Prostate cancer – what you need to know

What is prostate cancer?

Prostate cancer is a form of cancer that grows in the prostate. The prostate belongs to the male reproductive system. The main functions of the gland are the partial production of semen (about 30% of the total volume), as well as participation in the process of ejaculation. A man's ability to retain urine is also related to prostate function.

Short information about prostate cancer

Most often, the disease develops at the age of 55-60 years and older. In Western Europe, prostate cancer is in third place among male oncological diseases, and in the U.S. it is in the first place.

The peculiarity of prostate cancer is that the malignant formation develops very slowly.  The disease can proceed without any noticeable symptoms. Therefore, after 45 years, men need to be examined and tested regularly. The earlier the disease is diagnosed, the higher are the chances of successful therapy.

Diagnostics of prostate cancer

The following steps are usually followed for the diagnosis:

- Digital examination through the anus;
- Transrectal ultrasound;
- Blood test for specific antigen and prostate biopsy.

Ultrasound is an informative and harmless diagnostic method that does not require serious preparation and too much time from the man. Ultrasound of the prostate, as a method of objective visualization, is widely used in the preliminary diagnosis of different prostate diseases.

To confirm prostate cancer, as a rule, a prostate biopsy is performed and further histological examination of the material. Further tests such as computed tomography (CT) and bone scan can be performed to identify the proliferation of the process to the bones, lymph nodes, and other organs.

Treatments options

There are various treatments for this type of cancer, which primarily are based on the stage of the disease.

The primary therapies imply surgery including TURP (transurethral resection of the prostate gland), radiation therapy or observation of the disease dynamics. Other methods such as hormone therapy, chemotherapy are used contingent on the clinical scenario, contraindications for the primary therapies, and so on.

Hormonal therapy in the late stages of the disease gives good results but for early forms, this therapy is ineffective, as shown by modern research.
If prostate cancer is detected when it has already spread, its treatment consists in the use of hormone therapy and medicines that enhance the effect of the therapy as Eulexin (Flutamide), which in such cases plays an important role.  Hormone therapy is aimed at the inhibition of the action of testosterone on prostate cells.  The basic principles of hormone therapy are either to suppress testosterone production in a man's body or to prevent its effects on prostate tissue.

Prostate cancer treatment methods

Symptoms of prostate cancer

The disease can cause pain, difficulty urinating, problems with intercourse, and impotence. The listed symptoms can cause both prostatitis and benign prostate tumors (adenoma) and enlarged prostate.

Prostatitis (the prostate becomes inflamed) is the most frequent urological disease in men. More often, the disease develops as a chronic one, without disturbing the man too much. Hyperplasia is a disease related to age: the older the man, the greater the risk of this disease.

Manifestations of prostate cancer are similar to those of prostate hyperplasia:

- Frequent urges to urinate;
- Pain during urination;
- Weak and/or intermittent urine flow;
- Feeling of not fully emptied bladder.

Due to the high likelihood of an asymptomatic course of the disease at an early stage, as well as the nonspecificity of signs of prostate cancer, it is advised to all men over 45 years of age undergo an annual examination of the prostate.

Prostate cancer symptoms sometimes manifest such as weakness of erection (in case cancer has affected the nerves that control erection) or impotence, a decrease in semen volume during ejaculation (the ejaculatory canal is blocked by a tumor).

The disease manifestations are very severe when the disease is already at an advanced stage. It can be painful sensations, blood in the urine. Thus, the symptoms differ at different stages of the disease. Bone metastases often manifest as pain. Pain can occur in the back, legs. The intensity of pain varies from person to person. This cancer spreads metastases to the liver, adrenal glands, lungs, bones (spine, pelvis, hips). This is the biggest danger. Bone metastases do not mean the development of bone cancer as a separate condition.

But there may be early metastases - even a small tumor spreads to other tissues and organs. The problem is that prostate cancer usually shows symptoms when the disease has gone too far. It should be understood that state- 4 prostate cancer requires very complex and lengthy treatment. Do not neglect the disease, see your doctor at the first alarming symptoms or better go once a year to your urologist and do all appointed tests.

Prostate cancer risk factors

The spread of prostate cancer varies worldwide. In East and South Asia, prostate cancer is found much less frequently than in Europe. This disease is especially frequent in the United States.

Main reasons:

- Genetic predisposition;
- The influence of carcinogenic factors;
- Unhealthy diet;
- Progressive prostatic hyperplasia (prostate adenoma).

Genetic predisposition

In the U.S., the condition is more frequently diagnosed in African American than in white or Hispanic men. Men with a history of prostate cancer in their immediate family are twice as likely to have the disease. Studies of twins in Scandinavian countries have suggested that 40 percent of the risk can be attributed to genetic factors. At the same time, there is no single gene responsible for the occurrence of prostate cancer. Various genes may be involved in the onset of this disease: in particular, mutations in the BRCA1 and BRCA2 genes. Other genes that are included in the prostate cancer gene are androgen receptor genes, vitamin D receptor genes, and the HPC1 gene.

Unhealthy diet

There are studies that show that high-fat, high-calorie foods contribute to prostate cancer. There is a great risk in men who consume large quantities of meat, milk, eggs, cheese. Vegetarians are less likely to develop the disease.

The risk is also increased with low blood levels of vitamin D, usually associated with a lack of exposure to ultraviolet light. Consuming broccoli, cauliflower, or other cruciferous vegetables has been shown to reduce the risk by 40%. The phytochemicals diindolylmethane and indole-3-carbinol, found in cruciferous vegetables, have immunomodulatory and antiandrogenic properties.

Prophylaxis of prostate cancer

There are several main directions related to the prophylaxis of prostate cancer.

- Healthy lifestyle. This is, first of all, giving up bad habits such as smoking, alcohol abuse. It is also necessary to increase the level of physical activity.
- Nutrition. Particular importance in nutrition should be given to vegetables and fruits (tomatoes, cabbage, broccoli, soybeans, grapes, etc.). At the same time, it is necessary to limit the consumption of foods containing animal fats and calcium.

Post by: John Johansson, M.D., Amsterdam, Netherlands