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Prostate cancer is one of the most commonly diagnosed cancers in the UK. Every year, more than 40,000 men are diagnosed with prostate cancer in England and 3,000 in Scotland. It mainly affects men over 50 years old.
What Is Prostate Cancer?
Prostate cancer is a serious medical condition that occurs when cells in the prostate (a small walnut-shaped organ) starts to grow in an uncontrollable, disorganised manner.
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The most common type of prostate cancer is prostate adenocarcinoma. In adenocarcinoma of the prostate, cells that make up the glandular tissue of the prostate proliferate uncontrollably. Other less common types include sarcomas, neuroendocrine tumours, prostate small cell carcinoma, and transitional cell carcinoma.
How Does Prostate Cancer Develop?
The prostate is a small gland located below the bladder in men. It is responsible for the production of a fluid that nourishes and protects sperms. In women, it is possible to have cancer of the Skene's glands, which is sometimes called the 'female prostate cancer'.
To understand how prostate cancer develops and how it causes symptoms, it is important to have a basic understanding of the anatomy of the prostate gland.
The prostate can be divided into three different zones. The innermost zone is known as the transitional zone; the middle zone is referred to as the central zone, and the outermost zone is known as the peripheral zone. Almost 70% of prostate cancers occur in the peripheral zone. Since the peripheral zone occupies the outermost region, it does not usually present with obstructive urinary symptoms.
When the cancerous cells occur in the transitional zone of the prostate, this can interfere with the passage of urine, as the tube that carries urine is very close to this zone.
Prostate cancer begins when some of the cells’ DNA materials undergo mutation. Consequently, the mutated cells begin to grow and divide rapidly. These abnormal cells are what scientists refer to as cancerous cells. Cancerous cells steal the nutrients of normal prostate cells and can interfere with the functioning of them. In advanced stages of the disease, cancerous cells can invade the bladder and seminal vesicles or spread to the pelvic bones, lumbar vertebrae and lymph nodes. At this point, it is known as metastasis.
The following risk factors have been identified:
- Age – men aged above 50 years old are more at risk of developing this cancer.
- Positive family history of prostate cancer. In some instances, it can run in the family. Familial prostate cancer accounts for 20% of all prostate cancers.
- Race. Statistics reveal that black men may be more at risk.
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Depending on the stage of cancer, the symptoms of this condition vary. The most common ones are:
- Weak or disturbed flow of urine
- Straining to pass urine
- Pain or burning sensation during urination
- Presence of blood in the urine or in seminal fluid
- Discomfort when sitting
- Frequent urination or urge to pass urine at night
- Erectile dysfunction.
Often, prostate cancer can present at an advanced stage with signs that indicate that cancer has spread outside of the prostate gland. These emergency signs or symptoms include:
- Unintentional weight loss
- Fatigue and other symptoms of anaemia
- Loss of appetite
- Change in bowel habits
- Back, hip, and pelvic pain.
If you are experiencing the symptoms above, it is advisable to consult a medical professional for a thorough examination.
Signs of prostate problems can be picked up by rectal examination. You may experience some degree of discomfort, but rectal examinations should not be painful. Clinical examination will direct your physician towards the right diagnosis.
Benign Prostatic Hyperplasia (BPH) is often confused with prostate cancer, as patients suffering from BPH may present with similar symptoms. During a physical examination, your physician will be able to differentiate these two conditions.
In BPH, the central part of the prostate will be affected. In contrast, in prostate cancer, it is usually the sides. If your physician identifies prostatic nodules and an irregular induration, he will suggest further investigations to confirm the diagnosis.
Diagnosing Prostate Cancer
To confirm the presence of prostate cancer, your doctor will want to order some tests. These are:
General Blood Tests
General blood tests such as red blood cell count, white blood cell count, and platelet count are necessary blood tests that help rule out the complications of advanced prostate cancer, such as bone marrow invasion, anaemia, and coagulopathy.
Biopsy Of The Prostate
Prostate biopsy, also known as Trucut biopsy, is a technique used to harvest a small portion of affected tissues from the prostate. The sample is then sent to a laboratory for microscopic analysis. A scoring system known as the Gleason’s Pattern Scale is usually used to classify the severity of the cancer.
Radiography Of The Chest
In some patients with advanced symptoms, physicians may wish to carry out additional tests, such as radiographic images of the chest and vertebra. This is because prostate cancer is notorious for spreading to the lungs and lumbar vertebrae.
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Living with prostate cancer is hard. You may feel angry, disappointed, depressed and worried about how this will affect you and the lives of your loved ones. You may also feel lost and confused about what steps to take next to prevent the progression of the disease and manage your current symptoms. Below is some general advice:
Improve Bladder Control
Prostate cancer can often affect bladder control. You may experience an urgent need to pass urine or experience leakages, or may not be able to empty your bladder despite wanting to do so. If you are currently experiencing bladder problems, you may benefit from pelvic floor exercises. Pelvic floor exercises, also known as Kegel exercises, can help strengthen the muscles that support your bladder. You can also consider wearing pads or adult diapers if you suffer from frequent leakages.
Use Supports To Help You Move Around
As prostate cancer progresses to a more advanced stage, it may become more challenging to walk around due to fatigue and weakness. Fatigue can also affect your mood, making you depressed, sad, and disappointed because you cannot carry out the tasks you were once able to. It can affect even the simplest tasks, such as getting dressed, having a bath or preparing a meal.
Use Cushions To Reduce Interface Pressure
Prostate cancer patients may experience pain or some degree of discomfort on sitting due to pressure. Patients may find it helpful to use special cushions when sitting.
Maintain Healthy Habits
Anyone who has been diagnosed with cancer should make certain lifestyle changes to optimise their health. Most cancer societies recommend maintaining a healthy weight and consuming a healthy diet with lots of fruits and vegetables. Research shows that patients suffering from obesity have a higher risk of dying from prostate cancer. Quitting smoking can also bring about lots of health benefits. Studies reveal that practising exercises during prostate cancer treatment can improve the general health status of a patient.
If you have been diagnosed with prostate cancer, you may be curious about the different treatment options available. Medical treatment depends on the stage of the disease and the age of the patient.
In symptomless patients with stage one, slow-growing prostate cancer or localised cancer, active surveillance is the best choice. Your oncologist will keep monitoring you with tests, such as regular PSA tests, MRI scans and prostate biopsies.
Removal By Surgery
In patients with intracapsular tumours and no cancerous spread, surgery may be indicated. Prostatectomy is the term used to describe prostate surgery. However, the general health status of the patient must first be evaluated as, along with all the advantages, prostatectomy can also cause unpleasant side effects, such as long-term sexual changes and urinary incontinence.
Radiotherapy involves the use of radiation to destroy cancerous cells. Radiotherapy is recommended in patients without cancerous spreads beyond the prostate. The side effects of radiotherapy include diarrhoea, bladder inflammation, fatigue, loss of pubic hair, erectile problems, among others.
Chemotherapy is recommended when the cancerous cells have already spread to other parts of the body. Chemotherapy aims at killing cancerous cells to reduce the symptoms of the disease. Chemotherapy has unpleasant side effects, such as hair loss, mouth soreness, and vomiting.
Hormonal therapy is usually used along with radiotherapy to increase the effectiveness of the overall treatment. Hormone therapy works by blocking the effect of testosterone to slow down the progression of the illness.
You can read more about the different treatment strategies of the NHS here.
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Prostate Cancer UK – was founded in 1996. Prostate Cancer UK is a registered charity in England, Wales and Scotland run by a dedicated, hard-working team of professionals, all working towards a common goal – that of preventing prostate cancer from killing men. Click here to visit their website.
Prostate Cancer Research Centre is run by a team of volunteers and healthcare professionals who work to improve the lives of patients and families suffering from prostate cancer. Find out more about Prostate Cancer Research Centre by visiting their website through the following link: Prostate Cancer Research.
Orchid, Fighting Male Cancer is the UK’s leading charity that dedicates its time and efforts to the fight against male cancers – prostate cancer, penile cancer, and testicular cancer. Find out more about Orchid here.
Cancer Research UK is a registered charity governed by a council of trustees that provides support, hope, and evidence-based information to patients suffering from cancer. You can visit Cancer Research UK by clicking on the following link: Cancer Research UK.
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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.
BPH – stands for Benign Prostatic Hyperplasia. It is a common condition affecting older men. It is characterised by the enlargement of the prostate
DNA – stands for deoxyribonucleic acid. DNA is the genetic material found in cells that contain the 'biological codes' that determines function, growth, development and confers distinctive characteristics to each individual
Lumbar vertebrae – the lumbar vertebrae are the larger and heavier bones that make up the spine
Mutation – is the term used to describe a change in the nucleotide sequence of the genetic material of an organism, consequently leading to a change in the genetic message coded by that particular sequence