Prostate Cancer

What happens?

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The prostate is a small, solid gland located at the base of the urinary bladder. It is found only in males and is normally about the size of a walnut. The prostate is wrapped around the urethra, the tube that through which urine and semen moves out of the body.

In prostate cancer, some of the cells in the prostate gland grow out of control and form lumps of cells called tumours. The tumour can cause problems as it grows, such as difficulty urinating and bloody urine. Cancer cells can also break off the main lump and spread to other parts of the body where they continue growing and causing more problems.

In many developed and developing countries, prostate cancer is the most commonly diagnosed malignancy affecting men beyond middle age.

Despite its high rate of occurrence, little is known about the causes of this condition. There are however things that have been identified to increase its likelihood of occurring. They are called risk factors. They include:

  • Ageing; the strongest risk factor
  • Family history of prostate cancer
  • The presence of testes and the hormones produced by them
  • High dietary fat
  • Cigarette smoking

What are the symptoms?

Prostate cancer grows slowly, and may remain unnoticed for many years. In this situation, it is usually picked up during routine screening as an abnormal rectal examination finding or hormone level.

The symptoms that occur are due to the local effects of the growing tumour, invasion of nearby tissues by the tumour and distant spread to other parts of the body. These include:

  • Urgency to urinate
  • Wetting oneself if urination is delayed
  • Hesitancy of urine to flow
  • Straining to urinate and weak urine stream
  • Feeling of an incompletely emptied bladder
  • Bloody urine and painful urination
  • Urinary incontinence
  • Pain around the genitals and erectile dysfunction
  • Bleeding through the rectum and constipation
  • Low back pain and easy fracturing of bones
  • Paralysis
  • Weight loss

What treatments work?

Prostate cancer is a serious but often curable disease. There are several methods of managing it. The option the doctor chooses is largely dependent on the stage of the disease.

If the cancer has not spread, the management options include:

  • Watchful waiting for elderly men with short life expectancy, or old men expected to live for only a very short period because of other illnesses.
  • If the conditions are favourable, a surgery may be done to remove the prostate and some of the tissues around it. This is called radical prostatectomy. The goal is to remove all the cancer cells and stop it spreading.
  • Radiotherapy may be done for people medically unfit for surgery. He aim is to kill the cancer cells using high-energy X-rays.

If the cancer has spread around but not too far away, the following options may be available:

  • Hormonal treatment followed by surgery
  • Hormonal treatment followed by radiotherapy
  • Hormnal treatment alone
  • Watchful waiting

Normal prostate cells need the hormone testosterone to grow, and so do the cancer cells. So, hormonal treatment involves drugs to block testosterone or surgery to remove the testes which produce it. This slows down the growth of the cancer cells.

How do I prevent it?

Prevention focuses on the following:

  • Regular screening for prostate cancer for early detection and complete cure.
  • Avoidance of the known risk factors earlier mentioned.
  • Taking drugs to slow down the disease.