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Ayush Maurya

Prostate Cancer: Common Issues and Preventive Measures



Prostate cancer is the fifth-leading cause of cancer-related death among males worldwide. In 2020, it accounted for approximately 375,000 fatalities, representing about 3.8% of all cancer deaths. Wealthy nations such as the United States, Canada, Australia, and parts of Europe typically have higher rates, while nations in Asia and Africa tend to have lower rates. While there is no foolproof strategy to prevent prostate cancer, maintaining a healthy lifestyle throughout life or taking steps to address current health issues can reduce the risk. It is important to be aware of the associated risks for prostate cancer and take preventive measures.


Understanding Prostate Cancer


Prostate cancer develops in the prostate, a small walnut-shaped gland located behind the bladder, in men and those born with a masculine gender identity. The prostate gland produces fluids that combine with semen to support sperm health and fertilization.


Is Prostate Cancer Common?

Yes, prostate cancer is common among men worldwide. The U.S. Centers for Disease Control and Prevention states that about 13 out of every 100 men with a prostate gland will eventually develop prostate cancer. However, most men will lead normal lives and ultimately die from unrelated causes, with some not requiring specific treatment or care. The risk of prostate cancer increases with age, and it is uncommon in men below the age of 40. However, prostate cancer can develop in any man due to genetic abnormalities.


Symptoms Associated With Prostate Cancer


Prostate cancer may not always exhibit noticeable signs and symptoms, especially in the early stages. Symptoms usually become apparent as the disease progresses. Common issues associated with prostate cancer include:

  • Slower urine flow or starting and stopping during urination.

  • Pain during urination, similar to Urinary Tract Infections (UTIs).

  • Involuntary urine flow, even when unconscious.

  • Painful ejaculation and erectile dysfunction.

  • Presence of blood in the semen during ejaculation.

Prostate Cancer Stages

Prostate cancer often progresses slowly in its initial stages and can go undetected without obvious signs. Early identification is crucial for optimal treatment outcomes.


PSA Test: PSA blood testing and a digital rectal exam (DRE) are primary procedures used in monitoring prostate cancer. The PSA test measures the levels of a protein called PSA, which can be elevated in cases of prostate cancer. The DRE involves a healthcare professional inserting a gloved finger into the rectum to examine the prostate for abnormalities.


"Generally, prostate cancer develops in men over the age of 50. If you have a first-degree relative (father or brother) with prostate cancer, your risk of developing it increases, and screening is recommended," says Dr. Raman Tanwar, National Expert in Andrology, Urology, and Men's Health. Prostate cancer has three stages:

  • Stage 1: PSA may be elevated, but there are no symptoms. The cancer can be cured completely if diagnosed at this stage.

  • Stage 2: Cancer spreads beyond the prostate to neighboring areas, resulting in symptoms as mentioned earlier.

  • Stage 3: Metastatic prostate cancer, where the cancer has spread to the bones, lymph nodes, lungs, or other organs. This stage is generally more challenging to cure than stages 1 and 2.

According to Dr. Raman, PSA testing should be done for individuals with a family history of prostate cancer, typically once every two years. However, since PSA testing can lead to false-positive results and overdiagnosis, it is a topic of discussion among medical professionals. Elevated PSA results may prompt further investigations such as a prostate biopsy, which carries potential risks and complications. Therefore, the decision to undergo PSA testing should be made after consulting with a healthcare provider and considering factors such as age, personal medical history, family history of prostate cancer, and personal preferences.


Treatment Methods for Early-stage Prostate Cancer

Treatment options for early-stage prostate cancer vary based on the severity of the cancer, the patient's age, and overall well-being.

  • Surgical Methods: Radical prostatectomy, which involves surgically removing the prostate gland, is a popular type of surgery. Less invasive alternatives such as laparoscopic or robotic-assisted surgery can also be used.

  • Cryotherapy: This procedure involves freezing the prostate gland to kill cancer cells. It is less commonly used and considered for insignificant, early-stage tumors.

  • Radiation Therapy: Cancerous cells are destroyed using high-energy beams such as protons or X-rays.

  • Hormone Therapy: Androgens, the male hormones, are essential for the growth of prostate cancer cells. Hormone therapy aims to reduce the body's androgen levels through medication or surgical removal of the testicles (orchiectomy).

Complications


Prostate cancer surgery, including radical prostatectomy, can have various side effects. It is important to note that not everyone will experience these issues, and their severity may vary. It is recommended to seek advice and information from a healthcare professional.

  • Erectile Dysfunction (ED): One of the most common side effects of prostate surgery is erectile dysfunction. Surgeries can damage the arteries and nerves that regulate erections. The restoration of erectile function varies from person to person. Additional therapies such as medication, suction erection devices, or penile implants are available.

  • Urinary Incontinence: Prostate surgery can impact urine control, leading to temporary or long-term urinary incontinence, where one lacks the ability to control the amount of urine produced.

  • Urine Retention: Some men may experience urine retention due to an inability to completely empty their bladders after surgery.

  • Infection: There is a risk of infection with any surgical procedure, including prostate surgery. Infections can occur within the urinary system or at the surgical site and may require antibiotic treatment.

Preventive Measures to Lower the Risk of Prostate Cancer

While men from Asia have a lower risk of developing prostate cancer compared to men in Western countries, the exact reasons for this difference are not fully understood. Specialists believe that variations in eating habits between Asia and the West, including unhealthy eating patterns and a heavy dependence on meat in Western countries, may contribute to this discrepancy. Although the direct relationship between diet and prostate cancer is not fully established, maintaining a healthy diet can lower the risk to some extent. Following are a few key things to keep in mind to lower the risk of prostate cancer:

  • It is advisable to consume foods low in fat, incorporate fruits and vegetables, green tea, and soy into meals as substitutes for unhealthy choices.

  • Additionally, maintaining a healthy body weight within the proper BMI range and engaging in regular exercise can improve the immune system and reduce the risk of cancer.

  • Smoking and excessive alcohol consumption should be reduced or eliminated as they not only increase the risk of cancer but also contribute to other health issues.

  • It is important to inform your physician if there is a family history of prostate-related cancer, especially in close relatives like your grandfather, father, or brother, as they may recommend more frequent or earlier screenings.

Drug Prevention

Age-related changes in metabolism, being overweight, poor diet, and genetic factors have been associated with a higher likelihood of prostate cancer. A study conducted in Mumbai found that individuals who underwent prostate cancer removal therapy had a higher survival rate (91%).

Drugs such as finasteride or dutasteride, which reduce dihydrotestosterone (DHT), are commonly used in the treatment of men. These medications have been extensively researched to determine if they can prevent prostate cancer, and the findings suggest a potential 25% reduction in cancer-related risk.


Conclusion

In conclusion, prostate cancer is a common worldwide health issue, although its diagnosis may not be prevalent or well-known. The exact causes of prostate cancer are still unknown, but age, genetic factors, hereditary traits, and lifestyle choices, including diet, play a role. Effective treatment and control of prostate cancer depend on regular screenings and early diagnosis. It is advisable to seek expert advice and undergo recommended tests if you have concerns about prostate cancer.


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