Prostate cancer

21 September 2023

OVERVIEW

Prostate cancer is cancer that originates in the prostate gland, a small walnut-sized gland that is located below the bladder and produces seminal fluid. World-wide, prostate cancer is the second most commonly diagnosed cancer among men – with an estimated 1,4 million new cancer cases and 375,304 deaths in 2020.

Image Source: Pereira, Kaitlin. Illustration of the prostate gland (2023). https://imbri.org.za/prostate-cancer/

RISK FACTORS

Several factors could increase the risk of developing prostate cancer, however it is important to note that men who don’t have the following risk factors could also develop prostate cancer.

Well-established risk factors include:

Age: the risk of developing prostate cancer increases with age, with most cases being diagnosed in men over 50 years of age
Race: Prostate cancer occurs more commonly in black men, however the reason for ethnicity factors in developing prostate cancer are unclear
Family history: The cancer risk increases if there is a family history of prostate cancer – especially if male family members (brother or father) were diagnosed before the age of 60.
Inherited genetic mutations: inherited mutations of the BRCA1 or BRCA2 genes. In addition, men with Lynch syndrome also have an increased risk of developing prostate cancer.

SYMPTOMS

During the early stages of prostate cancer there are often no symptoms; however, when prostate cancer does cause symptoms, it may include:

Frequent urination (especially at night),
Blood in urine or semen,
Painful ejaculation,
Weak or interrupted urine flow.

Nonetheless, these symptoms may also be indicative of other conditions, such as benign prostatic hyperplasia (enlargement of the prostate) or inflammation of the prostate. It is thus very important to seek medical assistance for effective treatment.

In situations where the prostate cancer is advanced, symptoms usually include bone pain, tiredness and unexplained weight loss.

DIAGNOSIS AND TYPE OF TESTS

Prostate cancer is highly treatable if detected early, it is thus very important to get screened. Common screening tests include the digital rectal exam, as well as the prostate-specific antigen or PSA test (based on age, health and risk profile); however, a prostate biopsy (which involves removal of a sample of tissue) is typically used to confirm the presence of prostate cancer.

TREATMENT OPTIONS

Treatment options depend on several factors such as:

The stage of the cancer [this includes the level of PSA, Gleason score (a grading system that measures how rapidly the cancer cells can progress and affect other tissues), how much of the prostate is affected by the malignancy or whether it has already metastasized to other parts of the body]
Overall health of the patient
The patients’ age and life expectancy
The potential benefits of the treatment
The potential side effects of the treatment
The patients’ personal preference

Some treatment options include:

Watchful waiting or active surveillance
Surgery
Radiation therapy and radiopharmaceutical therapy
Hormone therapy
Chemotherapy
Targeted therapy
Immunotherapy

Note:

Although prostate cancer is fairly common, thanks to advances in screening options for prostate cancer, it is possible to detect this cancer early to improve a patient’s prognosis.

Regular cancer screening is thus a very important preventative measure because when the cancer is detected early, it will be easier to treat and could result in increased survival rates and improved quality of life.

REFERENCES

Chen F, Zhao X. Prostate Cancer: Current Treatment and Prevention Strategies (2013). Iran Red Cres Med J. 15(4):279-84.
Cleveland Clinic Editorial Board. Benign Prostatic Hyperplasia. Updated (2022). Available at: https://my.clevelandclinic.org/health/diseases/9100-benign-prostatic-hyperplasia Accessed 12/09/2023
Medical News Today Editorial Board. What to know about prostate cancer. Updated (2023). Available at: https://www.medicalnewstoday.com/articles/150086 Accessed 10/09/2023
PDQ® Adult Treatment Editorial Board. PDQ Prostate Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated (2023). Available at: https://www.cancer.gov/types/prostate/patient/prostate-treatment-pdq. Accessed 13/09/2023 [PMID: 26389353]
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries (2021). CA Cancer J Clin. 71:209–49.
Urology Care Foundation Editorial Board. What is prostate cancer? Updated (2023). Available at: https://www.urologyhealth.org/urologic-conditions/prostate-cancer Accessed 15/09/2023
Wang L, Lu B, He M, Wang Y, Wang Z, Du L. Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries From 2000 to 2019 (2022). Front Public Health. 10:811044.

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The content provided is for educational purposes and is not intended to offer personal medical advice. You should seek the advice of your physician or other qualified health providers with any questions you may have relating to a medical condition