In about 6 cases in 10, doctors diagnose prostate cancer in men aged 65 or older, and it is rare before age 40. Here are other facts about prostate cancer every man should know;
Prostate cancer is the most common type of cancer that develops in men in Nigeria other than skin cancer with over 50,000 new cases diagnosed every year. In 2014, there was an estimate of 3,085,209 men living with prostate cancer in the United States. Just like every cancer case, it’s silent and deadly if you do not detect it early.
Prostate cancer is also the third leading cause of cancer death among men after lung cancer and colorectal cancer. Current statistics by the World Health Organisation (WHO) shows that in Nigeria within a period of four years, there is a speedy increase in death rate among men caused by prostate cancer.
Prostate cancer is a cancer of the prostate gland. The prostate gland is a walnut shaped gland which is found in the pelvis of the male reproductive system. It is found below the bladder and in front of the rectum. It wraps around the urethra (narrow-like tube for the exit of urine from the body). The prostate gland helps to secrete part of the liquid portion of the semen which carries the sperm for reproduction. Just behind the prostate gland is another gland called the seminal vesicle. It produces most of the fluid that makes up the semen. If the prostate grows too large, it squeezes the urethra. This may slow or stop the normal flow of urine.
Prostate cancer occurs when cells in the prostate begin to grow abnormally. This growth progresses slowly. If you do not identify it early, it can spread to other parts of the body like the bones, rectum and urinary bladder. It can obstruct blood vessels thereby leading to death.
The exact cause of prostate cancer is unclear. But there are certain factors that can predispose an individual to develop the disease. These factors are:
Age: Elderly men at 50 years and above have an increased risk of developing prostate cancer due to degenerative changes in the prostate cells. It is rare among men under the age of 45years.
Race: Doctors diagnose black Americans with prostate cancer very often than men of other race and ethnicities.
Family history: Prostrate cancer is hereditary. A man whose father or brother developed the disease has a high risk of developing it too.
Diet: The type of food you eat can predispose you to develop prostate cancer. Studies suggest that diet high in red meat and cholesterol can increase a person’s chance of developing the disease.
Obesity: Obesity is linked to the development of prostate cancer.
Having a risk factor doesn’t mean that you will develop prostate cancer, most men with the above risk factors are still yet to develop the disease.
Prostate cancer has stages. This helps the doctor to know the extent of cancer and plan cancer treatment. Cancer staging is described using the ‘TNM’ system. T refers to the description of the size or extent of a primary tumour. N refers to extent of cancer spread to the lymph nodes that may be nearer or farther from a tumour. M describes presence or absence of metastases i.e. the extent of spread to other parts of the body.
Early signs of prostate cancer include frequency in urination during both night and day, excessive strain to urinate, difficulty in initiating, maintaining and stopping urine, painful urination, difficulty to urinate while standing, inability to urinate, painful ejaculation, abdominal pains and blood in urine or semen. There are symptoms which occur in an advanced stage of the disease when it spreads from the prostate gland to other parts of the body via the bloodstream. It includes unexplained weight loss, loss of appetite, fatigue, increased short breath and bone pain.
Diagnosis: A digital rectal examination that doctors routinely do along with a medical history to aid the diagnosis of prostate cancer. The doctor inserts gloved and lubricated fingers into the rectum to feel the back portion of the prostate for size, irregular and firm areas. This is not accurate for detecting cancer that is deep within the gland. Findings such as abnormal size, lumps and nodules may indicate prostate cancer. Another test doctors use to diagnose prostate cancer is the prostate specific antigen blood test (PSA). This test helps to measure the level of protein the prostate produces in the blood which keeps the semen in liquid form. If the PSA test indicates an increased level of PSA then there is an increased likelihood of prostate cancer. However, it doesn’t provide a definitive diagnosis. Prostate biopsy is another procedure that doctors use to determine whether prostate cancer is present. It involves taking a tissue sample from the prostate gland. This procedure is usually uncomplicated with just some numbness or pain in the area afterwards. Therefore, doctors can make a diagnosis after two or three tests prove positive. Other tests that doctors carry out are Magnetic resonance imaging, transrectal ultrasound and bone scan.
Doctors use conventional treatment options for prostate cancer in managing prostate cancer cases, such as
Observation and active surveillance: This involves monitoring the course of prostate cancer with the goal of treating cancer with palliative care if, on physical examination, changes are discovered. Active surveillance involves actively monitoring the course of cancer with the intent of intervening if the cancer progresses.
Surgery (Radical Prostatectomy): This involves the removal of the whole prostate gland, the urethra that surrounds it and the attached seminal vesicles. The side effects of this include urinary incontinence, erectile dysfunction and impotence.
Radiation therapy: This is a curative treatment that uses radiation to kill cancer cells.
Chemotherapy: this involves the use of medications in form of injections or pills to either kill or slow the growth of metastatic prostate cancer cells.
Other therapies include focal therapy, cryotherapy and hormone therapy.
10. Cancer prevention strategy is unproven but one can reduce the risk of prostate cancer by making healthy choices like:
Choosing low-fat diet e.g. milk, cheese and yoghurt
Eating more vegetables and fruits
Eating fish with omega 3 fatty acids e.g. salmon, tuna and herring.
Maintaining a healthy weight by exercising for 30 mins regularly