PROSTATE CANCER

About the Condition

The prostate is a small gland found only in men and is located below the bladder and surrounding the urethra. The prostate’s primary function is to produce seminal fluid to nourish and transport sperm.

The cells that make up the outermost part of the prostate can become cancerous and give rise to prostate cancer. This is a slow growing cancer that can spread to other organs, particularly the skeleton. Patients who are diagnosed early have a very high survival rate.

Symptoms and Detection

Early stage prostate cancer is usually without symptoms and may be detected during a routine examination of the anus and rectum. Symptoms usually show up at later stages of the disease as the tumour grows and narrows the urethra and, when the cancer spreads to other organs.

The symptoms include:-

• weak or interrupted urine flow
• frequent urination (especially at night)
• difficulty in urination
• pain or burning sensation during urination
• blood in the urine or semen
• persistent pain in the back, hips or pelvis
• painful ejaculation

These symptoms are non-specific and may also be caused by benign (non-cancerous) conditions such as benign prostatic hyperplasia and prostatitis.

Screening and Testing

Prostate cancer can be diagnosed through the following clinical findings and laboratory tests.

1. Digital rectal examination

   Your doctor will examine the prostate through the rectum to determine if there are any abnormalities.

2. Prostate Specific Antigen (PSA) level

   A blood test for PSA, a substance produced by the prostate to liquefy semen, is carried out. A higher than normal level may indicate cancer.

3. Transrectal ultrasound guided biopsy

   Tissue samples from the prostate are taken and tested for the presence of cancer cells

Once prostate cancer has been diagnosed, your doctor may perform scans of the abdomen and a bone scan to determine if the cancer has spread.

Risk Factors and Causes

Very little is known about the cause of prostate cancer although some risk factors have been identified.

These risk factors include:-

• Age (over 55 years old)
• Race (higher risk in African Americans and Scandinavians)
• Family history of prostate cancer
• Diet (high in animal fat and red meat)
• Previous vasectomy

Prevention

As the exact cause of prostate cancer is not known, it is not possible to prevent the disease from occurring. However, you can take steps to maintain prostate health by having a balanced diet comprising more fruits, vegetables and fibre, be physically active and have regular check-ups.

Stages

The stages of prostate cancer are:-

Stage 1:	The tumour cannot be detected by routine tests, but was found during a surgery for another prostate disorder or found through a biopsy performed because of high PSA levels.
Stage 2:	The tumour can be felt during a rectal examination but has not spread beyond the prostate.
Stage 3:	The prostate cancer has spread beyond the prostate to nearby organs.
Stage 4:	The cancer has spread to the pelvic lymph nodes or distant organs such as the bones.

Treatment Options

The choice of treatment would depend on the prostate cancer profile, including:-

• age and life expectancy
• medical condition and risk factors
• presence of significant illnesses, such as heart problem, stroke, diabetes and so on
• Prostate Specific Antigen (PSA) level
• Gleason score (derived from the pathologist’s assessment of the prostate biopsy)
• presence of metastasis (extensive spread of disease)
• status of digital rectal examination

Your doctor will assess your cancer profile and recommend one of the following treatment options:-