Prostate Cancer
Prostate cancer is a malignancy that develops in the prostate gland, a walnut-sized gland in men that produces seminal fluid. It is one of the most common cancers affecting men, particularly those over 50. Prostate cancer typically grows slowly and initially remains confined to the prostate gland, where it may cause few or no symptoms and may need minimal or no treatment. However, some types can be aggressive and spread quickly. Early detection through regular screening is crucial, as treatment is most effective when the cancer is found early.
Causes
- Age - Risk increases significantly after age 50, with most cases diagnosed in men over 65.
- Family history - Having a father or brother with prostate cancer more than doubles a man's risk.
- Genetic factors - Mutations in genes such as BRCA1, BRCA2, and HOXB13 can increase risk.
- Race - African ancestry is associated with higher risk and more aggressive forms of prostate cancer.
- Diet - High consumption of red meat and high-fat dairy products may increase risk, while fruits, vegetables, and foods rich in certain nutrients may decrease risk.
- Obesity - Some studies suggest obesity is linked to more aggressive prostate cancer and increased mortality.
- Geographic factors - Prostate cancer is more common in North America, Europe, Australia, and Caribbean islands, suggesting environmental or lifestyle factors may play a role.
- Inflammation - Chronic inflammation of the prostate (prostatitis) may increase cancer risk.
- Hormonal factors - High testosterone levels may increase risk, though the relationship is complex.
- Chemical exposures - Some research suggests exposure to certain chemicals, such as those in some occupations, may increase risk.
Signs and Symptoms
- Early-stage prostate cancer often causes no symptoms at all.
- Difficulty urinating - Weak flow, difficulty starting or stopping, or frequent urination, especially at night.
- Blood in urine or semen - Visible blood that may appear red or pink.
- Erectile dysfunction - New onset of erectile problems.
- Discomfort in the pelvic area - Pain or pressure in the rectum or lower back.
- Bone pain - Especially in advanced cases where cancer has spread to the bones.
- Unexplained weight loss or fatigue - Particularly in advanced cases.
- Swelling in legs - Due to lymphatic blockage in advanced cases.
- Weakness or numbness in legs or feet - From spinal cord compression in advanced cases.
Diagnosis
Prostate-Specific Antigen (PSA) Test
A blood test measuring PSA levels, which may be elevated in men with prostate cancer. However, elevated PSA can also result from non-cancerous conditions like prostate enlargement or inflammation.
Digital Rectal Examination (DRE)
A physical examination where a doctor inserts a gloved, lubricated finger into the rectum to feel the prostate for abnormalities in size, shape, or texture.
Prostate Biopsy
If initial tests suggest cancer, a biopsy is performed to remove small samples of prostate tissue using a thin needle, guided by imaging techniques. The tissue is examined under a microscope to confirm cancer and determine its aggressiveness (Gleason score).
Imaging Tests
Various imaging methods may be used, including transrectal ultrasound (TRUS), MRI, CT scans, bone scans, or PET scans, to visualize the prostate, guide biopsies, or check if cancer has spread beyond the prostate.
Genomic Testing
Advanced tests that analyze genes in the cancer cells to help predict how aggressive the cancer is and guide treatment decisions.
Treatment Options
Active Surveillance
For low-risk, slow-growing prostate cancer, regular monitoring through PSA tests, DREs, and periodic biopsies may be recommended instead of immediate treatment. Treatment begins if tests show the cancer is growing or changing.
Surgical Options
Radical prostatectomy involves removing the entire prostate gland and some surrounding tissue. Approaches include traditional open surgery, laparoscopic surgery, or robot-assisted surgery, which is less invasive and may result in faster recovery.
Radiation Therapy
External beam radiation therapy directs radiation from outside the body to kill cancer cells. Brachytherapy involves placing radioactive sources directly into the prostate. Radiation may be used as primary treatment or after surgery.
Hormone Therapy
Since prostate cancer growth is fueled by testosterone, reducing testosterone levels through medications or surgery (orchiectomy) can help slow cancer growth. This is often used for advanced cancer or in combination with other treatments.
Home Remedies
Healthy Diet
Emphasize fruits, vegetables, whole grains, and healthy fats like olive oil and nuts. Limit red meat, processed foods, and high-fat dairy. Some evidence suggests that tomatoes (containing lycopene), cruciferous vegetables, green tea, and foods rich in omega-3 fatty acids may be beneficial.
Regular Exercise
Engaging in physical activity for at least 30 minutes most days can help maintain a healthy weight and may slow cancer progression. Exercise also helps manage treatment side effects and improves overall quality of life.
Stress Management
Techniques such as meditation, deep breathing, yoga, or tai chi can help reduce stress, which may impact cancer progression and certainly affects quality of life during treatment.
Adequate Sleep
Prioritizing good sleep hygiene and aiming for 7-8 hours of quality sleep can support immune function and overall health during cancer treatment.
Social Support
Joining support groups, either in-person or online, can provide emotional support, practical advice, and a sense of community with others facing similar challenges.
Preventive Care
- Regular screening - Discuss with your doctor when to begin PSA testing and DREs based on your risk factors.
- Maintain a healthy weight through proper diet and regular exercise.
- Eat a diet rich in fruits, vegetables, and whole grains, while limiting red and processed meats.
- Consider foods rich in lycopene (tomatoes, pink grapefruit) and cruciferous vegetables (broccoli, cauliflower).
- Exercise regularly, aiming for at least 30 minutes of moderate activity most days.
- Limit alcohol consumption to moderate levels.
- Don't smoke, and if you do, seek help to quit.
- Know your family history of prostate cancer and inform your doctor.
- Consider genetic counseling if you have a strong family history of prostate, breast, or ovarian cancer.
- Discuss risk reduction strategies with your doctor, especially if you have high-risk factors.
Surgical Options
Radical Prostatectomy
Surgical removal of the entire prostate gland and some surrounding tissue, including the seminal vesicles. Modern approaches include open surgery, laparoscopic surgery, or robot-assisted surgery, which offers greater precision and potentially fewer side effects like incontinence and erectile dysfunction.
Learn More About This ProcedureExternal Beam Radiation Therapy (EBRT)
Advanced techniques like intensity-modulated radiation therapy (IMRT) or image-guided radiation therapy (IGRT) deliver precise radiation doses to the prostate while minimizing exposure to healthy tissues. Treatment typically involves short sessions 5 days a week for several weeks.
Learn More About This ProcedureBrachytherapy
A form of internal radiation therapy where tiny radioactive seeds are implanted directly into the prostate. Low-dose-rate (LDR) brachytherapy uses permanent implants, while high-dose-rate (HDR) brachytherapy uses temporary implants. This delivers high doses of radiation directly to the cancer while limiting exposure to surrounding tissues.
Learn More About This ProcedureCryotherapy (Cryoablation)
A minimally invasive procedure that uses extremely cold temperatures to freeze and destroy cancer cells in the prostate. Thin needles are inserted into the prostate through which argon gas is circulated to create ice balls that destroy the prostate tissue.
Learn More About This ProcedureHigh-Intensity Focused Ultrasound (HIFU)
A non-invasive procedure that uses focused ultrasound waves to heat and destroy cancer cells in the prostate without affecting surrounding tissue. This is typically used for localized prostate cancer and may preserve urinary and sexual function better than some other treatments.
Learn More About This ProcedureSchedule a Consultation
If you're experiencing symptoms of prostate cancer, our expert team is here to help you find the right treatment approach for your specific needs.