Prostate cancer is one of the most common cancers affecting men worldwide. While it can be a serious condition, early detection and treatment significantly improve outcomes. In this comprehensive guide, we will explore what prostate cancer is, its symptoms, causes, and risk factors, along with expert insights from Dr. Rahul Jena, a leading Consultant Uro-oncologist and Robotic Surgeon at Bagchi Sri Shankara Cancer Centre and Research Institute, Bhubaneswar, Odisha.
Understanding Prostate Cancer
What Is the Prostate?
The prostate is a small, walnut-sized gland located below the bladder and in front of the rectum in men. It plays a crucial role in the male reproductive system by producing seminal fluid, which nourishes and transports sperm.
What Is Prostate Cancer?
Prostate cancer occurs when abnormal cells in the prostate gland grow uncontrollably, forming a tumor. While some prostate cancers grow slowly and may not cause significant harm, others can be aggressive and spread quickly to other parts of the body (metastasis).
According to Dr. Rahul Jena, “Prostate cancer is highly treatable when detected early. However, due to its slow progression in many cases, some men may not experience symptoms until the disease has advanced.”
Prostate Cancer Statistics
Prostate cancer is the second most common cancer in men globally (after lung cancer).
As per the Indian Council of Medical Research (ICMR), prostate cancer accounts for 7% of all cancers in Indian men.
The American Cancer Society estimates that 1 in 8 men will be diagnosed with prostate cancer in their lifetime.
The risk increases with age, with over 65% of cases diagnosed in men aged 65 and older.
Symptoms of Prostate Cancer
In its early stages, prostate cancer may not cause noticeable symptoms. However, as the disease progresses, the following signs may appear:
Early-Stage Symptoms
Frequent urination, especially at night (nocturia)
Weak or interrupted urine flow
Difficulty starting or stopping urination
Pain or burning sensation during urination
Blood in urine or semen
Advanced-Stage Symptoms
Bone pain (especially in the spine, hips, or ribs, indicating possible metastasis)
Unexplained weight loss
Fatigue and weakness
Erectile dysfunction
Loss of bladder or bowel control (in rare cases where cancer presses on the spinal cord)
Dr. Rahul Jena emphasizes, *”Men over 50, or those with a family history of prostate cancer, should undergo regular screenings even if they don’t have symptoms. Early detection through PSA (Prostate-Specific Antigen) testing and digital rectal exams (DRE) can save lives.”*
Causes of Prostate Cancer
The exact cause of prostate cancer remains unclear, but research suggests that a combination of genetic, hormonal, and environmental factors contribute to its development.
Genetic Factors
Family History: Men with a father or brother who had prostate cancer are twice as likely to develop it.
Inherited Gene Mutations: Mutations in genes like BRCA1, BRCA2, and HOXB13 increase risk.
Hormonal Influences
Testosterone and DHT (Dihydrotestosterone): These male hormones stimulate prostate cell growth. Higher levels may contribute to cancer development.
Environmental and Lifestyle Factors
Diet: A diet high in red meat, processed foods, and dairy may increase risk, while fruits, vegetables, and lycopene-rich foods (like tomatoes) may lower it.
Obesity: Obese men have a higher risk of aggressive prostate cancer.
Exposure to Chemicals: Certain industrial chemicals (e.g., Agent Orange) may be linked to prostate cancer.
Risk Factors for Prostate Cancer
Several factors influence a man’s likelihood of developing prostate cancer:
1. Age
Rare before 40, but risk increases significantly after 50.
About 60% of cases are diagnosed in men over 65.
2. Race and Ethnicity
African-American men have the highest risk and are more likely to develop aggressive forms.
Asian men have a lower incidence, possibly due to dietary and genetic differences.
3. Family History and Genetics
A first-degree relative (father or brother) with prostate cancer doubles the risk.
Lynch syndrome and BRCA mutations also increase susceptibility.
4. Lifestyle Factors
Smoking is linked to aggressive prostate cancer.
Sedentary lifestyle and obesity may worsen outcomes.
High calcium intake (from supplements) may elevate risk.
5. Chronic Inflammation and Infections
Prostatitis (chronic inflammation of the prostate) may increase cancer risk.
Sexually transmitted infections (STIs) could play a role in prostate changes.
Diagnosis and Screening
Early detection is crucial. The following tests help diagnose prostate cancer:
1. Prostate-Specific Antigen (PSA) Test
Measures PSA levels in the blood. High levels may indicate cancer, but can also be due to benign conditions like BPH (Benign Prostatic Hyperplasia) or infection.
2. Digital Rectal Exam (DRE)
A doctor physically examines the prostate for abnormalities.
3. Biopsy
If PSA or DRE results are suspicious, a prostate biopsy is performed to confirm cancer.
4. Imaging Tests
MRI, CT scans, and bone scans help determine if cancer has spread.
Dr. Rahul Jena advises, “Not all elevated PSA levels mean cancer. Further tests are needed for confirmation. Men should discuss the pros and cons of screening with their urologist.”
Treatment Options
Treatment depends on the cancer’s stage, aggressiveness, and the patient’s overall health.
1. Active Surveillance
For low-risk, slow-growing cancers, regular monitoring may be sufficient.
2. Surgery (Prostatectomy)
Robotic-assisted surgery (which Dr. Jena specializes in) offers precision and faster recovery.
3. Radiation Therapy
External beam radiation or brachytherapy (radioactive seeds) targets cancer cells.
4. Hormone Therapy
Reduces testosterone levels to slow cancer growth.
5. Chemotherapy and Immunotherapy
Used for advanced or metastatic prostate cancer.
6. Targeted Therapy and Clinical Trials
New treatments like PARP inhibitors show promise for genetic-linked prostate cancers.
Prevention and Early Detection Tips
Regular screenings from age 50 (or 45 for high-risk men).
Healthy diet rich in fruits, vegetables, and omega-3 fatty acids.
Exercise regularly and maintain a healthy weight.
Avoid smoking and excessive alcohol.
Conclusion
Prostate cancer is a significant health concern for men, but with early detection and advanced treatments, survival rates are high. Dr. Rahul Jena stresses, “Awareness and timely medical consultation are key. Men should not ignore urinary symptoms and must prioritize regular check-ups.”
By understanding the symptoms, causes, and risk factors, men can take proactive steps toward prevention and early intervention. If you or a loved one are at risk, consult a urologist or uro-oncologist for personalized guidance.