The prostate is a walnut-sized gland that is part of the male reproductive system. It sits below the bladder in front of the rectum, and forms a ring around the urethra (the tube that carries urine out of the bladder and body). The function of this gland is to secrete fluid that is part of the semen which nourishes, protects and transports sperm.
Prostate cancer develops when normal cells in the prostate gland change into abnormal cells and grow out of control. This may be due to mutations in the abnormal cells' DNA. The abnormal cells continue to live and grow, when other normal cells would die. This results in the formation of a tumour that can invade surrounding structures, causing damage. Some abnormal cells can even break away and spread to other parts of the body.
Although prostate cancer is common, the cancer is not typically fatal as it usually grows very slowly. It does not cause serious harm when confined to the prostate gland. However, there are aggressive types of prostate cancer which can spread rapidly to lymph nodes and other organs such as the bone.
Early-stage prostate cancer usually does not have any symptoms. Some warning signs of prostate cancer include:
Do note that presence of these symptoms may not necessarily be due to prostate cancer and can be due to other conditions. However, you should consult your doctor for further assessment if any of the above symptoms persist.
Risk factors for prostate cancer include:
Screening for prostate cancer is important because it offers the hope of catching prostate cancer early before it has a chance to grow, spread and cause symptoms. As with all cancers, early diagnosis is important because it translates to early and more effective treatment, and reduced morbidity and mortality. For early-stage cancers, the 5-year survival rate is more than 95%.
Screening can be done via a blood test called the PSA (Prostate Specific Antigen) test. PSA is a protein made by the prostate and is usually found in higher levels in men with prostate cancer. Men aged between 50 to 70 years, or those at a higher risk of prostate cancer are recommended to take the test. However, prostate cancer is not the only condition that causes raised PSA levels. As other conditions such as an enlarged prostate (benign prostatic hyperplasia) and prostate infection can also cause raised PHA levels, further tests will need to be done to confirm the diagnosis if prostate cancer is suspected.
Cancer staging is a system to describe the size, aggressiveness and how far a cancer has spread. Staging is important in the management of cancer because it helps to guide treatment and predict the chance of cure.
A prostate cancer's stage is based on the following:
These 3 categories, along with the PSA test, are used to assign a prognostic stage group. There are 4 stages in cancer staging (stage I to IV):
In general, lower stage cancers are less aggressive and less likely to recur after treatment.
There are several treatment options for prostate cancer. The choice of treatment depends on the patient's age, health, preference and stage of cancer.
For stage I and II cancers, treatment includes:
For stage III cancers, treatment often includes a combination of two approaches:
Stage IV advanced cancer (prostate cancer with metastasis) is not curable, but treatment can often help to control the disease for prolonged periods of time, hence reducing symptoms and improving quality of life. It is usually treated with a combination of different approaches, which may include hormone therapy, chemotherapy, radiotherapy or immunotherapy. Surgery is usually not offered when there is spread to the other parts of the body such as the bones (distant metastasis).
Your risk of developing prostate cancer can be reduced by having a healthy lifestyle, including regular exercise and a healthy diet. You should consume fruits, vegetables and whole grains, and avoid a high-fat diet.
Should you be concerned about your symptoms, please see your general practitioner or make an appointment with a urologist, who will be able to address your concerns and provide you with an accurate diagnosis of your condition.