Concerning Prostate Cancer
- JR Scroggins
- May 22
- 6 min read
Understanding Prostate Cancer
Prostate cancer originates in the prostate gland of men, a walnut-sized organ located just below the bladder that contributes to the production of seminal fluid. It is the most prevalent cancer among men, following skin cancer. While prostate cancer typically progresses slowly and may not pose a significant threat, certain forms are more aggressive and can rapidly spread if not treated.
Symptoms of Prostate Cancer
In the initial stages, men might not experience any symptoms. As the condition progresses, symptoms may include:
Frequent urination, particularly at night
Challenges in starting or stopping urination
Weak or interrupted flow of urine
Pain or burning sensation during urination or ejaculation
Presence of blood in urine or semen
Advanced cancer can lead to deep pain in the lower back, hips, or upper thighs.
Enlarged Prostate or Prostate Cancer?
As men age, the prostate may enlarge, potentially exerting pressure on the bladder or urethra and producing symptoms akin to those of prostate cancer. This condition is known as benign prostatic hyperplasia (BPH). It is not cancerous and can be managed if the symptoms become troublesome. Another condition that can lead to urinary symptoms is prostatitis, which involves inflammation or infection. This may also be accompanied by a fever and is often treated with medication.
Risk Factors Beyond Your Control
Advancing age is the most significant risk factor for prostate cancer, particularly after the age of 50. Research indicates that between 31% and 83% of men over the age of 70 may have some form of prostate cancer, often without noticeable symptoms. A family history of the disease significantly increases a man's risk; having a father or brother with prostate cancer more than doubles the likelihood. Additionally, African American men and Caribbean men of African descent are at a heightened risk and have the highest incidence of prostate cancer globally.
Controllable Risk Factors
Diet appears to influence the development of prostate cancer, which is significantly more prevalent in countries where meat and high-fat dairy products are dietary staples. The exact reason for this association remains unclear. Dietary fat, especially animal fat from red meat, may elevate male hormone levels, potentially promoting the growth of cancerous prostate cells. Additionally, a diet lacking in fruits and vegetables may contribute to this risk.
Common Misconceptions About Prostate Cancer
The following factors do not contribute to the development of prostate cancer: excessive sexual activity, vasectomy, and masturbation. Having an enlarged prostate (BPH) does not increase your risk of prostate cancer. Researchers continue to investigate whether alcohol consumption, sexually transmitted diseases, or prostatitis may influence the onset of prostate cancer.
Early Detection of Prostate Cancer
Screening tests are available for the early detection of prostate cancer, although government guidelines do not recommend routine testing for men at any age. These tests might identify cancers that progress so slowly that medical interventions would not be beneficial. Moreover, treatments can have significant side effects.
The American Cancer Society suggests that men consult with a physician about screening tests, starting at:
Age 50 for men at average risk who anticipate living at least another 10 years
Age 45 for men at high risk, including African Americans and those with a father, brother, or son diagnosed before age 65
Age 40 for men with more than one first-degree relative diagnosed at an early age
The U.S. Preventive Services Task Force (USPSTF) states that testing may be suitable for some men aged 55–69. They recommend that men engage in a discussion with their doctor to evaluate the potential risks and benefits of testing.
Screening: DRE and PSA
Your physician may initially perform a digital rectal exam (DRE) to detect any irregularities or hard areas on the prostate. Following a consultation with your doctor, a blood test can be conducted to measure prostate-specific antigen (PSA), a protein produced by prostate cells. An elevated PSA level may suggest an increased likelihood of cancer; however, it is possible to have a high PSA level without having cancer, and conversely, to have prostate cancer with a normal PSA level.
Prostate-Specific Antigen (PSA) Test Results
A normal PSA level is considered to be under 4 nanograms per milliliter (ng/mL) of blood, while a PSA above 10 suggests a high risk of cancer. But there are many exceptions:
Men can have prostate cancer with a PSA less than 4.
A prostate that is inflamed (prostatitis) or enlarged (BPH) can boost PSA levels, yet further testing may show no evidence of cancer.
Some BPH drugs can lower PSA levels, despite the presence of prostate cancer, called a false negative.
If either a PSA or DRE test are abnormal, your doctor will likely order other tests.
Prostate Cancer Biopsy
If a physical examination or PSA test indicates a potential issue, your doctor may advise undergoing a biopsy. This procedure involves inserting a needle either through the rectal wall or the skin between the rectum and scrotum to extract multiple small tissue samples for microscopic examination. A biopsy is the most effective method for detecting cancer and assessing whether it is slow-growing or aggressive.
Biopsy and Gleason Score
A pathologist examines tissue samples for cellular abnormalities and assigns a "grade" ranging from 1 to 5. The sum of two Gleason grades constitutes the Gleason score. These scores are critical in assessing the likelihood of cancer metastasis. Typically, Gleason grades of 1 and 2 are not assigned in biopsy evaluations, making 6 the usual minimum score for prostate cancer. Cancer with Gleason scores between 8 and 10 is classified as high-grade, indicating a higher potential for rapid growth and spread. Gleason scores are instrumental in guiding the treatment options recommended by your physician.
Prostate Cancer Imaging
In certain cases, further diagnostic tests are required to determine if the cancer has metastasized beyond the prostate. These tests may include an ultrasound, a CT scan, or an MRI scan. A radionuclide bone scan involves the use of a low-level radioactive injection to assist in detecting cancer that has spread to the bone.
Prostate Cancer Staging
Staging is utilized to describe the extent of prostate cancer metastasis and to assist in determining the most appropriate treatment.
Stage I: The cancer is small and remains within the prostate.
Stage II: The cancer is more advanced but still confined to the prostate.
Stage III: The cancer is of a high grade or has extended beyond the prostate to nearby tissues, such as the seminal vesicles, bladder, or rectum.
Stage IV: The cancer has spread to lymph nodes or distant organs, including bones or lungs.
Prostate Cancer Survival Rates
Prostate cancer typically progresses slowly, and 90% of cases are detected early. Impressively, the 5-year relative survival rate is 100% for men with cancer localized to the prostate or nearby tissues, with many living significantly longer. Even when the disease has spread to distant areas, the survival rate stands at 31%. These statistics reflect diagnoses made at least 5 years ago, and the prognosis is likely even more favorable for men diagnosed and treated today.
Hope for Advanced Cancer
Your doctor will confidently monitor your PSA levels and conduct further tests following prostate cancer treatment. Should the cancer return or spread, additional treatment will be strategically recommended. Lifestyle choices play a significant role as well. For instance, a study revealed that prostate cancer survivors who engaged in regular exercise experienced a reduced risk of mortality.
Coping With Erectile Dysfunction
Erectile dysfunction (ED) is a common side effect of prostate cancer treatments. Typically, erectile function significantly improves within two years after surgery. Younger men often experience greater improvement compared to those over age 70. ED medications can be highly beneficial. Additionally, treatments like injection therapy and vacuum devices offer effective solutions.
Food for Health
Adopting a diet that is mindful of cancer prevention may be the most beneficial approach for survivors seeking to enhance their health, as well as for individuals aiming to reduce their risk. This approach includes:
Consuming five or more servings of fruits and vegetables daily
Choosing whole grains over white flour or white rice
Reducing the intake of high-fat meats
Limiting or avoiding processed meats such as hot dogs, cold cuts, and bacon
Restricting alcohol consumption to 1-2 drinks per day, if consumed
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