Early diagnosis of prostate cancer is very important and there is a great deal all men can do to safeguard their health Currently, there is no scientific consensus on effective strategies to reduce the risk of prostate cancer. Therefore, we face significant challenges in determining what actions to take to address prostate cancer. The good news is prostate cancer need not be a death sentence.
Prostate cancer FAQS
Many people are confused about the prostate. Where is it situated? What are the symptoms of prostate cancer? What treatments are available?
To help better understand this important issue, we have compiled these Frequently Asked Questions
What is the prostate?
The prostate is a small gland located underneath the bladder in men. It is shaped like a doughnut and fits around the tube (called the urethra) which carries urine out of the bladder. The prostate produces the fluid that mixes with sperm when a man ejaculates.
What is prostate cancer and how common is it?
Prostate cancer is now the most common cancer in men in many western countries. Prostate cancer can grow quickly and eventually spread to the bones, where it can cause severe pain. Prostate cancer is the most common non-skin cancer in America, affecting 1 in 6 men. It is estimated that there are more than 2 million American men currently living with prostate cancer.
What causes prostate cancer?
Little is known about the causes of prostatic cancer. Several risk factors, such as age, race, family history, hormone levels and environmental influences are suspected of playing roles.
Which men are at risk? Are some men more likely to be diagnosed with prostate cancer?
Older age, African race, and a family history of the disease can all increase the likelihood of a man being diagnosed with the disease.
Prostate cancer is very rare in men under 50. The risk increases after the age of 50 with half of all cases occurring in men over 75. Some families have a higher risk of prostate cancer than others.
Men with one first-degree relative with prostate cancer have a twofold higher risk, and those with two first-degree relatives have a fivefold greater risk of developing prostate cancer compared with men with no family history. Men with strong family history also tend to develop the disease at an earlier stage.
Is diet linked to prostate cancer?
Some evidence suggests that a low-fat diet can reduce the risk of prostate cancer. Other studies have suggested that a diet high in tomatoes, Vitamin A, Vitamin E, local vegetables (such as broccoli, cabbage, cauliflower and brussels sprouts), soy products and selenium may prevent, inhibit or delay the progression of prostate cancer. However, these findings have not been confirmed.
Can prostate cancer be prevented? Is ‘population screening’ done for prostate cancer?
Currently, there is no scientific consensus on effective strategies to reduce the risk of prostate cancer.
At the moment, routine screening for prostate cancer is not carried out in any country, because none of the available tests are accurate enough. Screening men with the existing tests, such as the PSA blood test, would pick up many men without the cancer and would miss many who do have the cancer.
What are the symptoms of prostate cancer?
Patients with clinically localized disease (early stage) do not have urinary symptoms, and the lesion is discovered by the finding of a suspicious nodule on rectal examination or elevated prostate specific antigen level (discussed later).
Patients with advanced prostate cancer may present with symptoms such as difficulty in passing urine, inability to urinate, passing urine often (particularly at night), weak or interrupted urine flow, pain when urinating, blood in urine, difficulty in having an erection and pain in the lower back, hips and upper thighs. However, these symptoms can also be caused by other conditions such as benign prostate enlargement.
All men over 50 should be aware of the warning signs and take themselves to their doctor.
Is early diagnosis important? What are the recommendations on diagnostic testing?
If prostate cancer is diagnosed early, it can be treated very successfully. However, when the cancer is advanced, it becomes very difficult to cure.
It is recommended that both the PSA and DRE (see below) should be offered annually, beginning at age 50, to men who have at least a 10-year life expectancy. Men at high risk, such as African American men, and men with a strong family history of one or more first-degree relatives diagnosed at an early age should begin testing at age 45. Men at even higher risk, due to multiple first-degree relatives affected at an early age, could begin testing at age 40.
What tests can be used to detect prostate cancer?
A number of different tests are used, DRE and PSA levels are used for screening purposes, while TRUS guided biopsy is used for confirmation.
* Digital Rectal examination (DRE) – Careful DRE may detect some early prostatic cancers.
* Prostate Specific Antigen (PSA) blood test – PSA is used in the diagnosis as well as the management of prostate cancer. PSA is a product of the prostate gland that is normally secreted in the semen. In normal men only minute amounts of PSA circulate in the blood. If the level of PSA in your blood is too high, this suggests that there high probability of prostate cancer, but there are several other conditions which cause an increase in blood PSA levels.
* Transrectal Ultrasonography (TRUS)
* Biopsy – which involves taking a tissue sample from the prostate; microscopic examination by a histopathologist is required to confirm the diagnosis and provide information on the grade of cancer.
How curable is prostate cancer?
When prostate cancer is detected in the early or local and regional stages, the cure rate is very high – treatment is successful for nine out of ten of these cases.
However, when patients are not diagnosed until the cancer is advanced and has spread, treatment can give these patients several extra years of life and stop the pain of the disease, but cannot normally cure them.
How is prostate cancer treated?
Cancer of the prostate is treated by surgery, radiotherapy (mainly used for advanced cancers), and hormonal manipulations.
Currently, the most common treatment for clinically localized prostate cancer is radical prostatectomy. Major improvements in surgical technique, reducing the risk of blood loss during surgery and post-surgery impotence and incontinence, have popularized this procedure.
Outcome or prognosis after radical prostatectomy is based on the pathologic stage (how far the cancer has spread), the adequacy of surgery and the histopathology report.
We hope this article has provided the reader with current information about the benefits of routine screening and the early detection of prostate cancer.
