Prostate Cancer – Men’s Fear

Prostate Cancer is a slowly progressive adenocarcinoma of the prostate. It is most common in men older than 50 years of age. In fact, it is the third most common cause of death from cancer in men of all ages and is the most common cause of death from cancer in men older than 75 years of age. Prostatic cancer grows slowly and has a high survival rate if detected early. Early detection is important because it increases the chance of the patient to recover.

How It Spreads
Prostate Cancer depends on testosterone to grow. The cancer cells are usually slow growing and begin in the posterior (back) or lateral (side) part of the gland. The cancer spreads by one of three routes:

– If it spreads by local invasion, it will move into the bladder, seminal vesicles, or peritoneum.

– The cancer may also spread through the lymph system to the pelvic nodes and may travel as far as the supraclavicular nodes.

– The third route is through the vascular system to bones, lungs, and liver.

Prostate cancer is staged or graded based on the growth or spread.

Risk Factors
According to Sommers (Diseases and Disorders, p.127), possible etiologic factors for the development of Prostate Cancer are:

• Age – 50 yrs old and above (two-thirds of prostate cancer cases are found in 65 yrs old and above)

• Race – more common in African-American

• Nationality – most common in North America and northwestern Europe

• Family History – suggests an inherited or genetic factor

• Diet – increased intake of red meat or high-fat dairy products and fewer fruits and vegetables (most studies found no link between levels of calcium found in average diet to the development of prostate cancer)

• Exercise – A recent study from the Harvard School of Public Health found that men over age 65 who exercise vigorously had a lower rate of prostate cancer

• Vasectomy – Most recent studies however, have not found any increased risk among men who have had this operation

• Occupational exposure to cadmium (e.g., welding, electroplating, alkaline battery manufacturing)

• Unhealthy Lifestyle – drinking alcohol and smoking

According to the American Cancer Association, Symptoms are rare in the early stage (stage A) of prostate cancer.

Later stages (stages B and C) include symptoms of urinary obstruction, hematuria, and urinary retention. Hematuria may result if the cancer invades the urethra or bladder, or both.

In the advanced (metastatic) stage (stage D), symptoms may be bone pain in the back or hip, anemia, weakness, weight loss, and overall tiredness.

The definitive diagnosis can be made only by biopsy; however, tests may suggest the presence of prostate cancer.

A routine DRE (Digital Rectal Exam) of the prostate can be done, where the examiner looks for a hard lump or hardened lobe.

A blood test looking for high levels of prostate-specific antigen (PSA) or prostatic acid phosphates (PAP) is done to detect prostate cancer.

When there is a palpable tumor, the health care provider may order a transrectal ultrasound and biopsy to help confirm the diagnosis.

Bone scans and other tests may be ordered to determine if the cancer has spread outside the prostate gland.

According to the Prostate Cancer Foundation, there is no “one size fits all” treatment for prostate cancer. One must decide together with the physician so the treatment options will be presented and decided with respect to how well you can respond and tolerate with the treatments.

However, common treatment options are:

– medication

– surgery, such as TURP (transurethral resection of the prostate) or open prostatectomy

– combination of medication and radiation therapy

– brachytherapy

– hormone therapy

A radical prostatectomy (removal of the prostate and seminal vesicles) remains the standard surgical procedure for patients who have early-stage, potentially curable disease and a life expectancy of 10 years or more. An Italian Study suggests that High Intensity Focused Ultrasound may also be a promising treatment for prostate cancer

Prevention is indeed better than cure. Since there are a few causes that are modifiable, prevention is then focused on diet and lifestyle modifications since studies have shown their effectiveness in decreasing the chance of developing cancer and slowing its progression, allowing men to have happy and better lives without frequent fears of this dreaded disease.

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