Prostate Cancer

Prostate Cancer

prostate-cancer

Prostate is an organ found just between the penis and the bladder with the primary function of secreting fluids that help nourish mature sperm cells, thus it plays a major role in the male reproductive system. Prostate cancer is a type of cancer exclusively found in men. It is the number one non-cutaneous cancer in the United States. It has approximately 20% lifetime development risk both in white and African American men. In 2014, a little over 200,000 newly diagnosed cases were recorded in the US, most of these patients were more than 40 years old, rarely younger than that age.

Prostate cancer could be caused by different etiologies, but genetic predisposition remains to be the major cause of development of the said disease. Cross-sectional have proven that those patients who have a 1st degree relative with prostate cancer have a 5-10% increased risk of developing prostate cancer during their lifespan.

Lifestyle, like most of the other cancers also plays a role in developing this disease. Cigarette smoking, alcohol consumption, bad diet, and obesity are all contributory factors to prostate cancer. As mentioned above, prostate’s primary function is to secrete fluid needed for maturation of sperm cells. These function is governed by hormones. It is postulated that if there are mismatches in ratios of these governing hormones such as the luteinizing hormone and dihydrotestosterone, there could also be an increased risk of having prostate cancer.


Signs and symptoms of prostate cancer

Symptoms are usually related to urinary obstruction. These include dysuria or pain experienced during urinating, increase urinary frequency and feeling of incomplete voiding. In the late stage of the disease, a patient could already have anemia, weight loss and anorexia. These are constitutional signs and symptoms of tumor activity. If prostate cancer remains undiagnosed and spread throughout the body, the most commonly organ affected is the bone, thus the patient could feel bone pain without pathologic injury. Swelling of extremities is also common that could be accompanied by pain. This is a result of obstruction of venous and lymphatic passages due to nodal metastasis.

In the advent of newer technology and the result of years of researches, there is now a screening test to detect developing prostate cancer through the PSA (prostate specific antigen) evaluation as well as DRE or digital rectal exam. PSA is a protein produced by prostate and if this protein increased dramatically, there is good chance that the prostate is enlarged. This could also be supported by doing a digital rectal exam wherein a patient’s prostate is palpated via the anus. Unusual large prostate could be palpated through the anus. Through this screening, early detection of possible prostate cancer pushes through resulting to better case finding and early management.


Treatment

Management of prostate cancer depends on multiple factors. Before a treatment is initiated, factors such as life expectancy, complications, relative efficacy and quality of life are considered. All of these considerations are for the betterment of the patient. Treatment options include surgery, cryotherapy, and radiotherapy and hormone therapy. It is important to note that these treatments have their own side effects. Radical prostatectomy or surgery and radiation therapy result in permanent side’s effects, most commonly erectile dysfunction and urinary incontinence.

Even with the development of the screening tool and modern-day management, prostate cancer remains to be the 2nd most common cause of cancer death in men. It is therefore important to double the efforts form different groups including government, different organizations and prostate cancer victims to increase the awareness about prostate cancer, and how to prevent it.

There are many screening programs for different types of cancers. It’s very important to weight the benefits and the risks of any screening test before doing it.

Screening tests for prostate cancer

Prostate cancer may be screened by using two tests:

  1. PSA test: PSA stands for prostate specific antigen, this is a test to detect the level of PSA in the blood. Normal value is less than four nanograms per milliliter. Recent studies indicate that PSA is not a reliable screening test as it may be high for normal men!

  2. Digital Rectal Exam: This is also known as DRE, the doctor will put his finger into the patient’s rectum to feel any bulge or mass for the prostate. It’s not a comfortable test for the patient, many patients may have a benign (non-cancerous) enlargement of the prostate.

Abnormal results after PSA test or DRE

If one has abnormal results in the PSA test or DRE, the doctor will take a small biopsy from the prostate and send it to the histopathology lab for analysis. The sample is taken via a small needle which is inserted in the prostate tissue.

When to start screening for prostate cancer?

It’s highly recommended to know every single detail about prostate cancer screening tests including the benefits and the risks behind them. It’s very crucial to discuss these issues with your doctor. The doctor will advise you to do the right test at the right time. Men at normal risk of getting prostate cancer should discuss this issue with their doctors at the age of 50, while the high risk group should do that as early as age 40.

High risk group for prostate cancer

Following are the high risk group for prostate cancer:

  1. African American race,

  2. First degree relative with prostate cancer,

  3. Family history of prostate cancer.

Who should be screened for prostate cancer and why?

You may be wondering why we don’t screen all the men for prostate cancer as we do for colon cancer. The main problem with prostate cancer screening test is the high false negative and false positive rates. Many patients will have positive screening test results, while they don’t have prostate cancer. None of the prostate cancer screening tests can differentiates between prostate cancer and benign enlargement of the prostate which is a normal process with age.

Recent studies proved that regular PSA test doesn’t improve the life expectancy of the patient. At the same time, treating prostate cancer has lots of side effects on the patient life including a bad sexual impact. Therefore, it is important for patients to understand the information and the impact of screening test and treatment options.