Prostate cancer

In the early stages of prostate cancer, there may or may not be any signs or symptoms. However, as cancer progresses, some symptoms may appear. Here are some common signs and symptoms of prostate cancer:

• Poor bladder control: A person with early-stage prostate cancer may struggle to regulate his bladder, leading to frequent accidents due to urine leakage before reaching a bathroom. Urinary incontinence is a common sign of various urinary infections. If you experience this issue, consult a urologist and have your prostate evaluated for cancer.
• Trouble urinating: Urinary difficulties are a common presenting symptom of prostate cancer. Some individuals may even find it painful to empty their bladder.
• Decreased force in the stream of urine: An enlarged prostate can increase pressure on the urinary bladder, resulting in a weak urine flow. You may feel that your bladder is still full, and urine may dribble after you finish urinating.
• Urge to urinate: An enlarged prostate obstructs the easy emptying of the urinary bladder, causing a more frequent need to urinate, especially at night, which may lead to accidents before reaching the toilet.
• Painful urination: Experiencing regular painful urination is a sign to seek medical help, as it can be a warning sign of prostate cancer.
• Blood in the urine and semen: This symptom may indicate locally advanced prostate cancer. When cancer spreads to surrounding organs, blood may leak into urine and semen.
• Bone pain: Advanced prostate cancer may present with symptoms such as back pain. Pain in the pelvic region and hips may occur as the cancer begins to spread.
• Losing weight without trying: Similar to malignancies in other organs, prostate cancer patients may experience unexplained weight loss. This weight loss could be due to other underlying causes, but when associated with other symptoms, it may be a warning sign of prostate carcinoma.
• Persistent pain in the lower back: Ongoing pain in the lower back, hips, and pelvis is another warning indication. If this symptom occurs alongside the other symptoms listed, a detailed examination for prostate cancer may be warranted.
• Erectile dysfunction: Erectile dysfunction is a common symptom associated with various medical conditions. Several medications can lead to erectile dysfunction. If a person experiences erectile dysfunction along with painful urination, he should undergo testing for prostate cancer.
• Reduced semen: If an individual notices a decrease in the amount of semen ejaculated during sex, he should have his prostate tested for any signs of malignancy. This symptom is particularly significant if accompanied by other symptoms that could indicate prostate cancer.

The specific cause of prostate cancer is unknown. However, it is generally a result of mutation and uncontrolled division in normal prostate cells.

Oncogenes are genes that aid in cell growth, division, and survival.

Tumor suppressor genes are responsible for regulating cell growth, repairing DNA errors, or inducing cells to die at the appropriate time.

Prostate cancer begins to form when cells in the prostate gland undergo alterations in their DNA.

These abnormal cells group together to create a tumor, which can spread and invade neighboring tissue. Over time, some abnormal cells may break away and move to other parts of the body.

Certain risk factors can increase the likelihood of developing prostate cancer, which are discussed in the next segment.

Some of the factors that elevate the risk of prostate cancer include:

• Old age: Prostate cancer becomes more common after age 50, with advancing age being a significant risk factor.
• Race: African American men, West African ancestry from the Caribbean, and South American men have an increased risk of prostate cancer compared to those of other races.
• Family history: If a blood relative has been diagnosed with prostate cancer, such as a parent, brother, or child, your risk may increase for cancer.
• Gene changes: Certain gene mutations can increase the risk of prostate cancer. Men with BRCA1, BRCA2, or Lynch syndrome are more likely to develop the disease.
• Other possible risk factors:
  • Obesity
  • Alcohol consumption
  • Diet (saturated animal fat, red or smoked meat, high calcium/dairy intake, and dietary choline)
  • Chemical exposure
  • Prostatitis (inflammation of the prostate gland)
  • Sexually transmitted infections
  • Vasectomy (a type of male contraception)
  • Tobacco use

Note: Tobacco smoke contains over 60 carcinogens, and male smokers have higher androgen levels, potentially raising prostate cancer risk or aiding its progression.

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Most doctors advise men in their 50s to discuss the benefits and drawbacks of prostate cancer screening with their healthcare providers. An evaluation of risk factors and screening preferences should be part of this discussion, which includes:

• Prostate cancer screening tests
• Digital rectal exam (DRE): Your doctor inserts a lubricated, gloved finger into your rectum to feel your prostate gland for abnormalities in size, shape, or texture. If any irregularities are detected, further tests may be necessary.
• Prostate-specific antigen (PSA) test: PSA, a protein produced by the prostate gland, is measured through a blood test. High levels may indicate infection, enlargement, or cancer.
• Imaging tests
• Ultrasound: A probe instrument creates an image of the prostate gland using sound waves, helping to detect prostate abnormalities and guide biopsies for diagnosis.
• Magnetic resonance imaging (MRI): Provides detailed imaging of the prostate to detect cancer, assess its extent, and guide biopsies.
• Biopsy
• A prostate biopsy helps determine whether cancer cells are present. During the procedure, a tiny needle is inserted into the prostate to collect tissue, which is then examined for malignant cells.
• Tests to determine whether cancer has spread
• Bone scan
• Computerized tomography (CT) scan
• Ultrasound
• Positron emission tomography (PET) scan
• Magnetic resonance imaging (MRI)

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Grading of Prostate Cancer

Once a biopsy confirms the presence of cancer cells, the next step is to assess the progress of the cancer. A higher grade indicates cancer that is more aggressive and likely to spread quickly. The following are some methods used to determine the grade of cancer:

• Gleason score: A numeric system on a scale of 1 to 10. A Gleason score of 2 means non-aggressive cancer, whereas a score of 10 indicates aggressive cancer.
• Genomic testing: Examines prostate cancer cells for gene abnormalities. These tests provide additional details that assist in treatment planning and prognosis.

If you're concerned about the risk of prostate cancer, then prostate cancer prevention may be of interest to you. Here’s what you can do:

1. Focus on Diet
   • Consume a variety of fruits, vegetables, and whole grains.
   • The possibility of preventing prostate cancer with nutrition has yet to be proven clearly.
   • However, including the following food items has been shown to prevent or lower the risk of prostate cancer:
     • Soy
     • Lycopene
     • Green Tea
     • Coffee
     • Cruciferous Vegetables
     • Omega-3 Fatty Acids
     • Folate
     • Vitamin D
   • Fill the gaps in your diet with our exclusive range of vitamin supplements.
2. Follow an Exercise Routine
   • Exercise is one of the modified lifestyle therapies that appear to offer many benefits and relatively few side effects.
   • Lack of exercise has also been linked to an increased risk of prostate cancer.
3. Maintain a Healthy Weight
   • Maintaining a healthy weight reduces inflammation and hormone imbalances linked to prostate cancer risk.
   • Regular exercise and a balanced diet play a crucial role in prevention.
4. Discuss Your Prostate Cancer Risk
   • If you're at high risk, consult your doctor.
   • Conditions like diabetes and hypertension can increase your risk.

Prostate cancer treatment includes standard therapies, watchful waiting, or active surveillance. They include:

1. Surgery
   • Pelvic lymphadenectomy: A pathologist examines the tissue for cancer cells under a microscope. If cancer is present in the lymph nodes, the doctor will not remove the prostate gland and will advise other treatments.
   • Transurethral resection of the prostate (TURP): This technique is used to treat benign prostatic hypertrophy and relieve symptoms caused by a tumor before further cancer treatments. A thin, lighted tube with a cutting tool, called a resectoscope, is inserted into the urethra to remove prostate tissue.
   • Radical prostatectomy: During surgery, the prostate, nearby tissue, and seminal vesicles are removed, and sometimes the surrounding lymph nodes are also taken out. The most common types of radical prostatectomy are:
     • Open radical prostatectomy
     • Radical laparoscopic prostatectomy
     • Laparoscopic radical prostatectomy
2. Radiation therapy
   • External radiation therapy: Uses a machine outside the body to send radiation to the cancerous part of the body, allowing a high dose of radiation to reach the tumor while causing minimal damage to healthy tissue.
   • Hypofractionated radiation therapy: Delivers a higher-than-usual total radiation dose once a day for a shorter time (fewer days), which may have more side effects than regular radiation therapy.
   • Internal radiation therapy: Uses a radioactive substance filled in needles, seeds, or catheters inserted into cancer tissue. After the radioactive seeds are implanted in the prostate, the needles are removed after the procedure.
3. Radiopharmaceutical therapy

   This therapy uses radioactive drugs to target and destroy cancer cells while minimizing damage to healthy tissue. Examples include:

   • Alpha emitter radiation therapy: Treats prostate cancer that has spread deep to the bones.
   • Radium-223: A radioactive material administered into a vein and circulated through the bloodstream, gathering in cancerous parts of the bone to destroy the cancer cells.
4. Hormone therapy

   This therapy treats cancer by inhibiting cancer cell growth or blocking hormones, referred to as androgen deprivation therapy (ADT). Some hormone therapies for prostate cancer include:

   • Abiraterone acetate: A drug that inhibits the production of androgens in prostate cancer cells.
   • Orchiectomy: A surgical treatment that involves the removal of one or both testicles to reduce hormone production.
   • Estrogens: Hormones that can inhibit the production of testosterone in the testicles, though they are less commonly used today due to adverse effects.
   • Luteinizing hormone-releasing hormone agonists: Inhibit testosterone production in the testicles. Examples include Leuprolide, Goserelin acetate, and Buserelin.
   • Antiandrogens: Block the activity of androgens. Examples include Flutamide, Bicalutamide, Enzalutamide, Apalutamide, and Nilutamide.
5. Chemotherapy

   Chemotherapy involves administering drugs to cancer cells to limit their growth by killing them or preventing their proliferation. Chemotherapy medications enter the bloodstream, reach cancer cells throughout the body, and can be taken orally or injected.

6. Immunotherapy

   This cancer-fighting treatment uses the patient’s immune system, employing substances manufactured by the body or in the lab to restore natural defenses.

7. Bisphosphonate therapy

   When cancer has spread to the bone, bisphosphonate medications like clodronate or zoledronate are known to prevent bone damage. Bone loss is more common in men treated with antiandrogen treatment or orchiectomy.

8. Clinical trials to explore new types of treatment include:
   • Cryosurgery: A treatment that freezes and destroys abnormal or cancerous cells using extremely cold temperatures.
   • High-Intensity Focused Ultrasound (HIFU) Therapy: Uses focused ultrasound waves to heat and destroy cancerous tissues without harming surrounding areas.
   • Proton Beam Radiation Therapy: Targets tumors with high-energy proton beams to destroy cancer cells while sparing nearby healthy tissue.
   • Photodynamic Therapy (PDT): Combines a light-sensitive drug and laser light to kill cancer cells with minimal damage to healthy tissue.

Home remedies that are beneficial for prostate health include:

• Soy products: Soybean products contain high quantities of isoflavones, which provide various health benefits, including protection against prostate cancer.
• Pomegranate (Anaar) extract: The antioxidant properties of pomegranate extract have an anticancer effect on carcinogenic cells.
• Green tea: Green tea contains polyphenols, antioxidants associated with the prevention of many ailments, including prostate cancer.
• Tomatoes (Tamatar): Tomatoes are rich in lycopene, which reduces the risk of prostate, lung, and stomach cancer. Additionally, tomatoes can lower the risk of skin cancer.
• Cruciferous vegetables: Vegetables such as broccoli, cauliflower, and cabbage lower the risk of developing aggressive prostate cancer.

Don’ts:

• Avoid vegetable oils containing omega-6 fatty acids and diets high in saturated fats, as they can increase the risk and severity of prostate cancer.
• Processed red meat, including salami, bologna, sausage, bacon, and hot dogs, should be avoided.
• Grilled or fried meat, or meat cooked at high temperatures, may alter DNA and increase the risk of cancer.
• Limit sugar and carbohydrates, as they correlate with the risk of prostate cancer.
• Increased intake of foods rich in choline, such as beef and chicken liver, eggs, and wheat germ, raises the risk of lethal prostate cancer.
• A high intake of dairy and calcium products is also associated with an increased risk of prostate cancer.

Note: The SELECT trial studied whether selenium and vitamin E supplements could prevent prostate cancer. Results showed no benefit, and researchers advised against taking high-dose selenium above the recommended intake.

Prostate cancer, if undiagnosed or untreated in its early stages, might spread to surrounding tissues, complicating the disease further. A few complications include:

• Spreading of prostate cancer (Metastasis): Prostate cancer can spread to neighboring organs, such as the bladder. It can travel to bones or other organs through the bloodstream and lymphatic system.
• Urinary incontinence: This can be a side effect of prostate cancer and its treatment. Treatment for incontinence varies depending on the type, severity, and possibility of recovery over time.
• Erectile dysfunction: This is the inability to achieve or maintain an erection firm enough for sexual activity. It is a common complication of prostate cancer and its treatments, which can affect nerves, blood flow, or hormone levels.

Possible complications after prostate cancer surgery include:

• Sterility
• Leakage of urine from the bladder
• Leakage of stool from the rectum
• Shortening of the penis
• Inguinal hernia

Probable complications of hormone therapy include:

• Hot flashes
• Impaired sexual function
• Loss of desire for sex
• Weak bones
• Diarrhea
• Nausea
• Itching

It’s important to remember that complementary and alternative cancer treatments cannot replace medical treatment. When you try a supplemental treatment, always inform your doctor.

• Yoga: Yoga may help alleviate weariness caused by cancer therapy, according to some scientific research. Men undergoing treatment for prostate cancer who participated in twice-weekly yoga lessons experienced fewer sexual side effects and urinary issues compared to those who did not. Understand the science behind yoga. Read this to know more about its physical and mental benefits. Tap Here
• Meditation: Individuals with cancer can benefit from the calming effects of meditation and other relaxation practices. Mindfulness and meditation effectively relieve anxiety, fear, and depression in men with prostate cancer, as demonstrated in a small study.
• Acupuncture: Acupuncture, which involves a trained practitioner inserting thin needles into specific points on your body, may help relieve prostate cancer pain. Some cancer patients report that it helps improve their overall well-being.

Any diagnosis of cancer is not easy physically or mentally. However, a few lifestyle changes can help you sail through the treatment. Here’s how to have a better quality of life even if you have prostate cancer.

1. Manage complications
   • Perform pelvic and Kegel exercises to strengthen bladder muscles.
   • Try bladder training and consider anticholinergic medications or artificial sphincter surgery for urinary incontinence.
   • Consult a urologist specializing in male sexual dysfunction for tailored treatment.
   • Don’t let urinary incontinence affect your confidence. Explore our wide range of adult diapers to stay comfortable and self-assured.
2. Focus on Emotional Well-Being
   • Address frustration or loss of manliness with professional counseling or support groups.
   • Engage in stress-reducing activities like yoga, mindfulness, or relaxation techniques.
3. Prioritize Physical Health
   • Maintain regular physical activity to improve overall strength and stamina.
   • Follow a balanced diet to support recovery and manage the side effects of treatment.
4. Get All the Support
   • Join prostate cancer support groups for shared experiences and advice.
   • Communicate openly with loved ones and healthcare providers to address challenges.