Article by Dennis Kordie, DNP
Prostate cancer is one of the most common cancers in men, affecting millions worldwide. It
develops in the prostate gland, a small walnut-shaped organ located below the bladder and in
front of the rectum. The prostate’s main function is to produce seminal fluid, which nourishes
and transports sperm. Prostate cancer occurs when the cells in the prostate grow uncontrollably,
forming a tumor. While many cases are slow-growing and may not cause serious health
problems, some can be aggressive and spread rapidly
Prevalence and Risk Factors
Prostate cancer is the second most common cancer among men after skin cancer. According to
the American Cancer Society, approximately 1 in 8 men will be diagnosed with prostate cancer
during their lifetime. Most cases are diagnosed in men over the age of 65.
Several risk factors increase the likelihood of developing prostate cancer:
• Age: The risk increases significantly after age 50.
• Race: African American men have a higher risk and are more likely to develop
aggressive forms of prostate cancer.
• Family History: Men with a father, brother, or son who had prostate cancer are at greater
risk.
• Genetics: Inherited mutations in the BRCA1 and BRCA2 genes increase the likelihood
of developing prostate cancer.
• Lifestyle: A diet high in red meat, processed foods, and fat may raise the risk, while a
diet rich in fruits and vegetables may reduce it.
• Obesity: Overweight men may face a higher risk of developing more aggressive forms of
prostate cancer.
Symptoms of Prostate Cancer
Prostate cancer often develops slowly and may not cause symptoms in its early stages. When
symptoms appear, they can include:
• Difficulty starting or stopping urination
• Weak or interrupted urine flow
• Frequent urination, especially at night
• Pain or burning during urination
• Blood in the urine or semen
• Pain in the back, hips, or pelvis
• Erectile dysfunction
Since these symptoms can also be caused by benign conditions like an enlarged prostate (benign
prostatic hyperplasia), proper medical evaluation is essential
Diagnosis
Prostate cancer is often detected through:
1. Prostate-Specific Antigen (PSA) Test: A blood test that measures the level of PSA, a
protein produced by the prostate. High levels may suggest cancer, but other conditions
can also raise PSA levels.
2. Digital Rectal Exam (DRE): A doctor inserts a gloved finger into the rectum to feel for
abnormalities in the prostate.
3. Biopsy: If PSA levels are high or the DRE is abnormal, a biopsy may be done. A small
tissue sample from the prostate is examined under a microscope for cancer cells.
4 .Imaging Tests: MRI and CT scans help determine the extent of the cancer and whether it
has spread.
Treatment Options
Treatment depends on the stage and aggressiveness of the cancer, as well as the patient’s overall
health.
- Active Surveillance
For low-risk cancers, doctors may recommend regular monitoring through PSA tests and
biopsies rather than immediate treatment. - Surgery
A radical prostatectomy involves removing the prostate gland and surrounding tissues. This
option is usually recommended for localized cancer. Side effects can include urinary
incontinence and erectile dysfunction. - Radiation Therapy
Radiation therapy can be delivered externally (external beam radiation) or internally
(brachytherapy) with radioactive seeds placed directly into the prostate. - Hormone Therapy
Reducing testosterone levels can slow the growth of prostate cancer. This may involve
medications or surgical removal of the testicles (orchiectomy). - Chemotherapy
Chemotherapy is used for advanced prostate cancer that has spread beyond the prostate. Drugs
such as docetaxel and cabazitaxel help shrink tumors and relieve symptoms. - Immunotherapy and Targeted Therapy
Newer treatments like sipuleucel-T (Provenge) use the immune system to attack cancer cells.
PARP inhibitors are effective for cancers with certain genetic mutations
Prognosis and Outlook
Prostate cancer has a high survival rate when detected early. The 5-year survival rate for
localized prostate cancer is over 99%. If the cancer has spread to nearby tissues, the survival rate
remains high at 99%. However, if the cancer has metastasized (spread to other organs), the
survival rate drops to around 32%
Prevention and Screening
While prostate cancer cannot always be prevented, men can reduce their risk by:
• Eating a diet rich in fruits, vegetables, and whole grains
• Limiting red and processed meats
• Maintaining a healthy weight
• Exercising regularly
• Avoiding smoking
Screening recommendations vary:
• The American Cancer Society (ACS) recommends discussing PSA testing with a doctor
at age 50 for men at average risk, at 45 for African American men and those with a family
history, and at 40 for those at very high risk.
• The U.S. Preventive Services Task Force (USPSTF) recommends individualized
decision-making for PSA screening for men aged 55 to 69 and advises against routine
screening after age 70.
Conclusion
Prostate cancer is highly treatable when detected early. Advances in screening, surgical
techniques, and targeted therapies have improved outcomes for men with prostate cancer. Men
over 50, or those with a higher risk due to family history or race, should discuss screening
options with their doctor to make informed decisions about their health