Prostrate Cancer

The Function of the Prostate and Complications Associated with Prostate Cancer

The prostate is a small, walnut-sized gland located just below the bladder in men. It surrounds the urethra and plays an important role in the male reproductive system. The prostate’s main job is to produce seminal fluid, which nourishes and carries sperm during ejaculation. It also helps control urine flow and supports hormone balance.

When the prostate becomes diseased or enlarged, it can affect both urinary and sexual health. Prostate cancer is one of the most common cancers in men, especially after the age of 50. If not detected early, it can cause complications like urinary blockage, erectile problems, and in severe cases, spread to other organs such as bones or the liver. Because prostate cancer often develops slowly, regular screening and awareness are very important.

Types of Prostate Tumours

Prostate cancer can be divided into two main categories: Primary Prostate Cancer and Secondary (Metastatic) Prostate Cancer.

• Primary Prostate Cancer: This type starts in the prostate gland itself. The most common form is Adenocarcinoma, which accounts for more than 95% of prostate cancers. Less common types include small cell carcinoma, neuroendocrine tumors, squamous cell carcinoma, and transitional cell carcinoma.
• Secondary Prostate Cancer: This happens when prostate cancer spreads to other parts of the body, most often to the bones, lymph nodes, liver, or lungs. When it spreads, it may cause pain, fractures, or other organ-related problems.

Major Risk Factors

• Age above 50 years
• Family history of prostate or breast cancer
• African ancestry
• Diets high in red meat and animal fat
• Obesity and lack of physical activity
• Exposure to harmful chemicals like Agent Orange

Signs and Symptoms

In the early stages, prostate cancer may not cause noticeable symptoms. As it grows, men may experience:

• Frequent urination, especially at night
• Difficulty starting or stopping urination
• Weak or interrupted urine stream
• Pain or burning while urinating (less common)
• Blood in urine or semen
• Erectile dysfunction
• Pain in the lower back, hips, or thighs
• Loss of bladder or bowel control (in advanced cases)

Because some symptoms are similar to benign prostate enlargement (BPH), it’s essential to consult a doctor for proper evaluation.

Diagnosis of Prostate Cancer

Doctors use several tests to diagnose prostate cancer accurately:

• Medical Exam: Includes a digital rectal examination (DRE) to feel for abnormal lumps.
• Blood Test (PSA): Measures prostate-specific antigen levels in the blood. High PSA may indicate cancer, but further tests are needed for confirmation.
• Imaging Tests: MRI, CT scans, or ultrasound help locate and measure the tumor.
• Biopsy: A small tissue sample is taken and examined under a microscope to confirm cancer and its aggressiveness (Gleason score).
• Staging: Determines whether the cancer is localized or has spread to other parts of the body.

Best Treatment Options for Prostate Cancer

Treatment depends on the stage of cancer, PSA levels, Gleason score, and overall health of the patient. Common options include both traditional and advanced therapies.

1. Surgical Procedures

Radical Prostatectomy: Complete removal of the prostate gland and nearby tissues. It can be done through open surgery, laparoscopy, or robot-assisted methods. Sometimes, pelvic lymph nodes are also removed to check for cancer spread.

2. External Beam Radiation Therapy (EBRT)

This non-invasive treatment uses targeted high-energy X-rays to destroy cancer cells. It can be used for early-stage cancer, after surgery, or to relieve symptoms in advanced stages. Side effects may include mild fatigue or temporary urinary changes.

3. Systemic Chemotherapy

Usually used for advanced prostate cancer that no longer responds to hormone therapy. Common drugs include docetaxel and cabazitaxel. Side effects can vary but are carefully managed by doctors.

4. Hormone Therapy (Androgen Deprivation Therapy – ADT)

Since prostate cancer cells need testosterone to grow, ADT lowers or blocks this hormone through medication or minor surgery. Common methods include LHRH agonists, anti-androgen tablets, or orchiectomy (surgical removal of testicles).

Advanced Treatments for Prostate Cancer

1. Microinvasive Surgeries

Cryotherapy (Cryoablation): Freezes and destroys cancer cells using special probes. Often used for small or recurrent tumors.

NanoKnife (Irreversible Electroporation): Delivers electrical pulses that kill cancer cells while sparing nearby healthy tissues like nerves and blood vessels.

2. Targeted and Immunotherapies

PARP Inhibitors (e.g., Olaparib): Effective for men with specific genetic mutations such as BRCA1/2.

Radioligand Therapy (Lutetium-177-PSMA): Combines radiation with targeted molecules that find and destroy prostate cancer cells.

Immunotherapy (Sipuleucel-T and Checkpoint Inhibitors): These treatments boost the immune system to identify and attack prostate cancer cells naturally.

3. Brachytherapy (Internal Radiation)

This therapy places tiny radioactive seeds directly inside the prostate. It provides focused treatment with minimal harm to nearby tissues.

Prevention and Healthy Lifestyle

• Eat a diet rich in fruits, vegetables, and omega-3 fats
• Exercise regularly and maintain a healthy weight
• Limit red meat and dairy fat
• Stop smoking and reduce alcohol intake
• Get regular PSA and DRE screening after age 50 (or earlier for high-risk men)
• Manage chronic diseases like diabetes and hypertension

Prognosis and Survival Rates

Prostate cancer usually grows slowly, and when caught early, it is highly treatable. The 5-year survival rate for localized prostate cancer is over 99%. For advanced stages, survival is lower, but new treatments are improving long-term outcomes. Lifelong check-ups help manage recurrence and maintain quality of life.

Conclusion

Prostate cancer is one of the most treatable cancers when detected early. Understanding the function of the prostate, regular screening, and adopting a healthy lifestyle can make a huge difference. Modern treatments such as robotic surgery, targeted therapy, and immunotherapy offer hope for better recovery and improved life quality for men worldwide.