged Prostate Gland

  • A weak or slow urinary stream.
  • A feeling of incomplete bladder emptying.
  • Difficulty starting urination.
  • Frequent urination.
  • Urgency to urinate.
  • Getting up frequently at night to urinate.
  • A urinary stream that starts and stops.
  • Straining to urinate.

 

Prostate cancer

Prostate cancer is simply cancer of the prostate gland, it is the second leading cause of cancer death in men with 1 in every 10 males diagnosed of prostate cancer during their lifetime.

Prostate cancer grows slowly and is initially confined to the prostate gland, where it may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.

Prostate cancer cells spread by breaking away from the prostate tumor and this can metastasize via blood or lymph node, reaching other parts of the body.

When these cancer cells spread from its original point to another part of the body, the new tumor has the same kind of abnormal cells as the primary tumor. To explain further, in event of spread to maybe the bone, it is known as metastatic prostate cancer and treated as prostate cancer in bone and not bone cancer.

Causes 

It’s not clear what causes prostate cancer.

It’s believed that prostate cancer begins when some cells in the prostate becomes abnormal. Mutations in the abnormal cells’ DNA cause the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living, when other cells would die. The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. Some abnormal cells can also break off and spread (metastasize) to other parts of the body.

Signs and Symptoms of Prostate Cancer

  • Urinary complaints: frequent urinating,trouble urinating, burning or weak flow of urine or retention
  • Back pain
  • Hematuria
  • Blood in semen
  • Discomfort in the pelvic area
  • Bone pain
  • Erectile dysfunction

Risk factors 

  • Age. From age 50 years and above
  • Race. For some unexplainable reasons, black men carry a greater risk of prostate cancer than do men of other races. In black men, prostate cancer is also more likely to be aggressive or advanced.
  • Family history. If men in a family have had prostate cancer, there may be increased risk of other men having prostate cancer. Also, family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, predisposes the men to high risk of prostate cancer.
  • Obesity. Obese men diagnosed with prostate cancer may be more likely to have advanced disease that’s more difficult to treat.

There are different types of prostate cancer and they are:

  • Transitional cell carcinomas: Transitional cell carcinoma, also known as urothelial cancer, typically starts in the structures surrounding the prostate, including the cells lining the urethra (the tube the carries urine out of the body from the bladder), or the bladder. Prostate cancer can develop as the primary tumors in the urethra and bladder break off and start locally spreading. Although it is incredibly rare, it is possible for this type of cancer to begin in the prostate and then spread to the bladder, however, this carcinoma typically presents the other way around. Transitional cell carcinoma often presents with blood in the urine or difficulty urinating.
  • Neuroendocrine tumors: Neuroendocrine tumors are also referred to as carcinoids. These tumors are present in the neuroendocrine system, which is comprised of the nerve and gland cells responsible for making and releasing hormones into the bloodstream. These tumors often grow slowly and most often start in the digestive system (GI tract), before moving to other places, such as the prostate. NETs are extremely rare. However, it has been discovered that NETs do not affect PSA levels and that they seem to be hereditary in nature. These tumors can begin to secrete their own hormones that lead to symptoms such as diarrhea, wheezing, fast heart beat, dizziness, and flushing of the skin.
  • Small cell carcinomas: Prostate small cell carcinoma is another type of neuroendocrine cancer, however, they are made from small round cells and are more common than NETs. Small cell carcinoma is very aggressive and also does not induce a change in PSA levels. They comprise less than 1 percent of all prostate cancer cases and once they are finally discovered, the cancer has often already metastasized and is well beyond early treatment options like hormone therapy. The prognosis for small cell carcinoma is very poor, often presenting with an estimated life expectancy of less than a year.
  • Squamous Cell Carcinoma: Squamous cell carcinoma is another incredibly rare and fast-growing type of prostate cancer. This type of prostate cancer does not start in the gland cells, like adenocarcinoma, but rather, starts in the flat cells that cover the prostate gland itself. Squamous cell carcinoma is very aggressive.

Diagnosis

Elevated prostate-specific antigen (PSA) level

  • No PSA level guarantees the absence of prostate cancer.
  • The risk of disease increases as the PSA level increases, from about 8% with PSA levels of ≤1.0 ng/mL to about 25% with PSA levels of 4-10 ng/mL and over 50% for levels over 10 ng/mL.

Abnormal digital rectal examination (DRE) findings

  • DRE is examiner-dependent and serial examinations over time are the best.
  • Most patients diagnosed with prostate cancer have normal DRE results but abnormal PSA readings.

Biopsy

  • Biopsy establishes the diagnosis
  • False-negative results often occur, so multiple biopsies may be needed before prostate cancer is detected.

Prostate cancer Screening

The American Cancer Society (ACS) recommends that men decide whether to be screened for prostate cancer based on a discussion with their health care provider about the uncertainties, risks, and potential benefits of screening.

The recommended age for starting screening is:

  • 50 years of age for men at average risk who have at least a 10-year life expectancy.
  • 40 or 45 years of age for African Americans and men who have had a first-degree relative diagnosed with prostate cancer before age 65 years.
  • 40 years of age for men with several first-degree relatives who had prostate cancer at an early age

A guideline from the US Preventive Services Task Force (USPSTF), issued in May 2018, advises that in asymptomatic men aged 55 to 69 years, the decision to undergo periodic PSA-based screening for prostate cancer should be individualized and should include discussion with the clinician on the potential benefits and harms of screening (grade C recommendation). The USPSTF recommends against PSA screening in men aged 70 and older (grade D recommendation).

Prostate cancer staging

According to John Hopkins, staging is used to describe the extent of the disease. Prostate cancer staging is vital because it is used to guide the treatment plan and predict the patient’s prognosis.

Clinical Stages

The clinical stage is based on the results of the urologist’s physical examination of the patient’s prostate (including a digital rectal exam (DRE)) and any other tests done prior to definitive treatment (i.e., surgery or radiation).

The following clinical stages are used to describe prostate cancer:

  • T1: The tumor cannot be felt during the DRE or seen during imaging (e.g., a computed tomography (CT) scan or transrectal ultrasound). It may be found when surgery is done for another medical condition.
    • T1a: The tumor is discovered accidentally during a surgical procedure used to treat benign prostatic hyperplasia (BPH), which is the abnormal growth of benign prostate cells. Cancer is only found in 5 percent or less of the tissue removed.
    • T1b: The tumor is found accidentally during BPH surgery. Cancer cells are detected in more than 5 percent of the tissue removed.
    • T1c: The tumor is found during a needle biopsy that was performed because of an elevated PSA level.
  • T2: The tumor appears to be confined to the prostate. Due to the size of the tumor, the doctor can feel it during the DRE. The cancer may also be seen with imaging.
    • T2a: The tumor has invaded one-half (or less) of one side of the prostate.
    • T2b: The tumor has spread to more than one-half of one side of the prostate, but not to both sides.
    • T2c: The cancer has invaded both sides of the prostate.
  • T3: The tumor has grown outside the prostate. It may have spread to the seminal vesicles.
    • T3a: The tumor has developed outside the prostate; however, it has not spread to the seminal vesicles.
    • T3b: The tumor has spread to the seminal vesicles.
  • T4: The tumor has spread to tissues next to the prostate other than the seminal vesicles. For example, the cancer may be growing in the rectum, bladder, urethral sphincter (muscle that controls urination) and/or pelvic wall.

Treatment of Prostate Cancer:

This depends on the type of prostate cancer diagnosed and its spread.

For Localized prostate cancer

Standard treatments for clinically localized prostate cancer include:

  • Radical prostatectomy
  • Radiation therapy
  • Active surveillance
  • Androgen deprivation therapy (ADT)

Metastatic prostate cancer

Metastatic prostate cancer is rarely curable, and management of these cases typically involves the following:

  • Therapy directed at relief of particular symptoms (eg, palliation of pain)
  • Attempts to slow further progression of disease

Prostate cancer Prognosis and survival Rate:

Many men with prostate cancer will not die from it; they will die from other causes. For men who are diagnosed, it is better if it is caught early.

Survival rates for men with prostate cancer have increased over the years, thanks to better screening and treatment options. Today, 99% of men with prostate cancer will live for at least 5 years after diagnosis. Many men having treatment are cured. Most prostate cancer is slow-growing and takes many years to progress. One out of three men will survive after five years, even if the cancer has spread to other parts of the body.

Prevention of Prostate Cancer

  • Choose a healthy diet full of fruits and vegetables. Avoid high-fat foods, instead focus on choosing a variety of fruits, vegetables and whole grains. Fruits and vegetables contain many vitamins and nutrients that can contribute to health.
  • Choose healthy foods over supplements. No studies have shown that supplements play a role in reducing risk of prostate cancer. Instead, choose foods that are rich in vitamins and minerals so that healthy levels of vitamins in the body can be maintained.
  • Exercise most days of the week. Exercise improves overall health, helps maintain weight and improves mood. There is some evidence that men who don’t exercise have higher PSA levels, while men who exercise may have a lower risk of prostate cancer.
  • Maintain a healthy weight. If your current weight is healthy, work to maintain it by exercising most days of the week. If you need to lose weight, add more exercise and reduce the number of calories you eat each day. Visiting the gym can help but where it’s not feasible try other forms of exercise.

Support

TLC from family and friends aids during this treatment period.  I mean these therapies are painful and stressful on its own, the least these men want will be opposite of TLC.

Education/Enlightenment posts

Like this post and more should be encouraged. Awareness, counselling should be carried out on the benefits of early PSA screening.

Usual Disclaimer: This post is solely for educational purposes and to create awareness on Prostate cancer. Visit your Doctor, get screened-Check PSA level, stay alive and healthy for your family.

I am open to suggestion and questions… and when it’s beyond my scope, a consultant could be engaged to help out.

Till the next post.

Peace✌😁😁

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