What Men Should Know About the Symptoms of Prostate Cancer
After skin cancer, prostate cancer is the leading type of cancer in men. According to the American Cancer Society, approximately 164,690 new cases of the disease will be diagnosed in 2018. During that same year, around 29,430 men will die from prostate cancer.1
Although prostate cancer is very common, it also tends to grow slowly and can often be treated successfully. In fact, undiagnosed cases of prostate cancer are often discovered during autopsies. The disease can grow so slowly and cause so few noticeable symptoms that people can and do live with it and die from other things without knowing that they ever had it. Even so, knowing the symptoms of this type of cancer is crucial for males, so keep reading to learn more.
What is Prostate Cancer?
Like other forms of cancer, prostate cancer occurs when cells start growing out of control.2 In the case of prostate cancer, cells in the prostate gland begin growing and multiplying in this manner. Although there are other types, the vast majority of prostate cancers are adenocarcinomas, which means that they develop from the gland cells. Since only men have prostate glands, only men can develop prostate cancer. Situated under the bladder and in front of the rectum, the prostate gland changes and grows larger as men age.
Signs and Symptoms
Obvious signs and symptoms aren’t usually present with early-stage prostate cancer. In more advanced cases of the disease, common signs and symptoms include:
- blood in the urine or semen.
- pain in the back, chest, or hips due to cancer that has spread to nearby bones.
- trouble urinating; the stream might be weaker and slower, or the urge might be more frequent.
- erectile dysfunction.
- sudden loss of bowel or bladder control from tumors pressing against spinal cord.
Causes and Risk Factors
The exact causes of prostate cancer remain unclear, but research is continuing to uncover more information. It appears that the cancer generally occurs due to changes, or mutations, to the DNA of healthy prostate cells. These DNA changes may be inherited or passed along to from parent to child, or they may be acquired or picked up at some point during one’s life. The vast majority of prostate cancer cases are believed to be caused by acquired DNA changes rather than inherited ones, but a lot more research needs to be done.
A few of the most common risk factors for developing prostate cancer include:
- Age: Six out of every 10 cases of prostate cancer occur in men who are age 65 or older, and the average age at onset is 65.
- Race: African-American men are more likely to develop prostate cancer, and they are more than twice as likely to die from it.
- Location: Researchers still don’t understand why, but prostate cancer primarily occurs to men who live in North America, Australia, northwestern Europe, and the Caribbean Islands.
- Family History: Men who have a father or brother who have had prostate cancer are more than twice as likely to develop the disease themselves.
- Diet: More research is needed, but it appears that men who consume diets that are heavy with meat or high-fat dairy foods are more likely to develop prostate cancer.
- Obesity: Although being obese doesn’t appear to increase the risk of developing prostate cancer, research indicates that overweight men are more likely to develop more aggressive forms of the disease.
Some of today’s top treatments for prostate cancer include:3
Watchful Waiting and Active Surveillance
Since prostate cancers grow so slowly, doctors sometimes opt for watchful waiting or active surveillance before proceeding with other treatment options.
With active surveillance, a man’s prostate cancer is monitored closely. Every six months or so, they may undergo prostate-specific antigen blood tests, or PSA blood tests along with digital rectal exams, or DREs. Doctors often also prescribe biopsies every year or so.
With watchful waiting, the cancer is monitored but less aggressively. Fewer tests may be used, and the doctor may rely more on the patient’s description of symptoms than on regular biopsies and the like.
These approaches make the most sense when prostate cancer is still very small; is growing slowly; is in the prostate only; and is not causing symptoms.
As long as the prostate cancer has not yet spread elsewhere in the body, surgery to remove the prostate gland completely is typically prescribed.
Several types of surgery are available, but most patients undergo what is known as a radical prostatectomy. With this surgery, the entire prostate gland is removed along with surrounding tissue and the nearby seminal vesicles. This surgery is increasingly being performed laparoscopically, which results in less downtime for patients. Common risks of surgery for prostate cancer include infection, blood clots in the lungs or legs, bad reaction to anesthesia, bleeding, and damage to nearby organs.
In cases where prostate cancer is only in the prostate gland and considered low grade, radiation therapy may be used as a first treatment. This option involves exposing cancer cells to high-energy rays, and it may also be used following surgery if the cancer is not removed completely or if it comes back. In cases of advanced prostate cancer, radiation therapy may be used on a palliative basis to relieve symptoms. Either external beam radiation or internal radiation therapy may be used depending on the specifics.
For early stages of prostate cancer, a treatment known as cryotherapy may be used. This option may also be used in cases where the cancer has returned following radiation therapy. Cryotherapy involves destroying the prostate gland through the use of very cold temperatures. This is done with probes that expose the cells to freezing cold gases. The prostate is then frozen and destroyed.
For many patients, this is a viable alternative to more invasive, actual surgery.
Hormones in the male body known as androgens stimulate prostate cancer cells to grow. Through the use of androgen deprivation therapy, androgen levels in the body may be reduced or prevented from reaching the prostate cancer cells. As a result, these cells may shrink and begin to grow more slowly, which can buy time for additional treatments.
It is important to note that hormone therapy alone does not cure this form of cancer. It is most commonly used when radiation or surgery is not an option because the cancer has spread too far. It may also be used if cancer remains or comes back following surgery or radiation therapy, and it may even be used prior to radiation therapy to shrink the cancer for easier removal.
Clinical studies and additional types of research are constantly being performed in the pursuit of better treatments for prostate cancer. Lately, there’s been a lot of buzz in the medical community regarding hormonal medications known as 5-alpha reductase inhibitors, which include medications like Proscar and Avodart. These medications work by blocking the conversion of testosterone, a common androgen, into dihydrotestosterone, which is much more active and therefore may trigger the disease to grow and spread more quickly. There have also been advances in the area of high-intensity focused ultrasound, which involves the use of high heat to kill cancer cells.4