Approximately 1,414,259 cases of prostate cancer and 375,304 prostate cancer deaths were estimated to have occurred globally in 2020.
Prostate Cancer happens when the cells in the prostate gland (male sex gland) start growing out of control. The prostate gland is a small walnut-shaped gland in men which is essential to produce semen fluid that nourishes and transports sperm.
Most prostate cancers grow gradually and stay confined to the gland, where they might not be much harmful. However, other types could be aggressive and can spread quickly. Early diagnosis is the key to successful treatment.
Though early stages might be asymptomatic, the five potential warning signs of prostate cancer are:
Other symptoms include:
In cases spread beyond the prostate gland, there could be swelling in the lower body, and the presence of back, hip or bone pain. There could also be abnormal bowel movements or urinary habits and unexplained weight loss.
The type of prostate cancer depends on the type of cell involved:
Other rare forms are :
DNA mutations (especially the genetic mutations of BRCA1 and BRCA2) are known to be the main causal factor for prostate cancer. Although it still remains uncertain why one develops cancer, the below indicated risk factors increase the chances of developing prostate cancer:
Prostate cancer might lead to the below complications:
Prostate Cancer is classified clinically from T1 to T4 stages:
|T1||The tumour cannot be felt during a rectal examination or seen during imaging. It may be accidentally found during surgery for another medical condition.|
|T2||Tumour is confined to the prostate and can be felt during the rectal examination due to its size. It may also be seen in imaging. It is further classified as
|T3||Tumour has grown out of the prostate.
|T4||Tumour has spread to tissues next to the prostate like the rectum, urinary bladder, urethral sphincter, and pelvic wall.|
Radical Prostatectomy involves the removal of the prostate gland. It is the best option when the cancer is confined only to the prostate. Laparoscopic surgeries are more commonly used these days as it is minimally invasive than an open radical prostatectomy.
Involves a course of radiation therapy, particularly in advanced cases, to prevent the spread of cancer. It can be external beam therapy where the machine moves around the body directing high-powered radiation beams to the prostate area; or brachytherapy (internal radiation) where radioactive material is directly placed into the prostate using a hollow needle.
Drugs are used to kill the rapidly growing cancer cells. Administration of drugs is via veins or oral pills.
4. Ablative therapy:
Freezing or heating prostate tissue to destroy the cells is used for very small prostate cancers where surgery is not possible. Cryotherapy or cryoablation involves freezing tissues while HIFU (High-intensity focused ultrasound) uses high-intensity ultrasound to heat the prostate tissue.
5. Hormone Therapy:
It is used to reduce the size of the prostate and prevent further growth.
Drugs are used to strengthen one’s own immunity to fight off cancer cells.
7. Targeted drug therapy:
Uses specific drugs, especially in advanced or recurrent cases if the patient is not responding well to hormone therapy
8. Watchful waiting:
Involves monitoring patients for their symptoms and treating them only when there are signs of growth of prostate cancer. This is particularly useful in older men who develop cancer at later stages of their life where treatment can be very harsh given their old age. Active surveillance is another method where DRE and PSA are continuously done as a part of monitoring.
DRE (Digital Rectal Examination) and PSA (Prostate-Specific Antigen) testing are the most commonly used screening measures to detect cancer. If one is particularly at risk of having prostate cancer, a doctor would advise screening. However, confirmatory diagnoses are very essential to further confirm cancer.
The 5-year survival rate (the percentage of people alive after 5 years of diagnosis of cancer) for people with prostate cancer is 99%. 1 out of 3 men will survive after 5 years of diagnosis, even if it has spread to other parts of the body. The survival rate has improved in recent years with better screening and treatment options.
Medical professionals do not recommend performing a self DRE. However, regular screening like PSA testing & DREs performed by a doctor can be useful. Another option is to watch out for warning symptoms like painful urination, blood in urination, etc can help in early detection.