As the world is slowly recuperating from the Covid-19 pandemic, it is no surprise that men too experience a lot of physical and mental challenges. They may be more prone to certain disorders as compared to women. According to reports, an estimated one in eight men will be diagnosed with prostate cancer in their lifetime, making it the second leading cause of cancer deaths. Nonetheless, prostate cancer is dangerous because it is easily overlooked as men tend to not talk openly about its symptoms, thereby increasing their risk of death, if they develop. Whether it’s your partner, father, brother or friend, it’s important to check whether they are getting regular tests done for early detection of the deadly disease.
What is prostate cancer?
The prostate is a part of the male reproductive system, located just below the bladder. It is around the size of a walnut and surrounds the urethra. The prostate produces fluid that makes up a part of semen.
The most common risk factor for prostate cancer is the age of a man. The older a man is, the greater the chance of getting prostate cancer. Some men are at an increased risk for prostate cancer, owing to their race, like African Americans. Also, men with a family history of prostate, ovarian, breast, colorectal, endometrial or pancreatic cancers have an increased risk due to underlying shared mutations. Such people are advised to be screened regularly after the age of 40.
Symptoms of prostate cancer
The symptoms can include difficulty in starting urination, weak or interrupted flow of urine, frequent urination, especially at night, pain or burning during urination, blood in the urine or semen along with pain in the back, hips, or pelvis that persists. Some men do not have symptoms at all. In such men, screening for prostate cancer can be very helpful.
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Screening for prostate cancer
Prostate cancer is screened using two common tests, which include the Prostate Specific Antigen (PSA) Test and Digital Rectal Examination (DRE).
A Prostate-Specific Antigen (PSA) test measures its level in the blood. PSA is a substance made by the prostate, and levels of PSA in the blood can be higher in men with prostate cancer. The PSA level may also be elevated in other prostate conditions.
In Digital Rectal Examination (DRE), a gloved, lubricated finger is inserted into the rectum to feel the prostate for lumps or bumps. The guidelines strongly recommend a shared decision-making process for men aged 55-69, considering PSA screening and proceeding based on a man’s values and preferences. For men younger than age 55 years and are at higher risk, decisions regarding prostate cancer screening should be individualized.
Apart from the two methods, biopsy is also a procedure for diagnosis, in which a small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells. The other diagnostic tests include transrectal ultrasound (TRUS), magnetic resonance imaging (MRI), bone scan and PET scan.
How to treat it?
An immediate treatment may not be required in all cases. In fact, very early stage cancers may need only observation with yearly imaging and biopsies, known as active surveillance. Depending on the stage of the cancer, different modalities of treatment may be offered to the patient. The treatment given also depends on the age, health status of the patient and patient preference.
Here are a few treatments for prostate cancer:
- Radical prostatectomy: This involves removal of the prostate gland and its surrounding glands. The urinary bladder above the prostate gland is sutured to the urethra. This may be done via open procedure, laparoscopic or robotic surgery.
- Radiation therapy: Localized radiotherapy is given to the prostate gland under image guidance. This is known as external beam radiotherapy. Brachytherapy is another option, where needles are placed in the prostate gland for radiation. This is given by the radiation oncologist.
- Hormonal therapy: This is in the form of surgical castration or medical castration. Medical castration involves giving hormonal injections for a long period of time.
- Chemotherapy: This is reserved for metastatic prostate cancer. Chemotherapy involves a combination of chemotherapeutic drug injections given intravenously.
Early detection and improved lifestyle can help
There are several ways in which one can reduce their risk of prostate cancer, including eating a healthy diet, exercising regularly, not smoking and reducing their alcohol intake. The best way to beat it is to catch it early. So, ladies, if your husband or father is above the age of 45 years, it is imperative to make sure that they take up a prostate cancer test (PSA and DRE) every two years. It will help find prostate cancer early at a time when it’s more likely to be cured.
Having said that, men need to take charge of their overall health and talk to their doctor about periodic screening for prostate cancer. Children need to actively persuade their parents to regularly undergo health check-ups. One need not be afraid of the diagnosis and stage of the disease as the treatment is available in all stages of the disease.