HEALTH NEWS: PROSTRATE CANCER -- WHAT YOU SHOULD KNOW

Prostate cancer develops in a man’s prostate — the walnut-sized gland just below the bladder that produces some of the fluid in semen. It’s the most common cancer in men after skin cancer. Prostate cancer often grows very slowly and may not cause significant harm. But some types are more aggressive and can spread quickly without treatment.

Symptoms

In the early stages, men may have no symptoms. Later, symptoms can include frequent urination, especially at night; difficulty starting or stopping urination; weak or interrupted urinary stream; painful or burning sensation during urination or ejaculation; blood in urine or semen

Advanced cancer can cause deep pain in the lower back, hips, or upper thighs.

Enlarged prostate or prostate cancer?

The prostate can grow larger as men age, sometimes pressing on the bladder or urethra and causing symptoms similar to prostate cancer. This is called benign prostatic hyperplasia. It’s not cancer and can be treated if symptoms become bothersome.

A third problem that can cause urinary symptoms is prostatitis — an inflammation or infection that may also cause fever and, in many cases, is treated with medicine.

Risk factors: Growing older is the greatest risk factor for prostate cancer, particularly after age 50. After 70, studies suggest that most men have some form of prostate cancer, though there may be no outward symptoms. Family history increases a man’s risk.

Again, diet seems to play a role in the development of prostate cancer, which is much more common in countries where meat and high-fat dairy are mainstays. The reason for this link is unclear. Dietary fat, particularly animal fat from red meat, may boost male hormone levels. And this may fuel the growth of cancerous prostate cells. A diet too low in fruits and vegetables may also play a role.

Detection

Screening tests are available to find prostate cancer early. You should talk with a doctor or, preferably, a urologist, about screening tests once you are 40. This is highly recommended for anyone at high risk such as those with a father, brother, or son diagnosed before age 65, and those with more than one first-degree relative diagnosed at an early age.

Your doctor may initially do a digital rectal exam to feel for bumps or hard spots on the prostate.  A blood test can be used to measure prostate-specific antigen, a protein produced by prostate cells. An elevated level may indicate a higher chance that you have cancer, but you can have a high level and still be cancer-free. It is also possible to have a normal PSA and have prostate cancer.

If a physical exam or PSA test suggests a problem, your doctor may recommend a biopsy. A biopsy is the best way to detect cancer and predict whether it is slow-growing or aggressive.

Survival rate: The good news about prostate cancer is that it usually grows slowly. In advanced countries, nine out of 10 cases are found in the early stages. Unfortunately, in our part of the world, most people only present when the disease has spread very far and is therefore in the late stages.

Treatment options

With low-risk cancer, one option is to watch and wait. This is determined by several factors. Your doctor will order periodic testing. Other treatments — with the risk of sexual or urinary problems — may not be necessary. Some men who are older or have serious health conditions may not need treatment. However, more aggressive treatment is usually recommended for younger men or those with more aggressive disease.

Radiation therapy: External beam radiation to kill cancer cells can be used as a first treatment or after prostate cancer surgery. It can also help relieve bone pain from the spread of cancer. In brachytherapy, tiny radioactive pellets about the size of a grain of rice are inserted into the prostate. Both methods can impair erectile function. Fatigue, urinary problems, and diarrhoea are other possible side effects.

Surgery: Removing the prostate, or radical prostatectomy, is used to eliminate the cancer when it is confined to the prostate. New techniques use smaller incisions and seek to avoid damaging nearby nerves. If lymph nodes are also cancerous, prostatectomy may not be the best option. Surgery may impair urinary and sexual function, but both can improve over time.

Hormone therapy may shrink or slow the growth of the cancer, but unless it is used with another therapy, it will not eliminate the cancer. Drugs or hormones block or stop the production of testosterone and other male hormones, called androgens. Side effects can include hot flashes, growth of breast tissue, weight gain, and impotence.

Chemotherapy kills cancer cells throughout the body, including those outside the prostate, so it is used to treat more advanced cancer and cancer that did not respond to hormone therapy.  Because the chemotherapy kills other fast-growing cells in the body, you may have hair loss and mouth sores. Other side effects include nausea, vomiting, and fatigue.

Cryotherapy freezes and kills cancerous cells within the prostate. It is not as widely used because little is known about its long-term effectiveness. It’s less invasive than surgery, with a shorter recovery time. Because the freezing damages nerves, as many as 80 per cent of men become impotent after cryosurgery. There can be temporary pain and burning sensations in the bladder and bowel.

Prostate cancer vaccine is designed to treat, not prevent, prostate cancer by spurring your body’s immune system to attack prostate cancer cells. Mild side-effects can occur such as fatigue, nausea, and fever.

Hope for advanced cancer. Your doctor will continue to monitor your PSA levels and may perform other tests after treatment for prostate cancer. If it recurs or spreads to other parts of the body, additional treatment may be recommended. Lifestyle choices may matter, too. One study found that prostate cancer survivors who exercised regularly had a lower risk of dying.
And be sure to tell your doctor if you are taking vitamins or supplements.

SOURCE: THE PUNCH