Prostate cancer develops in the prostate gland, a part of the reproductive system in men. Worldwide, prostate cancer is the most commonly diagnosed male malignancy in men. This amounted to 1,4 million newly diagnosed cases worldwide in 2020. This cancer is caused by abnormal growth of cells in the prostate gland and usually progresses slowly. The signs and symptoms may be subtle in the early stages but prostate cancer that's more advanced may cause signs and symptoms such as trouble urinating, pain and erectile dysfunction. However, these symptoms are similar to and can also be seen in benign prostatic hyperplasia. Nowadays, prostate cancer is most commonly diagnosed based on elevated prostate-specific antigen (PSA) levels in blood. When a man has an abnormal PSA test, it is investigated whether the raised PSA levels are caused by prostate cancer and, if necessary, a prostate biopsy is performed for definitive diagnosis. Treatment is planned according to the patient's age, overall health and medical condition.

What is prostate cancer?

The prostate, about the size of a walnut, is a small gland located below the bladder. Prostate cancer occurs when abnormal cells in the prostate gland grow in an uncontrolled way. In most cases, prostate cancer progresses slowly and is mostly confined to the prostate gland and may not cause serious damage to surrounding tissues. However, some types are more aggressive and can spread rapidly. Early prostate cancer is usually asymptomatic but prostate cancer that's more advanced may cause signs and symptoms such as trouble urinating, pain and erectile dysfunction. The rate of successful treatment may be higher when the disease is diagnosed early and limited to the prostate gland,

What are the causes of prostate cancer?

Experts still research what causes cells in the prostate to become cancer cells. As with cancer in general, prostate cancer forms when cells divide faster than usual. While normal cells eventually die, cancer cells don’t. Instead, they multiply and grow into a lump called a tumor. As the cells continue to multiply, parts of the tumor can break off and spread to other parts of your body. The causes of prostate cancer may include:

●         Genetic predisposition: People with a family history of prostate cancer may have an increased risk of developing prostate cancer. Some gene mutations can cause the development of prostate cancer.

●         Age: One of the most common risk factors is age. The risk of prostate cancer may increase with age. Hormonal effects and genetic factors that change with age may be effective in the occurrence of the disease.

●         Race and Ethnicity: Ethnicity can affect the risk of developing prostate cancer. While it is common in men of African ancestry, in Scandinavian countries and the United States, it is less common in Far Eastern countries.

●         Dietary Habits and Obesity: An unbalanced and high-fat diet can increase the risk of the disease. People who are obese may have a higher risk of prostate cancer compared with people considered to have a healthy weight.

●         Hormonal Changes: Hormonal changes, especially an increase in testosterone levels, can be effective in the development of prostate cancer.

What are the signs and symptoms of prostate cancer?

Early-stage prostate cancer rarely causes symptoms. The signs and symptoms of the disease usually occur only after the disease has progressed. But it should be kept in mind that many of these symptoms, especially frequent need to pee and pain or burning when you pee may be from other common prostate problems that aren't cancer, such as a benign enlarged prostate. Common symptoms of prostate cancer are:

●         Frequent, sometimes urgent, need to pee, especially at night

●         Weak urine flow or flow that starts and stops

●         Pain or burning when you pee

●         Loss of bladder control

●         Painful ejaculation and erectile dysfunction

●         Blood in semen or pee

●         Pain in your pelvic region, back or groin

What are the stages of prostate cancer?

Cancer staging allows your healthcare provider to determine how advanced your cancer is, or how much it has spread. Staging plays a key role when determining the types of treatment you need. Prostate cancer diagnosed in early stages can often be treated more effectively. The stages of prostate cancer can be classified as follows:

●         Stage I: In this stage, the tumor has not spread and is confined to the prostate. The size of the tumor is usually small and is often noticed incidentally during routine check-ups.

●         Stage II: In stage II, the tumor may have spread beyond the tissues of the prostate gland but has not spread to surrounding organs or tissues. Stage II may indicate that the cancer may spread to other parts of the prostate.

●         Stage III: The tumor may spread beyond the prostate and affect nearby lymph nodes. This indicates that the tumor has spread to other tissues.

●         Stage IV: The tumor may have metastasized to distant organs, especially bones or other organs. This stage is the most advanced stage of prostate cancer. 

Prostate Cancer Treatment

Prostate cancer can be treated and treatment usually involves a variety of methods, including surgery, radiotherapy, hormone therapy, chemotherapy and immunotherapy. Treatment options aim to control prostate cancer, shrink the tumor or completely eradicate it. Commonly used treatment options for prostate cancer include:

●         Surgery: Surgery involves the removal of the entire prostate gland and surrounding androgenic glands and is called radical prostatectomy. Radical prostatectomy aims to control the tumor locally and reduce the risk of the cancer spreading. In slightly more advanced stages, the prostate is removed along with surrounding lymph nodes and checked for possible tumor spread. Surgery is usually performed with robot-assisted or open surgery methods.

●         Radiotherapy: High x-rays are used to kill tumor cells. In addition to external beam radiotherapy, different radiotherapy methods such as brachytherapy can also be performed. In brachytherapy, radioactive pellets are placed into the prostate to control cancerous cells, but this is a treatment method that can be applied only to a very limited group of patients with early stage prostate cancer.

●         Hormone Therapy: Hormone therapy aims to control tumor by blocking or affecting testosterone production. Hormone therapy is usually used in combination with other treatment modalities and may be used after surgery or in combination with radiation therapy in early stages, or alone or in combination with chemotherapy in more advanced stages.

●         Chemotherapy: Chemotherapy is a systemic treatment method used in advanced prostate cancer. Chemotherapy uses drugs that prevent cell division to control the growth of tumor cells.

●         Immunotherapy: Immunotherapy stimulates the immune system to recognize and destroy tumor cells. It is often applied before or after surgery. Immunotherapy tries to develop a specific defense mechanism against prostate cancer so that the patient's own immune system can fight the tumor.

Are there any natural remedies for prostate cancer?

A natural remedy that can be applied at home against prostate cancer, is to adopt a healthy lifestyle and improve eating habits. Consuming antioxidant-rich fruits and vegetables can support prostate health. A balanced diet and avoiding harmful habits are important for overall health. Regular exercise can strengthen the immune system and improve overall health. Polyphenols in green tea may be beneficial. However, since everyone has a different overall health and allergic status, at-home remedies should be used under a doctor’s advice.

FAQs

Prostate cancer is nowadays a common condition that can severely affect everyday life. If diagnosis and treatment is delayed, the disease can progress and cause more serious complications. For this reason, men with a family history of prostate cancer should be regularly checked by a urologist from the age of 45 and other men from the age of 50.

Is prostate cancer dangerous?

Prostate cancer is usually a slow progressing cancer. Many men may have no symptoms and early detection and treatment can lead to very long life expectancy. However, prostate cancer can be dangerous in some cases. If the tumor grows rapidly or spreads to surrounding tissues, treatment options can become difficult and the risk of recurrence can increase. With early diagnosis and effective treatment, prostate cancer can usually be successfully managed.

Which department treats prostate cancer?

Prostate cancer is diagnosed and treated by urologists. Urologists specialize in problems related to the urogenital system, including the diagnosis, treatment options and follow-up of patients with prostate cancer.

Prostate cancer is a serious condition that affects people's daily life and it is important for patients to make an appointment with a urology outpatient clinic and start treatment as soon as symptoms appear.

References

https://www.nhs.uk/conditions/prostate-cancer/

https://www.nhs.uk/conditions/prostate-cancer/symptoms/

https://www.ncbi.nlm.nih.gov/books/NBK470550/

https://www.cdc.gov/cancer/prostate/basic_info/what-is-prostate-cancer.htm

https://my.clevelandclinic.org/health/diseases/8634-prostate-cancer

https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087

https://medlineplus.gov/prostatecancer.html

https://www.healthdirect.gov.au/prostate-cancer#causes