Prostate Cancer

What is Prostate Cancer?

The prostate is a walnut-sized exocrine gland. This means that its fluids and secretions are intended for use outside of the body.

The prostate produces the fluid that nourishes and transports sperm on their journey to fuse with a female ovum (egg) and produce human life. The prostate contracts and forces these fluids out during orgasm.

The protein excreted by the prostate, prostate-specific antigen (PSA), helps semen retain its liquid state. An excess of this protein in the blood is one of the first signs of prostate cancer.

The urethra is the tube through which sperm and urine exit the body. It also passes through the prostate. As such, the prostate is also responsible for urine control, tightening and restricting urine flow using thousands of tiny muscle fibers.

How Does It Start?

Prostate cancer usually starts in the glandular cells, known as adenocarcinoma. Tiny changes occur in the shape and size of prostate gland cells, known as prostatic intraepithelial neoplasia (PIN). This develops slowly and often shows no symptoms in early stages.

• Nearly 50% of men over age 50 have PIN
• High-grade PIN is considered pre-cancerous and needs further evaluation
• Low-grade PIN is usually not a cause for concern
• Cancer can be treated successfully if detected early before spreading
• Advanced cancer commonly spreads to the bones

Symptoms

Early-stage prostate cancer often shows no symptoms. When symptoms appear, they may include:

• Frequent urination, especially at night
• Difficulty starting or stopping urination
• Blood in urine
• Painful urination or ejaculation
• Difficulty achieving or maintaining an erection

Advanced prostate cancer symptoms may include:

• Bone pain (spine, pelvis, ribs, femur)
• Bone fractures
• Leg weakness
• Urinary incontinence
• Fecal incontinence

Treatment

Early Stage Prostate Cancer

Treatment depends on the stage and overall health of the patient. Early-stage prostate cancer is usually managed with:

• Watchful Waiting / Monitoring: Regular PSA tests with no immediate treatment
• Radical Prostatectomy: Surgical removal of the prostate gland
• Brachytherapy: Implanting radioactive seeds in the prostate
• Conformal Radiation Therapy: Precisely shaped radiation beams
• Intensity Modulated Radiation Therapy (IMRT): Advanced radiation with variable intensity
• Radiation therapy combined with hormone therapy for 4–6 months in some cases

Treatment recommendations vary for each patient. It is important to consult a urologist or oncologist to choose the most suitable option.