All about prostate cancer
Early detection, symptoms and treatment of prostate cancer
Prostate cancer is the most common type of cancer in men worldwide. In this article, we will delve into this condition and answer the key questions: What are the early signs of prostate cancer, how is it detected, what is a normal PSA level, what is prostate cancer, and which doctor is responsible for diagnosis and treatment?
What is Prostate Cancer?
Prostate cancer, also known as prostatic carcinoma, is a malignant tumor disease that originates in the prostate, a walnut-sized gland in the male reproductive system. The prostate is located below the bladder and surrounds the urethra, which carries urine from the bladder through the penis. The main function of the prostate is to produce a part of the seminal fluid that transports sperm cells. This fluid is crucial for the motility and fertilization capability of sperm.
The exact causes of prostate cancer are not yet fully understood, but there are certain risk factors that can increase the risk of developing the disease. These include age (the risk increases with age), family history, smoking, alcohol consumption, and ethnicity (prostate cancer is more common in African Americans). Prostate cancer initially develops locally in the prostate itself. In advanced stages, cancer can spread (metastasize). The lymph nodes in the pelvis and the bones are particularly commonly affected.
Early detection of prostate cancer is crucial, as the best chances of cure are in the early stages of the disease. This is typically done through the PSA test (prostate-specific antigen) and the digital rectal examination (DRE), in which the doctor looks for anomalies in the prostate. If prostate cancer is suspected, a prostate biopsy may be performed to take tissue samples for a more precise diagnosis.
What are the early signs of Prostate Cancer?
The early signs of prostate cancer can develop gradually and vary from person to person. Common symptoms may include:
Frequent urination
Men with prostate cancer may feel the need to urinate more often, especially at night.
Difficulty urinating
Problems starting or stopping urination, as well as a weak urine stream, may occur.
Painful urination
A burning or painful sensation during urination is possible.
Blood in the urine or ejaculate
The presence of blood in the urine or semen may indicate prostate cancer.
Erectile dysfunction
Difficulty achieving or maintaining an erection may occur.
It's important to note that these symptoms can also indicate other prostate conditions, including benign prostatic hyperplasia (BPH). Therefore, a thorough examination and diagnosis are crucial.
How is Prostate Cancer detected?
Early detection of prostate cancer is crucial, as an early diagnosis can significantly improve treatment chances. The two main methods of detection are:
PSA Test (Prostate-Specific Antigen)
This blood test measures the concentration of PSA, an enzyme produced by the prostate. An elevated PSA level may indicate prostate cancer, but it is not conclusive on its own and requires further testing.
Digital Rectal Examination (DRE)
In this examination, the doctor palpates the prostate with a finger through the anus to check for irregularities or nodules. This, along with the PSA test, can help in the early detection of prostate cancer.
What is a normal PSA level?
A normal PSA level is usually below 4.0 nanograms per milliliter (ng/ml) of blood. However, it's important to note that an elevated PSA level does not necessarily indicate prostate cancer. Other factors such as age, prostate size, and prostate inflammation can also lead to an increase in PSA levels. A PSA level above 4.0 ng/ml may warrant further testing and a prostate biopsy to either rule out or confirm prostate cancer.
Prostate Cancer: Which coctor is the right one?
If prostate cancer is suspected or for a preventive check-up, it's advisable to consult a urologist first. The urologist is a specialist in diseases of the urinary tract and the male reproductive system, including the prostate. They will conduct the PSA test and the digital rectal examination and, if necessary, initiate further tests such as a prostate biopsy.
How is Prostate Cancer treated?
The treatment of prostate cancer depends on various factors, including the stage of the disease, the patient's age, their overall health, and other individual factors. The most common treatment methods for prostate cancer are:
Active Surveillance
In the early stages of low-risk prostate cancer, where the tumor grows slowly and is not aggressive, the doctor may recommend regular monitoring of the disease instead of initiating active treatment immediately. This may involve regularly checking the PSA level and occasionally performing biopsies to ensure the cancer is not progressing. If the cancer worsens during monitoring, active treatment may be considered.
Surgical removal of the prostate (prostatectomy)
In this procedure, the entire prostate is removed. Prostatectomy can be done laparoscopically (minimally invasive) or through an open procedure. In some cases, this operation can enable a complete cure of the cancer. However, sexual dysfunction and urinary incontinence may occur after prostatectomy.
Radiation Therapy
Radiation therapy involves targeting high-energy rays specifically at the prostate to kill cancer cells. This can be done through external beam radiation therapy or brachytherapy, where small radioactive metal particles are inserted into the prostate. Radiation therapy can be used as the primary treatment or after a prostatectomy (adjuvant radiation therapy).
Hormone therapy
Hormone therapy aims to block the production of testosterone or the effect of testosterone on prostate cancer cells, as testosterone promotes the growth of prostate cancer. Hormone therapy can be used as a standalone treatment or in combination with other therapies.
Chemotherapy
Chemotherapy may be considered for advanced prostate cancer, especially if the cancer has spread to other organs. Chemotherapy for prostate cancer is a palliative treatment and does not aim to cure the cancer. Instead, it aims to control the prostate cancer, slow its progression, and extend life.
Immunotherapy
Immunotherapy activates the patient's immune system specifically to better recognize and destroy cancer cells. Treating prostate cancer with immunotherapy is currently being researched in clinical trials and is not yet a standard therapy.
The choice of appropriate treatment depends on a thorough diagnosis, assessment of the cancer stage, and the patient's individual circumstances. It's important to discuss all options with your treating physician to make the best decision for your situation. Advances in medical research have significantly improved the treatment of prostate cancer in recent years, providing many successful options for treating the disease and maintaining quality of life.