Prostate cancer is a kind of cancer that occurs in the prostate of a man. A prostate is a small gland that produces the seminal fluid that transports and nourishes sperm. Prostate cancer is the second most common cancer in men. In the initial stages, it remains confined to the prostate gland. However, many types of prostate cancer spread to other body parts if they are untreated.
Prostate Cancer Statistics
Prostate cancer affects men from all parts of the world. Statistically, it is the second leading cause of death due to cancer in men (behind only skin cancer). In 2013, it was estimated that 2,380,590 men were diagnosed with prostate cancer worldwide. This was a decline by 3,152 when compared to 2012. It was also estimated that 29,720 men died from the disease in 2013 (also a reduction by 1,550 when compared to 2012). Prostate cancer affects mostly men who are above 65 years old since 60% of all cases are found in these old men. In total, 1 out of 6 men are diagnosed with the disease during their lifetime. In addition, 1 in 36 men die as a result of the disease. In the United States, it is estimated that 2.5 million have prostate cancer. In 2010 alone, 196,038 men were diagnosed with the disease. That year, 28,560 men lost their lives due to the disease (His Prostate Cancer, 2013). With an aging population, the incidence of prostate cancer is going to increase.
Several factors can increase the risk of getting prostate cancer. These include:
- Old age: It has been established that as a man grows, the risk of him acquiring prostate cancer increases. This explains why the disease is common in men aged above 65 years.
- Ethnicity: Statistics suggest that black men have an increased risk of acquiring prostate cancer. They are also at a greater risk of acquiring advanced and aggressive types of prostate cancer. However, the reason why black men are at a greater risk is not known.
- Genetics: The gene BRCA1 and BRCA2 have been associated with high incidences of prostate cancer.
- Family history: In general, men who have reported prostate and breast cancers in their family history are at a greater risk of acquiring this disease.
- Obesity: Obese men tend to develop more advanced types of prostate cancers than other men (Tewari, 2013).
In practice, there are two key methods of checking whether a man has prostate cancer. These are the digital rectal exam (DRE) and the prostate-specific antigen (PSA) test. The DRE involves inserting a gloved, lubricated finger into the rectum to check texture, size and shape the prostate. Further tests will be carried when an abnormality is found. The PSA test involves drawing a blood sample and analyzing for PSA, a substance that is naturally produced by the prostate gland. If an abnormal level of PSA is observed, it may be a suggestion of prostate inflammation, infection, enlargement or cancer (Mydlo & Godec, 2003).
When the DRE or the PSA tests have indicated that there might be an abnormality in the prostate gland, further tests will be carried. The most widely used tests are an ultrasound and collection of prostate tissue sample. The ultrasound exam entails inserting a transrectal ultrasound gadget into the rectum so that to take a picture of the prostate gland. The second test involves inserting a thin needle into the prostate to collect tissue for analysis. This will establish whether cancer cells are present. Once the presence of cancer cells has been ascertained, doctors will determine how aggressive the prostate cancer is through a process called grading. Grading involves comparing the cancer cells to healthy cells. If it is established that the cancer cells differ greatly from healthy ones, this indicates that the cancer is aggressive and has a high likelihood of spreading quickly. Such cells are given a higher grade (Pynn, 2012).
The next step after grading is determining the extent to which the cancer has spread. Imaging tests such as ultrasound, bone scan, magnetic resonance imaging, computerized tomography scan and positron emission tomography are used to establish the stage of the cancer (Pynn, 2012). Once the tests have been carried, a doctor can assign one of the following stages:
Stage I: This signifies that the cancer is confined to a small part of the prostate gland. This also shows that the cancer cells are not aggressive.
Stage II: This indicates that the cancer is large and has grown on both sides of the prostate. The cells are also considered aggressive.
Stage III: This signifies that the cancer has spread outside the prostate to nearby tissues or seminal vesicles.
Stage IV: This shows that the cancer has spread such that it has invaded nearby organs, tissues and parts (Pynn, 2012).
Treatment and Management
Treatment and management of prostate cancer depends on a number of factors. This includes how fast the cancer is growing, its stage, the patient’s overall health and the potential side effects of the procedures. In very early stage prostate cancer, treatment might be unnecessary. While some men may never require treatment, it is recommended that patients go for regular checkups (active surveillance) to determine the progress of the cancer. Active surveillance is an option for cancers that are not causing any symptoms, are expected to grow very slowly or are confined in a small area of the gland. It is also an option for very old men or men suffering from another serious health conditions, where cancer treatment is always complicated. However, when the surveillance establishes that the cancer is growing, treatment will be necessary. Treatment can be in terms of therapy or surgery.
The types of therapies that are used in treatment of prostate cancer include radiation therapy and hormone therapy. Radiation therapy can be carried out externally or internally. External radiation involves directing high-powered energy beams to the prostate cancer usually for five days a week. This is carried out for several weeks. Internal radiation (brachytherapy) entails placing numerous small radioactive seeds in the prostate tissue. These seeds will deliver small doses of radiation over a specified amount of time. Radiation therapy is usually used in patients with early-stage prostate cancer (Torrey, 2008).
Hormone therapy is aimed at stopping the body from producing testosterone since prostate cancer cells depend on testosterone to grow. Therefore, cutting off the supply of this hormone will cause them to either die or grow very slowly. A number of medications can be used in hormone therapy. For example, there are drugs that stop the body from manufacturing testosterone (such as Vantas, Trelstar, Zoladex, Eligard, Lupron) and those that block testosterone from reaching cancerous cells (Casodex and Nilandron, along or before taking an LH-RH agonist). Another procedure is orchiectomy, which involves the removal of testicles. Hormone therapy is usually used in patients with advanced cancer so that to shrink the cancer or to slow down the growth of tumors. However, it can be used in early-stage cancer to shrink tumors before radiation therapy is carried out (Ellsworth, 2008).
Surgeries can also be used to treat prostate cancer. For instance, radical prostatectomy is used to remove the prostate gland, surrounding infected tissues and some lymph nodes. Cryosurgery is used to freeze tissue so that to kill the cancer cells. A high intensity ultrasound may also be used to heat prostate tissue, thereby killing the cancer cells. Chemotherapy, a common process in the treatment of all forms of cancers, can also be applied in the treatment of prostate cancer. It involves using drugs to kill rapidly growing cancerous cells.
After treatment, it is vital that a patient is managed carefully. Clinically, a person might be taken through hormone therapy (especially if he was treated surgically) so that to kill or slow down cancer cells that may have remained. Once at home, an individual will need to take care of himself. For instance, a patient is required to eat a diet full of vegetables and fruits. He should also exercise for several days a week and get enough sleep. Many patients who have undergone treatment normally suffer from low libido or erectile dysfunction. Consequently, their sex lives may suffer. To help them cope with the situation, it is vital that they are shown love and care even with their limitations.
Analyzing the risk factors of prostate cancer, it can be deduced that there is little one can do to avoid getting prostate cancer. However, one needs to maintain a healthy diet and a normal weight since obesity is also a risk factor. Fruits, whole grains and vegetables contain important nutrients and vitamins that can contribute to good health. One should try to limit the consumption of supplements and high-fat foods. Exercise is also an essential component for a healthy lifestyle.
Prostate cancer is one of the deadliest diseases amongst men but recent development in medication has meant that the number of people dying as a result of the disease has significantly reduced. With further advancements, it is hoped that the figure reduces even further. However, it is vital that all men take care of themselves so that they can reduce the risk of acquiring the disease. The only practical way of doing this is eating a healthy diet and exercising regularly.
Ellsworth, P. (2008). 100 questions & answers about prostate cancer. Sudbury, MA: Jones and Bartlett.
His Prostate Cancer (2013, 1 December). Prostate cancer statistics: The numbers for 2013.
Mydlo, J. H., & Godec, C. J. (2003). Prostate cancer: Science and clinical practice. Amsterdam, The Netherlands: Academic Press.
Pynn, C. T. (2012). One man’s life-changing diagnosis: Navigating the realities of prostate cancer. New York, NY: Demos Health.
Tewari, A. (2013). Prostate cancer: A comprehensive perspective. London, UK: Springer.
Torrey, E. F., & Stoiber, C. (2008). Surviving prostate cancer: What you need to know to make informed decisions. New Haven, CT: Yale University Press.