Prostate Cancer

Prostate cancer is a type of cancer that starts in the prostate, a gland about the size of a ping pong ball, situated below the bladder. This gland plays a significant role in semen production, thus contributing to male fertility, although it is not vital for survival. Among men, prostate cancer is the second most common cancer. Fortunately, it is also one of the most survivable forms of cancer.

Causes

Prostate cancer begins when cells within the prostate gland grow uncontrollably due to changes in their DNA, which allow them to bypass the body’s usual mechanisms for controlling cell division. Several factors can contribute to these changes:

• Genetic Mutations: Inherited mutations like BRCA1 and BRCA2 increase the risk.

• Age: The risk rises significantly as men age, particularly after 65.

• Family History: A family history of prostate cancer suggests a hereditary risk.

• Lifestyle Factors: Smoking has been linked to more aggressive prostate cancer forms.

While the exact processes through which these DNA changes lead to cancer are unclear, acknowledging these risk factors helps in early detection and prevention.

Symptoms

Prostate cancer often grows slowly, with symptoms commonly unnoticed in the early stages. Possible symptoms as the condition progresses include:

• Frequent urination, especially at night

• Difficulty starting or stopping urination

• Weak or interrupted urine stream

• Feeling of incomplete bladder emptying

• Pain during urination or ejaculation

• Blood in urine or semen

• Persistent pain in the back, hips, or pelvis

• Unintentional weight loss and fatigue

Many prostate cancer cases are discovered during screenings before symptoms occur. If you notice any symptoms, consult a healthcare provider, as they may indicate prostate cancer or other health issues.

Diagnosis

Diagnosis begins with screening tests like a prostate-specific antigen (PSA) blood test and a digital rectal exam. If results suggest potential cancer, further evaluations, such as MRI or ultrasound, may be conducted. The definitive diagnosis is made through a biopsy, where prostate cells are examined for cancer. The biopsy also provides a Gleason score to determine cancer aggressiveness, essential for planning the most appropriate treatment. Early detection through these methods is crucial for successful prostate cancer management and treatment.

Treatments

Prostate cancer treatments vary based on individual needs and circumstances, potentially involving:

• Active Surveillance: Monitoring the cancer closely with regular tests and initiating treatment upon signs of progression.

• Surgery: Common when cancer is confined to the prostate, possibly involving prostate removal.

• Radiation Therapy: Uses high-energy rays to destroy cancer cells, delivered externally or internally.

• Hormone Therapy: Reduces testosterone levels to prevent cancer cell growth.

• Chemotherapy: Typically for advanced cases, using drugs to target cancer cells.

• Emerging Treatments: Include ablation therapies and immunotherapy that support the immune system against cancer.

A diverse team of healthcare professionals collaborates to tailor the treatment to the cancer’s stage and the patient's situation.

Medications

Medications play various roles in prostate cancer management, including:

• Hormonal Treatments: Reduce testosterone levels to slow cancer growth (e.g., Leuprolide, goserelin).

• Antiandrogens: Block testosterone's effects on cancer cells (e.g., Bicalutamide, enzalutamide).

• Chemotherapy: Targets advanced cancer cells (e.g., docetaxel, cabazitaxel).

• Targeted Therapy: Like olaparib, precisely target cancer cell pathways.

• Immunotherapy: Boosts the immune response against cancer (e.g., sipuleucel-T, pembrolizumab).

• Radiopharmaceuticals: Deliver radiation to metastasized cancer cells.

Treatment is customized to a patient’s specific cancer and health needs for effective management.

Living

Receiving a prostate cancer diagnosis can be overwhelming. Remember, your emotions are normal, and support is available. Reach out to healthcare providers about support groups or mental health services if needed. Your medical team is there to help manage treatment side effects to enhance your quality of life during and after treatment. Managing side effects can improve treatment outcomes. Maintaining a healthy diet and staying physically active can also support the treatment process.

Prevention

While you cannot entirely prevent prostate cancer, certain lifestyle choices can lower your risk:

• Regular exercise

• Maintaining a healthy weight with balanced nutrition

• Consuming plenty of fruits and vegetables, limiting fats, red meat, and dairy

• Avoiding smoking and moderating alcohol intake

• Increasing vitamin D intake

For those with a higher risk due to familial factors, discussing screening options and preventive medications with a healthcare provider can be helpful.