PROSTATE CANCER

Main Article

What is prostate cancer?

Located just below the urinary bladder in men, the prostate is a small body part that produces some of the fluid (semen) that men release during sex. Prostate cancer is a disease in which some cells of the prostate begin to grow abnormally and without control. This abnormal growth may remain within the prostate, or it may spread to other body parts and cause problems in those organs. Prostate cancer is one of the most common cancers in men. It is different from a condition called benign prostatic hyperplasia (BPH) in which the prostate is enlarged but there is no cancer in it.

Why does a person develop prostate cancer?

The exact reason why prostate cancer develops is yet to be known, but the following factors are associated with having the disease:

1. Being above 50 years of age. However it is mostly seen in men who are 65 years and older. Prostate cancer is rare before age 40.
2. African and African-American men are more likely to develop prostate cancer than non-Africans.
3. Having a relative who developed prostate cancer increases the chances of developing the disease, especially if the relative had it before he turned 50 years.
4. Having a female relative with breast cancer or ovarian cancer may also increase the risk of developing prostate cancer.
5. Lack of regular physical activity, a diet that is high in animal fat such as red meat, and being obese are linked to having prostate cancer but these do not cause the cancer.

What happens when a person has prostate cancer?

A person can have prostate cancer and not feel any symptoms. However, because the prostate surrounds the urethra (the passageway through which urine and semen are released), problems with urination or sexual function can be early warning symptoms of the disease. These symptoms include:

• Blood in the urine or semen
• Painful urination
• Having to strain hard before urine comes out
• Urinating frequently, and an increase in waking up at night to urinate
• Difficulty in controlling urine flow
• Pain in the groin and upper thighs
• New difficulty in achieving or maintaining erection of the penis
• An uncomfortable feeling of incomplete emptying of the urinary bladder, even after urinating.

If the prostate cancer has spread to other body parts, other symptoms could include pain in the lower back, bone pains, constant feeling of tiredness, weight loss, and abnormal feelings in the legs. For some people, the cancer grows so slowly that they live into old age without treatment and eventually die from other causes, not prostate cancer.

Importantly, prostate cancer cannot be diagnosed by any combination of symptoms alone because similar symptoms can also occur during certain sexually transmitted infections, enlarged prostate without cancer, or infection of the prostate or urinary system.

How can prostate cancer be prevented?

There are no definite ways to prevent prostate cancer but the risk of developing it can be lowered by:

• Maintaining a healthy body weight
• Exercising regularly
• Eating a healthy diet, with lots of vegetables and fruits, and replacing unhealthy fats with good fats (available in fatty fish like salmon)
• Reducing high intake of caffeine, alcohol, and refined sugars.

Also, there are methods for detecting prostate cancer early, before symptoms manifest. This is referred to as screening. Screening is useful because early diagnosis and treatment can be made before prostate cancer spreads and becomes worse.

The following methods are used in screening for prostate cancer:

1. Adigital rectal examination: This is a physical examination process where a doctor wears a glove and inserts a finger through the patient’s anus to check for abnormalities of the prostate.
2. A prostate-specific antigen (PSA) test: This is a blood test that checks for a special protein produced by the prostate. PSA levels may be high in prostate cancer, although this can also be caused by an enlarged prostate without cancer or by prostate infection. Therefore, the result of this test is combined with the digital rectal examination findings to determine if further tests are needed.

Why do some men not go for screening?

Some men do not go for prostate cancer screening because they do not know that they need it. Some do not know where to go for the tests, or are afraid of the costs. Others feel it may be embarrassing, or are afraid of thinking about cancer.

In this regard, the following are important points to note:

1. Men with an average risk for developing prostate cancer are advised to undergo screening yearly from 50 years of age, but those at high risk are recommended to start screening by 40 years of age. Screening tests can be carried out in any standard hospital.
2. Since early detection and treatment of prostate cancer can improve chances of survival, the cost of screening is minimal compared to the danger of having an aggressive cancer.
3. Screening for prostate cancer is strictly professional and not intended to be an embarrassing encounter.
4. There is usually a fear of cancer because many people go to the hospital late after the cancer has spread and reduced the chances of survival. However, people in whom prostate cancer is detected and successfully treated early have a near 100% survival rate. Consequently, concern about prostate cancer should motivate men to present for screening as recommended.

If prostate cancer is suspected, it can be confirmed with a biopsy, a test in which tiny pieces of the prostate are taken and examined under a microscope. Various scans are also used to determine the extent and spread of the cancer. The mode of treatment will then depend on the test results. Sometimes watchful waiting is recommended in which no treatment is provided but the individual is closely monitored with blood tests and physical examinations.

Conclusion

Prostate cancer is a disease that affects men only and is common in men over 50 years of age. The early symptoms tend to affect urination and/or sexual activity but similar symptoms can be caused by other disease conditions. The risk of this cancer can be reduced to some extent by living a healthy lifestyle. Screening is a useful tool for detecting prostate cancer early, and enhancing the chances of treatment success and survival.   
      
 

Article by CH writer Dr. Mercy Folayan, MBBS