Prostate cancer is a malignant tumor in the prostate gland, which is a part of the male reproductive system. Here is a brief overview about the causes and treatment for the condition.
Cancer is one of the most dreaded diseases, and is caused by abnormal multiplication of cells, forming tumors. These tumors can be of two types – benign or malignant. Benign tumors do not affect the neighboring tissues and organs, whereas malignant ones spread to other body parts. Prostate cancer is a common type of cancer. It affects the prostate gland, a walnut-shaped male reproductive gland, found at the base of the urethra, covering the urethral opening. This gland produces a whitish fluid, which carries sperms. It also controls the flow of urine in males. Prostate cancer is highly common in American men. This is also the second major contributor to the rising number of cancer deaths in America (lung cancer being the first one).
What Causes Prostate Cancer?
There is no specific reason for a person to develop prostate cancer, but there are certain factors, that can increase the risk of this disease. They include age, genetics, diet, lifestyle, use of certain medication, geography, and ethnic origin.
Age: As far as prostate cancer is concerned, age is the most crucial factor. This cancer is commonly detected in men above 45. The chances of developing this cancer increase with age. Many studies show that up to 60% of men over 80 are affected by this cancer. Though rare, this cancer is detected in younger men too.
Genetics: A family history of prostate cancer makes a man vulnerable to this disease. Till now, no specific gene has been identified as the causing agent of this cancer. However, mutation of two genes ( BRCA1 and BRCA2), which are responsible for ovarian cancer and breast cancer, are said to be involved in the growth of cancer cells in the prostate as well.
Diet: It is believed that a diet rich in animal fats can trigger the onset of prostate cancer. Excessive intake of red meat, dairy products, and foods containing bad cholesterol, may also be a causal factor. A diet rich in vegetables and fruits is believed to prevent this cancer.
Lifestyle: A sedentary lifestyle can lead to obesity, which in turn increases the risk of prostate cancer. According to statistics, men with a Body Mass Index (BMI) of 32.5 or more, have a higher risk of death due to prostate cancer.
Medication: Medical conditions and medication can cause prostate cancer in two ways. Certain medication/medical procedures increase the risk of this cancer, while some reduces the chances of getting affected. Use of anti-inflammatory drugs may help to cut the risk of prostate cancer. Medicines meant for lowering cholesterol level may also prove beneficial for lowering such risk. The high level of testosterone (male hormone) in blood, and contraction of sexually transmitted diseases have also been identified as contributory factors. Though there is no evidence to prove the link between prostatitis (inflammation of prostate gland) and prostate cancer, it is assumed that prostatitis increases the risk of prostate cancer.
Geography: Some regions of the world witness a higher incidence of this disease, when compared to other parts. People in North America, Caribbean Islands, Australia, and Northwestern Europe are more prone to develop prostate cancer than those in Central America, South America, Asia and Africa. The reason behind this could be the lifestyle and diet of the people in these regions. It is also noted that native Americans are more at risk, than the Asians living in America.
Ethnic Origin: In some cases, members of a particular race are found to be more susceptible to prostate cancer, as compared to others. For example, incidence of this cancer is higher in Black men, when compared to White men. It is also noticed that this cancer develops at a comparatively younger age in African Americans. Likewise, American men are more vulnerable to this disease than the Japanese.
It has also been noticed that over-exposure to cadmium (as seen in welders, rubber workers, battery manufacturers, etc.) is also likely to cause prostate cancer. Studies show that regular ejaculation reduces the risk. Contrary to earlier belief, it is now proved that vasectomy does not contribute to prostate cancer.
Symptoms and Treatment
Prostate cancer is not characterized by any symptom, during the early stages. It may be detected accidentally, while undergoing a Prostate-specific antigen (PSA) test or a digital rectal examination. The symptoms are almost similar for both prostate cancer and benign prostatic hypertrophy (enlargement of the prostate gland in elderly men). In both cases, the prostate gland gets enlarged, causing pressure on the urethra, leading to difficulties in urination. The symptoms include frequent urination, especially at night; painful urination; blood and semen in urine, and no steady flow of urine. This cancer may also cause difficulties in erection and ejaculation.
Once a person is diagnosed with prostate cancer, various factors are taken into consideration, before deciding the course of treatment. They are:
- The stage of cancer – whether it has spread or not?
- The age and the state of health of the patient.
- Whether the cancer is a recurrent one?
Generally, the treatment includes observation or watchful waiting, surgery, hormone therapy, and radiation therapy.
Watchful waiting: This involves active surveillance of the growth of cancer without any treatment. This method is employed in aged people, who cannot be treated with other methods, due to the risks involved. Watchful waiting may also be recommended for those, who are in the early stages of prostate cancer.
Surgery: The prostate gland is removed, either during the early stage of cancer, or when the gland stops responding to other treatments. The removal of prostate gland through surgery is called prostatectomy. The surgery is termed as radical retropubic prostatectomy, when the prostate gland is removed through an abdominal incision. It is radical perineal prostatectomy, when the gland is removed through an incision made through the perineum (skin between scrotum and anus).
Robotic-assisted laparoscopic prostatectomy (RALP), is a surgery used to remove the prostate gland, with the assistance of modern technology. Unlike other forms of prostatectomy, this method does not involve any large incision. Nowadays, RALP is becoming more popular among both doctors and patients. Sometimes, prostatectomy may cause nerve damage, and complications may arise, if the surgery is done after radiation therapy. The most common side effects of surgery are impotence and loss of urinary control. Some patients also experience difficulties in erection and ejaculation.
Another type of surgical procedure is transurethral resection of the prostate (TURP), where a small portion of the growth is removed to relieve the symptoms. This procedure involves removal of that portion of the gland, which blocks the urethra, thereby causing urination problems. This is done by inserting a small instrument called resectoscope through the penis.
Cryosurgery is another method, where the prostate gland is frozen, using metal rods inserted into it, through the perineum. The water in the cells surrounding the rods gets frozen, and this results in death of the cells. This method is considered more successful than the other types of treatments. It creates lesser problems during surgery, and the side effects are also comparatively lesser. Treatment through surgery includes orchiectomy, where the testicles are removed for reducing the amount of testosterone, thereby controlling the growth of prostate cancer.
Hormone Therapy: This treatment involves the male hormone called testosterone. The hormone is responsible for the growth of cancer cells in the prostate gland, and hormone therapy tries to curtail the production of testosterone, thereby curbing the growth of cancer cells. Blocking testosterone sometimes helps to shrink the cells, and diminish the size of the malignant portion. Some drugs used in this method decrease the production of testosterone. Others reduce the body’s ability to use this hormone. Doctors may even suggest this method of treatment, along with surgery or radiation therapy. Hormone therapy may cause side-effects, like enlargement of breasts, loss of libido, liver damage, and skin problems. In some cases, the cells may become resistant to this treatment after one or two years, resulting in recurrent growth of prostate cells.
Radiation Therapy: Radiation therapy involves the use of high-energy X-rays or other types of radiation, to kill the cancer cells. External radiation therapy directs the radiation emitted by machines towards the cancer cells. Internal radiation therapy involves planting of minute radioactive substances in the form of seeds or needles, near or inside the cancer growth. These rays destroy the DNA in the cancer cells. Unlike the normal cells, cancer cells cannot repair this damage, which causes the death of the latter. This treatment may cause impotence, rectal bleeding, diarrhea, and involuntary urination.
Other types of treatments include High-intensity focused ultrasound (HIFU) and biologic therapy. In HIFU, ultrasound waves are focused on the cancer cells to destroy them. Biologic therapy tries to boost the immune system, using substances produced in the body, to revitalize the body’s natural defense mechanism.
It is believed that a diet rich in fish, fruits, and vegetables, reduces the risk of prostate cancer. Intake of fruits and vegetables, like watermelon, tomatoes, cauliflower, and broccoli, is also helpful in preventing this cancer. Enlargement of the prostate gland is common in men above 45, and it does not mean that the growth is cancerous. So plan a healthy diet, start exercising, and always consult a doctor at the earliest, if you experience any of the above said symptoms.
Disclaimer: This article is for informational purposes only, and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.