Breaking Down Prostate Cancer: Causes, Symptoms, and Treatments

Definition   |  Types of Prostate Cancer  |  Statistics |  Causes  |  Symptoms | Risk Factors   Grades and Stages  |  Diagnosis | Treatments |  Prevention  |  Note from Dr. Sannoufi

What is prostate cancer?

Prostate cancer is a condition that’s specific to male patients. The prostate is a small gland  about the size of a walnut in your reproductive system. It is responsible for producing the seminal fluid, a vital component for the nourishment and transport of sperm.

When we talk about prostate cancer, it’s like a seed that starts growing in this gland. Some of these ‘seeds’ grow slowly, not causing any trouble. In some cases, they are harmless and do not require aggressive treatment. But then, there are other types of prostate cancer that grow fast and can lead to more serious problems. That’s why it’s important to catch this cancer early. The earlier we find it, the better your chances are at managing it effectively.

By staying informed and proactive,  you’re making important steps in maintaining your health. Remember, early detection can make a world of difference in treating this condition.

What are the types of prostate cancer?

Now, let’s dive a little deeper into prostate cancer diagnosis. Most commonly, adenocarcinomas are the usual causes in prostate cancer cases. However, there are less common types of cancer cells, like small cell carcinomas, transitional cell carcinomas, neuroendocrine tumors, and even sarcomas.

Each type of cancer has its starting point in different cells within the prostate. Understanding the specific type of cancer you have isn’t just about satisfying curiosity. It directly influences how we approach your treatment and what your outlook might look like. That’s why it’s critical to have a transparent and informative discussion with your healthcare provider. They can guide you through your unique diagnosis and create a tailored treatment plan.

Remember, being proactive about early detection and understanding the type of prostate cancer you have can significantly enhance the effectiveness of your treatment.

How common is prostate cancer?

Prostate cancer is the most common cancer among Canadian men, apart from non-melanoma skin cancers. Even more significant, it’s the third leading cause of cancer-related deaths in men.

The Canadian Cancer Society has shed light on some startling figures. About 1 in 8 Canadian men are likely to develop prostate cancer during their lifetime. And sadly, 1 in 29 men may lose their battle with this disease. To put this into a more immediate perspective, recent studies indicate that 1 in 7 Canadian men will be diagnosed with prostate cancer at some point in their lives. These numbers highlight just how widespread this condition is.

Looking at the data from 2020 gives us a clearer picture. In that year alone, around 23,300 Canadian men were diagnosed with prostate cancer, and tragically, we lost about 3,105 men to this illness.

Now, these numbers might seem daunting, but they underscore an important message – the importance of regular screenings and staying proactive about your health. Early detection of prostate cancer can improve the chances of successful treatment. It’s important to face these statistics not with fear, but with a determination to be vigilant and responsible about your health checks. Remember, awareness and action are key in managing and potentially overcoming this prevalent disease.

What causes prostate cancer?

The exact process that causes normal prostate cells to turn cancerous isn’t entirely clear yet. But here’s what we do know: prostate cancer starts when cells in the prostate begin to grow and divide faster than normal cells.

Normally, cells follow a natural life cycle – they grow, divide, and eventually die. But abnormal cells break the rules. They don’t die when they should. Instead, they keep multiplying, eventually forming what we recognize as a tumor.

One of the critical aspects of prostate cancer is its potential to metastasize, meaning parts of the tumor can break off and spread to other body areas. That’s when things get more complicated and dangerous.

However, there’s a silver lining with prostate cancer. In most cases, it grows slowly. This gives us an advantage because we often diagnose these tumors early, while the cancer is still confined to the prostate. When caught at this stage, prostate cancer is highly treatable.

What are the symptoms of prostate cancer?

Prostate cancer can be sneaky in its early stages. It often flies under the radar because it doesn’t always show symptoms right away. But as it progresses, it starts to give us some clues.

The first signs usually have to do with changes in how you urinate. Maybe you find yourself needing to go more often, especially at night. Or you might notice that your urine stream is weaker than usual, or it starts and stops unexpectedly.

Pain or a burning feeling when you urinate – also called dysuria – can also be a sign that the cancer is advancing. In some cases, prostate cancer can lead to a loss of bladder or bowel control.

Now, let’s talk about how prostate cancer can affect your sexual health. Pain during ejaculation and erectile dysfunction (ED) are symptoms that can appear in advanced stages. Having blood in your semen or urine are also symptoms.

Sometimes, prostate cancer can even cause pain in other parts of your body, like your lower back, hips, or chest. If you notice any of these symptoms, it’s important to get in touch with your doctor. Staying informed and proactive about your health is the best way to stay ahead of this disease.

Are prostate problems always a sign of prostate cancer?

When it comes to your prostate health, there’s something you should keep in mind: not every growth or change in the prostate is cancerous. In fact, there are conditions with symptoms very similar to those of prostate cancer, and it’s important to distinguish between them. Two common conditions are Benign Prostatic Hyperplasia (BPH) and Prostatitis.

Let’s start with BPH. This condition, which results in the enlargement of the prostate gland, is something almost every man with a prostate experiences at some point in their life. The key thing to remember about BPH is that, despite causing enlargement similar to prostate cancer, it’s benign and doesn’t increase your risk of cancer.

Now, if you’re younger than 50 and experiencing prostate enlargement, it’s likely due to Prostatitis. This is another benign condition, characterized by inflammation and swelling of the prostate, often caused by bacterial infections.

If you’re experiencing symptoms like an enlarged prostate, don’t let fear get the better of you. The best step is to consult your healthcare provider for an accurate diagnosis. This will not only ease your worries but also ensure that if there’s a need for treatment, you’ll be on the right path immediately.

When to call a doctor

You should call your healthcare provider if you experience:

• Difficulty peeing.
• Peeing frequently (incontinence or the lack of voluntary control over urination).
• Pain when you pee or have intercourse.
• Blood in your pee or semen.

What are the risk factors for prostate cancer?

It’s important to understand the factors that can increase your risk of prostate cancer. Knowing these risk factors gives you a clearer picture of what to watch out for and how to approach your health:

• First is your age. As you get older, your risk of developing prostate cancer increases. It’s more common in men over 50, and about 60% of cases occur in men older than 65.
• Race and ethnicity also significantly impact your risk. If you’re Black or of African ancestry, your risk is higher. Not only are you more likely to get prostate cancer, but the type that develops is often more aggressive and can occur before age 50.
• Family history is another key factor. If your father, brother, or son has a history of prostate cancer, your own risk is two to three times higher.
• Genetics is also a factor. Certain genetic conditions, like Lynch syndrome, or inherited mutations in the BRCA1 and BRCA2 genes, which are linked to breast cancer risk, can increase your chances of developing prostate cancer.
• There are other potential risk factors to consider. These include lifestyle-related factors like smoking, obesity, and having had sexually transmitted infections. There’s also evidence pointing to environmental factors, like exposure to Agent Orange during the Vietnam War.

By understanding these risk factors, you’re in a better position to take control of your health. While some factors like age and genetics are beyond our control, others can be managed through a healthy lifestyle and regular screenings.

What are the grades and stages of prostate cancer?

Let’s talk about how we evaluate the severity of prostate cancer: the Gleason grade group and cancer staging. These are the key for getting a clear picture of how aggressive the cancer is and how far it’s spread, which in turn guides us in deciding the best course of treatment for you.

So, what exactly is the Gleason score? Think of it as a way to grade the aggressiveness of your cancer based on how abnormal the cells look under a microscope. The more abnormal the prostate cancer cells, the higher the Gleason score. This indicates a more aggressive disease.

Then we have cancer staging. This helps us assess how advanced your cancer is. At early-stage prostate cancer, the disease might be confined just to your prostate gland. As it progresses, it might invade nearby structures, which we call regional spread. In more severe cases it can spread to nearby tissues, or metastasize to distant organs.

Most commonly, prostate cancer spreads to the bones and lymph nodes, but it can also affect other organs like the liver, lungs, or even the brain.

Understanding your Gleason score and the stage of your cancer is key to grasping the seriousness of your diagnosis. It gives you a clearer view of what you’re dealing with and enables you to have well-informed discussions with your healthcare provider about your prognosis and treatment options.

How is prostate cancer diagnosed?

Screenings are your first line of defense against prostate cancer, especially when it comes to catching it early when it’s much more manageable. If you’re at average risk, we usually start screenings around age 40. But if you’re in a high-risk group – maybe due to family history or racial factors – we might need to start earlier. Generally, we continue these screenings until around age 75.

Now, if a screening raises a flag about potential prostate cancer, we follow up with additional tests.

One method is the Prostate-Specific Antigen (PSA) blood test. The PSA is a protein made by your prostate, and elevated levels in your blood can suggest cancer. However, higher PSA levels can also result from benign conditions, so it’s not a definitive diagnosis.

If these initial screenings indicate possible prostate cancer, we may recommend further tests, especially if the tumor seems aggressive. Imaging tests like MRI or transrectal ultrasound can give us a detailed picture of your prostate, highlighting any suspicious areas.

The most definitive test for prostate cancer is a biopsy, where we take a small tissue sample from your prostate for lab analysis. This is the only way we can confirm the presence of cancer and determine how aggressive it is. We can also perform genetic tests on the biopsy sample to identify specific characteristics of the cancer cells, which can guide us in choosing the most effective treatment.

How is prostate cancer managed or treated?

When it comes to the treatment for prostate cancer, the strategy we choose depends on a variety of factors: your overall health, the extent and rate of cancer spread, and your personal preferences. Depending on these, you might work with different specialists, like urologists, radiation oncologists, and medical oncologists.

Now, let’s explore the treatment options.

1. Surveillance: If your cancer is growing slowly and not spreading, we might go with active surveillance or watchful waiting. This means keeping a close eye on the cancer with regular screenings and biopsies, and only stepping in with treatment if things change.
2. Surgery: For cancer that’s contained within the prostate, surgery like a radical prostatectomy might be the best course. There are different surgical methods, including the traditional open surgery and the less invasive robotic surgery, which uses a high-tech robotic system.
3. Radiation Therapy: Radiation can be used alone or alongside other treatments. This could be brachytherapy, where we place radioactive seeds inside your prostate, or external beam radiation therapy, which targets the cancer with X-ray beams.
4. Systemic Therapies: If the cancer has spread, we might consider treatments like hormone therapy, which tackles how testosterone fuels cancer growth; chemotherapy, which uses drugs to kill cancer cells; immunotherapy, which boosts your immune system; and targeted therapy, which goes after specific genetic changes in cancer cells.
5. Focal Therapy: For low-risk, localized cancer, newer methods like high-intensity focused ultrasound (HIFU), cryotherapy, laser ablation, and photodynamic therapy are options. These techniques specifically target cancer cells while sparing healthy tissue.

Choosing the right treatment can be complex, and it’s tailored to each person’s unique situation. Understanding your options helps you engage in meaningful discussions with your health care team, empowering you to make well-informed decisions.

How can I prevent prostate cancer?

Though we can’t guarantee the prevention of prostate cancer, there are several proactive steps you can take to reduce your risk:

1. Regular Prostate Screenings: They’re the best way to catch cancer early when it’s most treatable. It’s important to discuss with your healthcare provider how often you should be screened, taking into account your personal risk factors.
2. Maintain a Healthy Weight: Keeping a healthy weight is not just about looking good. It’s about keeping your body in the best shape to fend off diseases, including prostate cancer. Your healthcare provider can help you determine what a healthy weight range is for you.
3. Exercise Regularly: Exercise is a key component of good health. The CDC recommends at least 150 minutes of moderate-intensity exercise per week. That’s just over 20 minutes a day. Regular exercise helps maintain a healthy weight and can reduce cancer risk.
4. Nutritious Diet: Eating right is essential. While no diet can outright prevent cancer, a balanced diet rich in fruits, vegetables, and whole grains, and low in red and processed meats, can boost your overall health and possibly reduce the risk of prostate cancer.
5. Quit Smoking: Smoking is a significant risk factor for many health issues, including cancer. If you smoke, quitting is one of the best things you can do for your health. Your provider can offer resources and support to help you quit.

Remember, these steps are about reducing risk, not guaranteeing prevention. Regular check-ups and maintaining open communication with your healthcare provider are crucial in managing your overall health and staying ahead in the fight against prostate cancer.

A note from Dr. Sannoufi

With early diagnosis and treatment, prostate cancer is often highly curable. It’s a fact that brings hope. Many patients diagnosed with prostate cancer, especially when it’s caught before it has spread beyond the prostate, go on to lead normal, healthy lives after treatment.

But, it’s important to remember that prostate cancer can behave differently in different people. That’s why having a personalized screening schedule is so important.

If you want to start taking proactive steps for your health, you can check our Comprehensive Wellness Assessment. Remember, the earlier we catch prostate cancer, the better your chances of successful treatment.

Where can I learn more about prostate cancer?

• Canadian Men’s perspectives about active surveillance in prostate cancer: need for guidance and resources – PMC
• Canadian Cancer Society
• Find prostate cancer
• Understanding Men’s Experiences With Prostate Cancer Stigma: A Qualitative Study | ONS
• Prostate Cancer, Nutrition, and Dietary Supplements (PDQ®) – NCI
• Prostate Cancer: Statistics