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Prostate Cancer Symptoms, Causes, and Treatment – Prostate Cancer

At first, prostate cancer symptoms may not be noticed, but later it can become troublesome for men; here, what you need to know.

It is the second leading cause of cancer deaths for men in the United States. It affects nearly 1 out of 9 men. The prostate is a gland within the pelvis, right next to the bladder; a doctor can examine it with a digital rectal exam. 

Within this article, you will find explanations for some of the most common inquiries regarding this disease, with a special emphasis on prostate cancer symptoms. Among these, you will find questions like what are the survival rates and what are the risk factors for this disease.

By reading this article, you will acquire critical insights into prostate cancer, its symptoms, what you should do, and the treatment options. Therefore, please continue reading this article to get pearls on this particular subject directly from a doctor’s hand. 

What is the Prostate?

The prostate is a gland that has the dimension of a walnut. Its location is between the bladder and the penis. It is also right in front of the rectum, so the digital rectal exam is a way to examine the prostate gland.

The urethra, coming directly from the bladder, passes right through the prostate, enabling the urine to leave the body. Hence, when there are troubles with the prostate, like benign prostate hyperplasia (enlarged prostate) or Prostatitis, the urine flow reduces. This could also occur due to prostate cancer and is a part of the possible prostate cancer symptoms.

The prostate tissue has three different types, which are the following:

  • Peripheral Zone: It is about 70% of all the prostate tissue. It is the tissue that surrounds the urethra. About 70% to 80% of all prostatic cancers originate from this zone of the gland.
  • Central Zone: This zone surrounds the ejaculatory ducts, and it covers around 20% of the prostate tissue. Approximately 2% to 3% of prostatic cancers originate from this zone. These cancers tend to be more aggressive as they may invade the seminal vesicles. 
  • Transition Zone: It covers about 5% of the prostatic tissue. This zone surrounds the urethra as well. About 10% to 20% of prostatic cancers originate from this zone.

Now, what is the specific function of the Prostate? The prostate cells produce a fluid, which becomes an important part of the semen. This fluid nourishes and protects the sperm. The prostate gland can change shape depending on the situation. It can switch between ejaculation and urination. It has two longitudinal muscle systems running along the prostatic urethra. Each one of them respectively causes the urethra to enlarge or to shrink.  

File:3D Medical Animation male accessory gland.jpg
Source

How many types of prostatic cancer are there?

To effectively decide which kind of cancer treatment a patient needs, the doctor must know what type of cancer it is. Also, the type of cancer tells in what type of cell cancer started in.

Cancer begins with a modification in healthy prostate glandular cells. The most common cells are in the peripheral zone, as most prostatic cancers originate from this zone.

To know what type of cancer it is, the doctors use information about the patient’s prostate. They will see how abnormal the prostate cancer cells under a microscope are; this is cancer grading. For the staging, the doctors will look at the size of cancer and if it has spread. However, these are some of the most common types of prostatic cancer:

  • Acinar Adenocarcinoma: These are the most common type of prostatic cancer. Adenocarcinomas are cancers in which the gland cells begin to mutate into cancer cells. This can happen in any prostate gland zone, but it is most common in the peripheral zone.
  • Ductal Adenocarcinoma: This type of cancer commences in the cells of the ducts or tubes of the prostate gland. This type of cancer manages to thrive and spread more quickly than acinar adenocarcinoma due to its location.
  • Transitional Cell (Urothelial) Cancer: This type of cancer begins in the cells from the tube that carries the urine outside of the body. This tube is the urethra. It is a type of cancer that usually starts in the bladder, and it later spreads to the prostate. However, it rarely starts in the prostate gland to later disseminate into the bladder entrance.
  • Squamous Cell Cancer.
  • Small Cell Prostate Cancer
  • Neuroendocrine tumors.
  • Sarcomas.

How many people are affected by Prostate Cancer?

Asides from skin cancer, Prostatic cancer is the most common cancer in American men. Overall, it occupies third place in the statistics for new cases in 2020, just below Lung Cancer and Breast Cancer.

The estimates for 2020 are the following:

  • There are going to be approximately 191.930 new cases of prostate cancer. 
  • Around 33.300 people will die from prostate cancer.

This is a type of cancer that affects approximately 1 out of 9 men during their lifetimes. Prostate cancer is more prone to happen in more aged men. It also has a higher incidence in African American men.

Most of the cases, approximately 6 out of 10 cases, which mean 60% of the cases, are diagnosed in men who are older than 65 years old. It is very rare and unlikely that it affects men younger than 40 years old. The average age for diagnosis is about 66 years old. 

On the other hand, Prostate cancer occupies the second leading cause of cancer deaths among men behind lung cancer. About 1 out of 41 men will die from Prostate Cancer.

This disease can be very serious; however, most men with a diagnosis of prostate cancer do not die from it. There are very good survival rates for this disease. Among the 3.1 million men with a prostate cancer diagnosis at some point in their lives are still alive today.

What are the survival rates for prostate cancer?

The survival rates give the patient an idea of what percentage of people with the same condition are still alive within a period. This time is usually about five years after diagnosis. It is important to know that these statistics will not tell the patient how long he will live. These statistics may give the patient an idea of how likely it is that the treatment will be successful from prostate cancer survivors’ data.

The American Cancer Society relies on the information from the SEER (Surveillance, Epidemiology, and End Results) database to build these statistics. The SEER database does not group the cancers by the TNM stages. This database groups the cancers into three different stages, which are the following:

  • Localized: Localized prostate cancer stage refers to that there is no clinical sign that suggests that cancer has spread outside the prostate.
  • Regional: This stage suggests that cancer has spread outside of the prostate. However, it has spread to nearby structures like lymph nodes.
  • Distant: For the distant stage, cancer has spread to parts of the body that are farther from the prostate. Among these parts of the body are the lungs, the liver, or the bones.

Now, with all this knowledge, the numbers will be easier to understand. It is essential to know that the numbers apply to the cancer stage when it is the first diagnosis. These numbers also do not take everything into account; it only groups the people how far cancer has spread. Even men with a recent diagnosis may have a better outlook than these numbers show.

  • Localized:  The 5-Year survival rate is nearly 100%
  • Regional: The 5-Year survival rate is approximately 100%
  • Distant: The 5-Year survival rate is 31%

What are the risk factors for prostate cancer?

A risk factor is anything that may raise the risk of getting a disease like cancer. Among them, some can be changed, and others may not be changed. But even though a person has one or several risk factors, this does not mean that this person will develop the disease.

Many people with risk factors may not have the disease, while others may develop it without risk factors. Among the principal prostate cancer risk factors, there are the following.

  • Age: This is one of the most important risk factors. People younger than 40 years old will rarely get this disease. However, the chance of getting prostate cancer rises rapidly after 50 years old. 6 out of 10 cases of prostate cancer affect men over 65 years old.
  • Race/Ethnicity: Although its reasons are not very clear yet, race influences this disease’s development. It is most frequent amongst African American men and in Caribbean men with African ascendance. These people are also very likely to develop this disease younger. On the other hand, Asian-American and Hispanic/Latino men tend to have a lower risk of developing the disease.
  • Family History:  This disease seems to run in some families, suggesting that some cases may be inherited or due to a genetic factor. However, most of the prostate cancer cases occur in men without a family history. Having a father or a brother with this disease doubles a man’s risk of developing this disease. A strong familial history of genes that increase the risk of breast cancer like BRCA1 or BRCA2 similarly further increases the risk. A strong familial history of breast cancer raises the risk of developing prostate cancer, as well.

Other Risk Factors

  • Diet: Although the role of diet in prostate cancer is not very clear yet, several studies indicate that it may play a role. Studies suggest that men that consume a lot of calcium may have a higher risk. Nonetheless, there is no strong evidence of this. Also, it is important to note that calcium has other important benefits for overall health.
  • Obesity: There are several studies with mixed results for obesity. Some of these results say that obese men have a lower risk of developing a low-grade form of the disease. However, these men also have a higher risk of getting a more aggressive form of the disease.
  • Smoking: Tobacco abuse is a risk factor for many diseases; however, most of the studies do not show a direct correlation between smoking and getting prostate cancer. Some research shows that tobacco may slightly increase the risk of developing this disease.
  • Inflammation of the Prostate: Some studies suggest that prostatitis directly correlates to a higher risk of developing the disease. On the other hand, some studies indicate that there is no correlation between them. This is because, in samples of prostatic tissue with prostate cancer, the inflammation of the tissue is also very common. 
  • Sexually transmitted infectionsThere are ongoing studies for infections like chlamydia or gonorrhea to see if they can increase prostate cancer risk. This is mainly because these infections lead to the inflammation of the prostate. However, there are no firm conclusions on this topic.
  • Vasectomy: Some studies suggest that men who go through this minor surgery may have a slightly higher risk of developing this disease. Nonetheless, there is no firm evidence for this. Research is still underway to find a possible link.

What are the signs or symptoms of prostate cancer? Or prostate cancer symptoms?

Early in the disease, there might not be any prostate cancer symptoms. Yet, they can be like those of an enlarged prostate (benign prostatic hyperplasia or benign prostatic hypertrophy) if they appear.

Some of the symptoms may also do not have any kind of correlation with benign prostatic hyperplasia. If a man suffers from any urinary symptoms or prostate problems, he should talk with his doctor.

These prostate cancer symptoms do not occur until the cancer has grown large enough. In this case, this refers to more advanced prostate cancer. If cancer grows large enough, it will pressure the tube that carries the urine from the bladder to the outside, the urethra.

Due to the nature of this type of cancer, men should perform a prostate cancer screening when they reach 50 years old. Among the most common prostate cancer symptoms and signs there are the following:

  • Frequent urination, the patient will be in need to pee more frequently. This can also happen very often during the night
  • Dull pain in the lower pelvic area
  • Hematuria or blood in the urine
  • Blood in the semen
  • Painful ejaculation
  • Decreased force in the stream of urine
  • Difficulty in starting to urinate
  • Feeling that after urinating, the bladder has not emptied fully
  • Straining or using a lot of time while peeing
  • Bone pain
  • Erectile dysfunction
  • Losing weight without trying

What should you do if you have prostate cancer symptoms?

If you feel uncomfortable while urinating or think that something is not quite right, the answer is very simple. Prostate cancer in the early stages usually does not have any symptoms.

These prostate cancer symptoms begin to appear when the disease reaches a more advanced stage. Therefore, every man that feels or has any of these symptoms should visit a doctor as soon as possible. The doctor will make an initial screening for prostate cancer. He will perform a digital rectal exam and ask for blood tests. Suppose there are any alterations in the results. In that case, the doctor will ask for further tests to make an assertive diagnosis of the disease.

What are the diagnostic procedures for Prostate Cancer?

To make a diagnosis of prostate cancer, there are several procedures. Medical organizations encourage men over 50 years old to discuss prostate cancer screening’s pros and cons with their doctors. African-American people or people with a familiar history should discuss this topic sooner. The screening for prostate cancer includes:

  • Digital Rectal Exam: The doctor introduces a finger with gloves and lubricant through the rectum. While doing this, the doctor will be able to examine the prostate. If the doctor finds any abnormality in the texture, shape, or size of the gland, he will ask for further tests.
  • Prostate Specific Antigen Test: The doctor will take a blood sample and will ask for its analysis. The prostate-specific antigen is a substance that the prostate usually produces. If there are higher levels than usual, it can mean prostate infection, inflammation, enlargement, or cancer.

After doing the prostate cancer screening, if the doctor finds any abnormalities will ask for further tests. Among the tests for making an assertive diagnosis, the doctor may ask for the following:

  • Transrectal Ultrasound: The ultrasound is very useful to examine soft tissues. During the transrectal ultrasound, the doctor will insert a small probe with the size and shape of a cigar through the rectum.
  • Magnetic Resonance Imaging: If the doctor needs a more specific picture of the prostate, he will ask for magnetic resonance. These images may help the doctor to plan a procedure to remove prostate tissue samples.
  • Prostate Biopsy: To determine if there is actually the presence of cancer cells in the prostate, the doctor will collect a tissue sample of it. This procedure uses a thin needle to collect the tissue through the rectum.

After these tests, the doctor will be able to grade and stage prostate cancer through the Gleason Score.

What are the treatment options for prostate cancer?

There are several options for prostate cancer treatment. However, this will depend on several factors, such as the growing rate of cancer, the patient’s overall wellness, and the likely advantages or side effects of the treatment. 

Some cancers grow so slowly that they may not even need any kind of treatment. Other types of cancer grow at a very quick rate, and treatment is necessary. This is why not every patient is the same. To cover all the treatment options, we will divide them into three types of treatment.

Surveillance

If cancer does not have a rapid growth rate, the doctor may recommend this type of treatment. This is usually for low-grade prostate cancers. It divides into two types of surveillance, active surveillance, and watchful waiting. Now knowing this, both of them will be briefly explained.

  • Active Surveillance: It is a type of treatment that does not actively treat cancer itself. In this type of treatment, the doctor monitors cancer growth with regular tests. The doctor may ask for regular prostate specific antigen tests, digital rectal exams, and periodic biopsies. With the help of these regular tests, the doctor may know if cancer grows. It is a treatment that works for people with the small and slow growing cancer. This allows the patient to avoid sexual, urinary, or bowel side effects for as long as possible. On the other hand, this method requires several biopsies over time to track cancer growth.
  • Watchful Waiting: This type of treatment is for men who do not want or cannot have therapy. It is also good for patients with other types of diseases that can interfere with more aggressive treatment forms. On the other hand, this treatment does not involve regular biopsies or other tools of active surveillance. The risk of this is that cancer may grow and spread between visits making it harder to control and treat.

Localized Therapy

  • Surgery: This type of treatment is very useful for cancers that are confined to the prostate. Sometimes it is useful for cancers that are advanced in combination with other types of treatments. The doctor will perform a radical prostatectomy. The surgeon removes the prostate gland, some surrounding tissue, and a few lymph nodes fully. It is very difficult to access the prostate zone, which is why there are different techniques. The most common is the robot-assisted laparoscopic prostatectomy or RALP. 
  • Radiation Therapy: It uses high energy rays to kill or slow the cancer cells’ growth rate. This can be the primary treatment for prostate cancer instead of surgery. It is very useful after surgery if the cancer is not fully removed or if it returns. There are two types of radiation therapy, which are the following, external beam radiation and brachytherapy. Brachytherapy is basically the placing of radioactive sources within the prostate tissue.
  • Cryotherapy: In this type of treatment, the doctor uses controlled freezing of the prostate gland. With the freezing, the doctor seeks to destroy the cancer cells. It is a procedure that needs anesthesia. This type of treatment is beneficial for patients with very small cancers. It is also a good option for patients that are not good candidates for surgery or radiotherapy. After this, the patients have regular control with prostate specific antigen tests and biopsies.

Systemic Therapy

  • Hormonal Therapy: This also receives the name of androgen deprivation therapy. Prostate cancer cells utilize the hormone testosterone to develop. With this type of therapy, the doctor seeks to slow down the progression of cancer. There are various ways to perform hormone therapy. The first one is through surgery; a surgeon will perform an orchiectomy. This is basically that the surgeon will remove the testicles to slow down the progression. The other ways are through medications. They can help stop the body from producing testosterone or block the testosterone to reach the cancer cells. It is a type of treatment usually used before radiation therapy to treat cancer that has not spread from the prostate.
  • Chemotherapy: This type of treatment is for later prostate cancer stages, basically for metastatic prostate cancer. This therapy uses drugs that destroy cancer cells anywhere in the body. These drugs destroy any rapidly growing cell, which means it can attack either cancerous or healthy cells. To perform this treatment, patients generally do not need to stay in the hospital. However, it is important to know that this is not the main treatment for prostate cancer patients. It is also a treatment that is used when hormonal therapy does not work.
  • Immunotherapy: Immunotherapy basically uses the immune system of the patient to fight cancer. This therapy stimulates the body’s immune system to find and attack cancer cells. The body may not give an adequate response to the cancerous cells because they tend to hide. The immunotherapy target is to interrupt the process of hiding these cells.

What to expect after prostate cancer surgery?

After the surgeon removes the prostate, the doctor will need to reconstruct the urinary tract and the bladder. However, every surgery always comes with a risk.

Some of them can happen early or later. That is why the surgeon will perform a series of controls to prevent or manage these possible complications. It is important to know that every patient is different, and not all of them will have the same complications.

Among the most common complications after the surgery are the following:

  • Erectile dysfunction: After the surgery, all men will suffer a different form of erectile dysfunction. This happens because the nerves that are involved in the erection process are surrounding the prostate. While being on the surgery process, some of these nerves may receive direct damage affecting the erection of the penis.
  • Incontinence: This complication refers to the inability to control the urine. It can happen while coughing or sneezing (This is the most common type). It can also happen that the bladder becomes oversensitive, and the patient feels the urge to go to the bathroom even if the bladder is not full. On the other hand, it can also happen that the patient loses the ability to control urine at any time, but this type is not very common.

Do you have prostate cancer symptoms, or you believe you are at risk of developing it?

This is a Prostate Cancer Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for this disease. Therefore, the tool will tell anybody who uses it their likelihood of having symptoms, great risk, or needing screening for prostate cancer. Using this tool is free and would take a few minutes.

What do you think?

Written by Dr. Esteban Kosak

Doctor of Medicine - MD Recently Graduated from Medical School and inspired to aid the global population during this situation. I think that we shall no longer be waiting to see a doctor when we feel sick. Several times we feel disease searches in Google drive us to a rabbit hole and come out thinking that we may die of cancer or something very serious, given that symptoms may seem to fit a wide variety of illnesses. Since I recently graduated from medical school. I have all the medical information fresh in my mind. My thorough experience as an expert researcher allows me to very-well known the different diseases and conditions that affect human bodies. Empowered by the United Nations 17 Sustainable Development Goals (SGDs). I think that we all can provide a grain of sand to help humanity. That's why we created Symptoms.Care a place where you can come and screen your symptoms and find what different illnesses can be related to them. Armed with the right information you can instantly, discretely, secure and from the comfort of your home talk with a Doctor that can Evaluate your Symptoms and help you seek the right treatment.

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