A friend just turned 45years old. He enjoys a good health, and a good life. As a part of regular health check- up, he underwent a digital rectal examination- a procedure he detests- because the physician puts a gloved finger into the patients rectum for examination. But this time, the physician had some bad news for him. His prostate gland had abnormal growth. He underwent further evaluations, and the news was finally broken to him. He had PROSTATE CANCER…
Prostate gland is a small, walnut-sized organ of the male reproductive system located under the urinary bladder (sack where urine is collected and stored) and in front of the rectum (the lower end of the bowel). Prostate gland secretes a sticky and clear fluid necessary for the nourishment and transport of the sperm, male sex cells. The urinary tract that carries urine and seminal fluid fluid that contains sperm together with secretion from prostate gland runs directly through prostate gland.
Cancer of the prostate gland
Abnormal or uncontrolled growth of a cell is called cancer. When this cell breaks off and travels to other parts or organs of the body and spreads, then the condition is called as metastasis.
Normally cells grow, divide and die. When these cells change (mutate), they grow and divide more quickly without dying, they cause outgrowth of cells. When these abnormal cells clump together, they form tumors. If these tumors damage other nearby normal tissue and cells, then these are called malignant tumors. If they do not cause any harm to other cells but only grow, then such tumors are called benign. When such abnormal growth of cells occurs in the prostate gland, then it is called cancer of the prostate. When these cancerous cells of the prostate gland become aggressive, and travel to other parts of the body, then it is called metastasized prostate gland cancer.
Following are the risk factors for the cancer of the prostate.
- Age: The risk increases with age. Men above the age of 50 are at higher risk.
- Ethnicity: If you are black, then you are at higher risk, than the others though the reason is unknown.
- Family history: If any men in your family or siblings had or have prostate cancer, then you too may be at higher risk.
- Overweight: If you are obese or overweight, then you may have the risk of developing t advanced prostate cancer that is hard to treat.
Symptoms
There may not be any symptoms of the prostate cancer at the early stages. Subsequently, as the cancer advances, you may have difficulty in starting to urinate and may urinate frequently particularly at nights. You may have reduced force while you urinate and experience pain while urinating. There could be blood or pus in your urine.
Blood may be present in your semen and you may experience pain while you ejaculate. The abnormal growth may cause pain in the lower pelvic region or in the hip or lower back. There could be swelling in the legs. In addition you may lose your appetite and also experience loss of weight.
Screenings and tests
In most of the instances, prostate cancer is discovered during routine screening. It is still controversial to screen men for prostate cancer. Some medical organizations recommend prostate cancer screening in men above the age of 50. Some organizations are against it. The study reports of UK and US trials are not clear to establish that the risks associated with the prostate screening tests which include infection, bleeding and problems subsequent to diagnostic testing such as impotence and incontinence, do not surpass the benefits the screening tests provide in terms of saving the lives. Consult your doctor regarding benefits of screening for prostate cancer and decide accordingly whether it is appropriate to go for screening.
Digital rectal exam (DRE) is an important test for diagnosing prostate cancer. Your doctor physically feels the texture, size and shape of your prostate by inserting gloved, lubricated finger into your rectum, and examines your prostate which is adjacent to your rectum. If any abnormalities are noticed, then further tests may be necessary.
Another test is the Prostate specific antigen (PSA) test. Prostate specific antigen is a substance produces by prostate gland and normal levels of PSA are found in the blood. If higher level of PSA is found in your blood then it may indicate that you have infection or inflammation or enlargement or cancer of the prostate.
If prostate cancer is suspected DRE & PSA tests, your doctor may ask you to undergo the following tests to determine whether you have prostate cancer or not.
- Ultrasound test: Sound waves are used to check for any abnormality in your prostate. This is done by inserting a cigar shaped probe into your rectum and sending sound waves to the adjacent prostate check for any irregularity in your prostate gland.
- Prostate biopsy: If the initial test indicates prostate cancer, then your doctor may suggest prostate biopsy. This procedure involves drawing the samples of the suspected cancer cells through a needle. A needle is inserted into the prostate and samples of the suspected cells are taken and analyzed for cancer. Based on the differences between normal prostate cells and cancer prostate cells, the prostate cancer is graded.
If the doctor suspects that the cancer has spread to other organs, he might require special tests such Bone scan (Instrument using radioactive materials to measure gamma radiation from the bones), Computerized tomography (CT) scan (Instrument using 3 dimensional imaging) and Magnetic resonance imaging (MRI) (Instrument that uses powerful magnetic field) so as to locate the cancer affected areas. Based on the results, prostate cancer is graded as follows:
- Stage I: Initial stages affecting a small portion of the prostate.
- Stage II: The cancer spreading is wider but confined to only prostate gland.
- Stage III: The cancer is spread to other adjacent areas.
- Stage IV: The cancer has spread to lymph nodes, lungs, bones and other organs.
Treatment
If the cancer is in the early stages of development and has not spread to the other parts, then ‘waiting and watching’ may be one of the early options available. At this stage you will be closely watched by your doctor for any sudden and abnormal development of the cancer. This stage does not involve any medications or surgery. This is mainly recommended for older patients with other debilities. Under this watchful waiting, you are under constant medical surveillance such as regular hospital visits, blood tests for PSA levels every 1or 3 months, rectal examinations and biopsies every 2-3 years together with frequent patient teaching and support services.
If the cancer begins to spread, then you may need to resort to more aggressive treatment options such as surgery, radiation, and drug therapy. These treatments are used to control the spread of the cancer through various means available. These treatments may cause inability to have sex, and inability to control urination. But these will disappear as soon as the treatments are withdrawn.
Prostate cancer survival rates
In the US, the survival rates of people with prostate cancer after 5 years increased from 79.6% in 1983-90 to 98% in 1992-99.
The prostate cancer patients who undergo surgery survive for at least 10 years more compared to those patients who opted for other treatments, more importantly in younger patients and those with specific characteristics of cancer.
The patients’ ten year survival rates are as follows:
Prostate surgery 83%
Radiotherapy 75%
Watchful waiting 72%
Hormone therapy 41%
Other treatment 71%
Prostate cancer can be treated
Prostate cancer in late stages can be life threatening, however, if detected early, it can be treated through surgery, radiation therapy and medications. If you are at risk of developing prostate cancer, it is better to get yourself regularly screened. If already suffering from prostate cancer, living with it might pose many challenges. Seeking support from family members and friends would help a lot. You may also contact the prostate cancer support groups.
