Prostate Cancer - Causes, Types, Symptoms and Treatment

According to the American Cancer Society, 6 out of 10 men older than 65 years are more likely to develop prostate cancer.

Want to know about this condition in detail?

Keep reading to know more about its causes, symptoms, and other important information.

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What Is Prostate Cancer?

Prostate is a small gland present in men's pelvis. Its primary function is to produce semen. Prostate cancer develops when a malignant tumour grows in this gland.

What Are the Causes of Prostate Cancer?

There are no definite reasons for prostate cancer. Although researchers have identified the following risk factors -

1. Age

The risk of developing prostate cancer increases with age. Individuals over 50 years are more likely to suffer from prostate cancer. Approximately 60% of people are or above 65 years of age diagnosed with prostate cancer.

2. Family Medical History

A date published in Cancer.Net in 2020 showed approximately 20% of prostate cancer cases developed from a familial history. This prostate cancer generally develops due to inherited genes, lifestyle or environmental factors. Hereditary prostate cancer is rare. Though it can begin if any of the following circumstances are present -

There is a presence of prostate cancer in 3 generations and a similar side of the family.
More than 2 close family relatives, such as your uncle, grandparent and nephew, were diagnosed with prostate cancer before 55 years.
More than 3 first degree family members (parents, siblings and child) were diagnosed with prostate cancer.

3. Location

Prostate cancer is more common among the residents of North American and North-western Europe. Prostate cancer is increasing among Asians as well. For example, the incidence rate of prostate cancer in India is between 2.9-7.5%.

4. Lifestyle Choices

Opting for a healthy diet and lifestyle is a crucial step to prevent the development of tumours in the body. Hence, regular consumption of processed food and a sedentary lifestyle increases the risk of obesity. Healthcare experts suggest that there is a correlation between obesity and the development of prostate cancer.

5. Genetic Alterations

There is no solid evidence available to prove that specific genes present in the body are responsible for prostate cancer. Genes such as HPC1, HPCX, HPC2 etc., increases the risk of developing this deadly disease in the body. Moreover, genes such as BRCA1 or BRCA2 or family history of breast cancer also increase the risk.

What are Types of Prostate Cancer

Knowing the types of prostate cancer helps the doctor to prescribe the correct treatment. Take a look at the different types of prostate cancer -

Types of Prostate Cancer	Meaning
Ductal Adenocarcinoma	It develops in the cells that line the tube of the prostate gland. It spreads quickly compared to acinar adenocarcinoma.
Acinar Adenocarcinoma	It develops in the glands cells of the prostate.
Small Cell Prostate Cancer	It is neuroendocrine cancer that is composed of small round cancer cells.
Squamous Cell Cancer	This type of cancer develops from the flat cells covering the prostate.
Transitional Cell Cancer	It develops in the cells lining the urethra. This is the tube that carries the urine outside the body. It may spread into the bladder and other tissues.

What Are the Symptoms of Prostate Cancer?

Note the following prostate cancer symptoms in males -

Early Symptoms of Prostate Cancer

Experiencing burning or pain during urination
Loss of control in the bladder
Reduced flow of urine
Frequent urination at night
Presence of blood in urine and semen
Erectile dysfunction

Advanced Signs of Prostate Cancer

Numb legs, feet or hips
Pain in bones
Enlargement of pelvis or legs

Recurrent Symptoms After Undergoing Treatment

Lower back pain
Tiredness
Jaundice
Difficult to breathe
Blood in the urine and difficulty in urinating

Stages of Prostate Cancer

Knowing the cancer stages helps the doctor assess how much cancer has spread to the body. There are 2 types of staging systems to determine the spread of prostate cancer -

Clinical Staging

It is based on the test results of DRA, PSE or Gleason score. These tests determine whether there is a requirement for any imaging tests. Doctors perform the following imaging tests -

X-ray
Ultrasound
MRI
PET
Biopsy

Imaging tests will further aid doctors to determine the cancer stage.

Pathological Staging

It includes surgery and laboratory tests of prostate tumours that a doctor operates out from a patient's body.

TNM

The American Joint Committee on Cancer developed TNM. It is the most popular staging system for prostate cancer. Doctors use this system to find out the answers to the following questions -

Tumour - What is the size of the primary tumour? What is its location in the body?
Node – Has the tumour reached the lymph nodes? If yes, how much has it reached?
Metastasis – How much has cancer spread to other parts of the body?

Apart from TNM, doctors also consider other tests to assign a cancer stage to a patient. These tests include -

Gleason score
PSA levels

What Is Gleason Score in Prostate Cancer

A healthcare professional decides the Gleason score based on a biopsy result of a prostate tumour. The score is also assigned based on the growth of cancer cells, location and how much it has spread. After adding the results, doctors give a score ranging between 6 to 10. Here's what each scale tells about the state of one's cancer tissue:

Gleason Score	Meaning
6 or lower Gleason score	Well-differentiated; healthy cells.
7	It is moderately differentiated, similar to healthy cells.
8, 9 and 10	Poorly differentiated; cells are not healthy
X	No scores are identified

Patients with higher Gleason scores need intensive treatment even though cancer has not spread much to the other body parts.

Different Stages of PSA in the Blood for Prostate Cancer

PSA is a protein composed of normal and cancerous cells in the prostate. A higher PSA level in your blood indicates the risk of developing prostate cancer. Take a look at what each PSA levels mean -

PSA Levels	Rate of Developing Prostate Cancer
4 and 10 ng/mL	25% chances of developing prostate cancer
More than 10 ng/mL	50% chances of developing prostate cancer

Most doctors prescribe additional tests if your PSA levels exceed 4 ng/mL.

Currently, American Urological Association recommends PSA testing for the following age group -

People between the age group of 55 to 69.
Individuals with family medical history or associated with other risk factors.

Now, based on these tests, doctors assign you from the following stages -

Stage I

This is the early stage of prostate cancer. Cancer cells remain localised and do not spread to other body parts.

Gleason Score – 6
PSA Level – Less than 10ng/mL
5-year survival rate – 100%

Stage II

In this stage, the tumour does not spread to the lymph node or other body parts.

Gleason Score – 6 or below
PSA Level – less than 20ng/mL
5-year Survival Rate – 100%

Stage II is divided into 2 categories based on Gleason scores -

Stage II Categories	Gleason Score
II B	7
II C	7 or 8

Stage III

The cancer cell is still distant from other parts of the body. Further the stage III is divided into 3 broad categories:

Stage III Categories and Meaning	Gleason Score	PSA Levels
A – Cancer cells have not spread outside the prostate or reached lymph nodes.	8 or below	20ng/mL or above
B – Cancer cells have spread to seminal vesicles and tissues around them.	Similar to stage III A	Any levels
C – Cancer cells may or may not have reached lymph nodes or other body parts	9 or 10	Any levels

Stage IV

It is the final stage of prostate cancer. In this, cancer usually spreads to other parts of the body. The 5-year survival rate reduces to 30%. Stage IV prostate cancer can have any PSA levels or Gleason score. It is further sub-divided into 2 categories:

Stage IV Categories	Meaning
A	Cancer has spread only to lymph nodes.
B	Cancer has spread to lymph and other body organs.

What Are the Treatments for Prostate Cancer?

After diagnosis, doctors will prescribe a treatment based on the following -

Cancer stage
Levels of PSA in the blood
Urinary and sexual function
Lifestyle and medical history

Now note the following treatments for each stage -

Active Monitoring and Waiting

In this, doctors carefully monitor the patient after performing a biopsy and checking PSA levels. In the case of watchful waiting, doctors perform no tests. Healthcare professionals proceed with treatments only if symptoms of prostate cancer develop. Healthcare experts recommend this for older adults who are likely to live less than 5 years.

Surgery

A surgical oncologist removes the prostate and surrounding lymph nodes. Health experts usually follow surgery methods mentioned below -

Radical prostatectomy
Bilateral orchiectomy
Laparoscopic prostatectomy
Transurethral resection of the prostate

Radiation Therapy

In this, high energy X-rays are used to destroy cancer cells. Doctors use 2 types of radiation therapy -

Types of Radiation Therapy	Procedure
External-beam radiation therapy	A machine is located outside the body with X-rays targeted at the cancer cells.
Brachytherapy or internal radiation therapy	Doctors insert radioactive seeds into the prostate. Seeds are surgically placed at or near cancer cells to destroy them.

Possible side-effects of radiation therapy are -

Problems in bowel
Bleeding from rectum
Tiredness

Doctors also use other therapies to treat prostate cancer -

Types of Therapies	Procedure
Chemotherapy	Doctors use drugs to destroy cancer cells.
Cryotherapy	A doctor inserts a probe into or near the prostate to destroy it.
Biological/immunotherapy therapy	This therapy is used to boost one's immune system. An improved immune system will work to fight cancer or relieve pain from cancer treatments' side effects.
Hormone therapy	It blocks cancer cells from receiving the hormone and prevents their growth.
Focal therapies	Doctors use heat or cold to destroy cancer cells in low risk or intermediate-risk cancer patients.
High-intensity focused ultrasound	Healthcare experts insert an ultrasound probe into the rectum. Sound waves are directed to the cancer cells and destroy them.

Other treatments include -

Using bone-modifying drugs
Targeted therapy

What Are the Ways to Prevent Prostate Cancer

It is not entirely possible to cure prostate cancer at an advanced stage. However, you can reduce the risk of developing the same.

Wondering "how to prevent prostate cancer naturally?"

Note the following tips -

What to Eat and Drink?

Eat red vegetables and fruits such as tomatoes and watermelons.
Include soybeans in your diet. The foods rich in isoflavones include tofu, chickpeas, lentils and peanuts.
Consume green tea and coffee.
Eat "good" fats, such as olive oil, fruits and nuts.

What Should You Avoid Eating?

Foods cooked in vegetable oil.
Fried meat.
Skip carbohydrates and sugar.
Vitamin E and selenium.
Consume foods that are rich in folates, such as beans and whole grains.

Change Your Lifestyle

Besides changing your diet, you must also make time for exercise to maintain a healthy weight. As per data released in Medical Xpress, obesity increases the risk of developing prostate cancer.

Globally, prostate cancer is the 2nd most common cancer in males. Hence recognising the symptoms at the earliest is most important. Keep the pointers mentioned above in mind to ensure your and your kin’s good health.

Frequently Asked Questions

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What are the side effects of hormonal therapy for prostate cancer?

Some of the side-effects of hormonal therapy are -

Depression
Gain of body weight
Loss of memory
Risk of developing heart diseases.

What should you not drink post prostate cancer surgery?

Post-surgery of prostate cancer, individuals must not consume too much coffee, tea or alcohol. Also, doctors recommend light exercise.