As the 2nd most common cause of cancer deaths in men, prostate cancer is a condition that deserves to be taken seriously. However, it is a disease many men are reluctant to talk about. With prostate cancer also being the most common form of cancer in men, we are looking at the symptoms of this condition and how it can be treated.
For more information on cancer as a condition, overall, read our useful guide.
Read our guide to the 20 Most Common Medical Conditions Affecting Older People
What is Prostate Cancer?
Cancers occur when cells in the body multiply too fast, forming tumours. With prostate cancer, this chaotic multiplication occurs in the prostate. This is a small gland in the pelvis that forms part of the male reproductive system. It is about the size of a walnut and is located between the penis and the bladder.
It often develops slowly, meaning there are no signs for several years.
Common Symptoms of Prostate Cancer
When someone has prostate cancer, the prostate gradually enlarges as the cancer spreads. Symptoms are unlikely to be noticed, however, until the prostate is large enough to affect the urethra. This is the tube that carries urine from the bladder when you pee.
Once it begins to affect the urethra, you may notice needing to pee more often, struggling to pee, and feeling like your bladder isn’t empty. If you notice these symptoms, it is important that you get checked by your doctor.
In many cases, this probably won’t be prostate cancer. Instead, the prostate may have been enlarged by other causes. However, it is always better to be safe than sorry.
A further sign could be blood in the urine or semen. If the cancer spreads, in a process called metastasising, you may experience symptoms such as bone or back pain, loss of appetite, pain in the testicles, and sudden, unexplained weight loss.
Causes of Prostate Cancer
The exact causes of prostate cancer have not been identified, though there are certain factors that increase your risk of developing it. These include:
- Age – Men over 50 are at increased risk of developing prostate cancer, with occurrences highest amongst men aged 75-79
- Family History – Research suggests that you are more likely to develop prostate cancer if your father or a brother also developed it before age 60. It is also suggested that you are at increased risk if a close female relative has had breast cancer
- Ethnicity – Figures show that prostate cancer is more common in black men
- Obesity – Men who are overweight are more likely to develop prostate cancer
- Diet – Though research is ongoing, there is evidence to suggest that people with high calcium diets are at increased risk of prostate cancer
Certain factors that increase the likelihood of developing any form of cancer include exposure to certain chemicals, radiation (including UV rays), and smoking, which can damage the cells in the body as well as the immune system.
Diagnosing Prostate Cancer
There is no single test for prostate cancer. Doctors instead use a variety of tests to determine whether you have the condition. When you visit your doctor with suspicions of prostate cancer, they are likely to ask for a urine sample. They may also take a blood sample to test your levels of ‘prostate-specific antigen’.
A further test involves a rectal examination to test the health of the prostate. Many men are embarrassed by this process, but there is no need to be. If you are concerned about prostate cancer, this procedure can provide peace of mind.
If your doctor thinks you may have prostate cancer, they will refer you to hospital for further tests. An MRI scan is usually performed first, and if doctors think there is a problem with your prostate, they will refer you for a biopsy.
A biopsy retrieves material from your prostate. This is an invasive procedure, and you may be anaesthetised during the process. The samples taken will be tested for cancer. In some cases, you may be required to have follow-up biopsies depending on the initial results.
What to Do if You’ve Received a Diagnosis
A cancer diagnosis is a troubling and upsetting experience. Fortunately, half of all diagnoses are survivable, and early diagnosis increases these odds.
Depending on your circumstances, treatment may not be necessary. Instead, the condition will be watched to ensure it does not spread elsewhere or cause more serious symptoms. The goal is to avoid resorting to treatments that may impact your quality of life for as long as the cancer is not affecting your lifestyle or overall health. However, by watching closely, doctors will be able to provide treatment quickly if it becomes necessary.
For older patients, watching and waiting may be recommended. This is because it is not thought that your condition will shorten your natural lifespan.
If you are diagnosed with prostate cancer, you will be assigned a multidisciplinary team to help monitor your progress. This team may be different depending on whether you are receiving treatment or not.
You can get additional support with a cancer diagnosis by speaking to Macmillan. Their teams are trained to provide answers to all sorts of questions and can can help you find other sources of support.
Prostate Cancer Treatment
If your doctor decides that treatment is necessary, certain options are available.
Surgery
One of these options is to surgically remove the prostate gland. This option is most often undertaken if the cancer has not spread from the prostate, or if the spread is very limited. By removing the prostate, the chances of cancerous cells forming elsewhere is reduced. Receiving this surgery can lead to issues such as incontinence or erectile dysfunction, however.
Another disadvantage of this surgery is that you will no longer ejaculate during sex. If you are hoping to have children but have been diagnosed with prostate cancer, you should discuss this with your support team.
Radiotherapy
Also used for prostate cancer that has not spread beyond the prostate, or has not spread far, radiotherapy uses radiation to kill cancer cells. However, there is also a risk of radiotherapy harming healthy cells. Other forms of therapy may also be required alongside radiotherapy to improve the odds of success.
Sometimes, radiotherapy may be recommended following surgery to prevent the cancer coming back.
Like surgery, radiotherapy can cause erectile dysfunction. Short-term effects include diarrhoea, tiredness, loss of pubic hair, inflammation of the bladder, and discomfort around your bottom.
Brachytherapy
You may also be offered brachytherapy. This is a form of radiotherapy in which the radiation is applied directly to the prostate gland. It is a slightly more invasive procedure, requiring radioactive seeds to be surgically implanted into the cancerous cells. Alternatively, it may be applied using thin, hollow needles in the prostate.
Brachytherapy is less likely to cause damage to surrounding tissues. However, the risk of urinary difficulties is higher.
TURP
Officially known as ‘trans-urethral resection of the prostate’, this treatment will not kill the cancer but can help alleviate some symptoms. It helps address issues with urination by removing pieces of the prostate to take pressure off your urethra.
TURP is an invasive process and is often performed under anaesthetic.
Cryotherapy
This treatment involves freezing cancer cells to kill them. It is used rarely, but usually when cancer has not spread beyond the prostate. Cryoneedles are inserted into the prostate gland, freezing it. This kills cancer cells, though some healthy cells will die too.
Side effects are rare but possible and can include incontinence and erectile dysfunction.
Chemotherapy
If the cancer has spread beyond the prostate, you may be referred to receive chemotherapy. Chemotherapy interferes with the multiplication of cancer cells, though it is not a cure. It can also help to reduce symptoms. However, chemotherapy also affects healthy cells, including those of the immune system. This can lead to several side effects, such as:
- Nausea and sickness
- Fatigue
- Loss of appetite
- Hair loss
- Infections
However, these side effects can be controlled with additional medication.
Living with Prostate Cancer
For many people, once identified, prostate cancer may have little impact on your lifestyle until doctors deem treatment necessary. However, knowing you have the condition could lead to increased anxiety, or possibly depression. It is important to reach out for help if you feel you need it. There is no shame in being worried or upset.
You can find additional resources for receiving support with prostate cancer on the Cancer Research UK website, as well as in the Prostate Cancer UK community.
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