Prostate Cancer

Overview

The prostate is a small gland in the pelvis about the size of a walnut. It is found between the penis and bladder, and its function is to create the thick white fluid that mixes with sperm from the testicles to produce semen.

Unfortunately, prostate cancer is one of the most common cancers in men and rarely has symptoms until it has grown large enough to pressure the urethra that carries urine from the bladder.

 Key facts 

• Prostate cancer does not usually cause any symptoms until the cancer has grown large.
• Obesity and family history are common causes.
• An MRI scan and a biopsy are used to diagnose prostate cancer.
• Sometimes, it can cause erection and urinary problems.

Symptoms & Diagnosis

Symptoms of prostate cancer include:

• needing to pass urine more frequently, particularly during the night
• straining or taking a long time while peeing
• weak flow of urine when peeing
• difficulty in starting to pass urine (hesitancy)
• feeling that the bladder has not emptied fully
• blood in urine or blood in semen

However, these symptoms can indicate other non-cancerous health conditions, so it is essential to speak with a doctor. If cancer has spread beyond the prostate, other symptoms can include bone and back pain, a loss of appetite, pain in the testicles and unexplained weight loss.

Diagnosis 

If you have symptoms that could be caused by prostate cancer, you should speak with a doctor. 

The doctor will assess your risk based on various factors, including age, family history, and ethnic group. There is no single definitive test, but your doctor is likely to recommend as first steps:

• Taking a urine sample to check for infection
• Taking a blood sample to test your level of prostate-specific antigen (PSA)
• Examining the prostate by inserting a gloved finger into your anus

You may also be sent to have a biopsy taken – this is where they take a tissue sample from your prostate. The most common type of biopsy conducted for prostate cancer in Nigeria is called a transrectal biopsy. This can be uncomfortable, so a local anaesthetic will likely be given to reduce the discomfort.

Once any biopsy has been completed, the tissue is studied in a laboratory. If any cancerous cells are found, further tests will occur to determine how quickly cancer could spread. This helps doctors “stage and grade” cancer so they can recommend the most appropriate treatment to fight it.

Further tests may be recommended if cancer has spread to other parts of the body.

These can include:

• an MRI scan, CT scan or PET scan – this help creates a detailed picture of the inside of the body.
• an isotope bone scan which helps identify if cancer has spread to the bones

Causes

Although the exact cause of prostate cancer is not known, several factors can increase your risk level

These can include:

• Age: most cases are diagnosed in men over 50 years of age
• Ethnic group: prostate cancer is more common among those of African-Caribbean and African descent than in Asian men
• Family history: if any close male relative has developed prostate cancer before being 60 years old, it indicates an increased risk of developing it; additionally, research highlights the same indication if a close female relative has developed breast cancer
• Obesity: recent research indicates there could be a link between being overweight and prostate cancer
• Diet: research is still ongoing, but there is some evidence that a diet high in calcium can lead to an increased risk of developing prostate cancer

Prevention

Although there is no conclusive proof that diet can prevent prostate cancer, having a healthy diet with a good mix of fruits and vegetables can improve your overall health, reducing your risk of health problems.

Additionally, exercising regularly and maintaining a healthy weight can reduce your overall risk.

Treatments

Treatment for prostate cancer will depend on each person’s circumstances. This is determined by identifying the cancer stage – how far cancer has spread. If prostate cancer is diagnosed early, chances of survival are considered good.

Treatment options include:

• Watchful waiting: Normally recommended for older men if the cancer is in its early stages, not causing symptoms and where it is unlikely to affect their natural lifespan. It can also happen if other forms of treatment are not advisable for the patient’s general health. In these cases, hormone treatments may be prescribed to treat any symptoms.
• Surgery to remove the prostate gland: This is an option for those whose cancer has not spread beyond the prostate or has not spread very far
• Radiotherapy: This involves using radiation to kill cancerous cells. This treatment is an option for those whose cancer has not spread beyond the prostate or has not spread very far. There are different types of radiotherapy which the doctor will talk through with you if it is required.

Conclusion

Men can have prostate cancer for many years without any symptoms, but it is worth speaking with a doctor about your health risks, especially after you have reached 50 years old. Treatment depends on the speed and ferocity of the cancer spread. Still, surgery and radiotherapy increase the chances of survival for those whose cancer is found before it has spread too significantly.