Prostatea walnut-shaped gland in the male reproductive system that is responsible for producing semen - a bodily fluid that acts as a vessel for sperm transport during ejaculation cancera disease where abnormal cells split without control and spread to other nearby body tissue and/or organs is a malignancy of the prostate gland, and is one of the most common cancers in men. In most cases, these tumours are adenocarcinomas (cancers arising from mucus-producing glands), however it can also develop as sarcomas (cancers arising from bone or soft tissuetissue/the material that joins, holds up or surrounds inside body parts such as fat, muscle, ligaments and lining around joints), small cell carcinomas (cancers arising from the tissues that line organs) or neuroendocrine tumours of the prostate (tumours that develop from neuroendocrine cellsthe basic structural and functional unit of all living things that produce hormones and peptides).
The prostate is a walnut-shaped gland in the male reproductive system. It sits below the bladdera hollow, muscular sac in the pelvis that stores urine, and in front of the rectumthe last section of the large intestine/bowel that holds waste until it is ready to be removed from the body (end of the small bowelportion of the digestive system that digests food (small bowel) and absorbs salts and water (large bowel); also called intestines). The prostate is responsible for producing semen, a bodily fluid that acts as a vessela tube that carries bodily fluid, such as blood or lymph fluid, around the body for sperm transport during ejaculation, and nourishment to keep the sperm alive outside of the body. It also has a small role in the urinary system, as the thin tube (ureter) that runs through the bladder to the penis is passed through the prostate.
Prostate cancers are most commonly found in men over 55 years of age. However, anyone with a prostate – including teenagers, transgender women, non-binary individuals, and intersex people – can develop this disease at any age.
Treatment
If prostate cancer is detected, it will be staged and graded based on size, metastasiswhen the cancer has spread to other parts of the body, also known as mets, and how the cancer cells look under the microscope. Stagingthe process of determining how big the cancer is, where it started and if it has spread to other areas and grading helps your doctors determine the best treatment for you.
Cancers can be staged using the TNM staging system:
- T (tumoura tissue mass that forms from groups of unhealthy cells) indicates the size and depth of the tumour.
- N (nodea small lump or mass of tissue in your body) indicates whether the cancer has spread to nearby lymph nodessmall bean-shaped structures that filters harmful substances from lymph fluid.
- M (metastasis) indicates whether the cancer has spread to other parts of the body.
This system can also be used in combination with a numerical value, from stage 0-IV:
- Stage 0: this stage describes cancer cells in the place of origin (or ‘in situ’) that have not spread to nearby tissuea group of cells that work together to perform a function.
- Stage I: cancer cells have begun to spread to nearby tissue. It is not deeply embedded into nearby tissue and had not spread to lymph nodes. This stage is also known as early-stage cancer.
- Stage II: cancer cells have grown deeper into nearby tissue. Lymph nodes may or may not be affected. This is also known as localisedaffecting only one area of body cancer.
- Stage III: the cancer has become larger and has grown deeper into nearby tissue. Lymph nodes are generally affected at this stage. This is also known as localised cancer.
- Stage IV: the cancer has spread to other tissues and organs in the body. This is also known as advancedat a late stage, far along or metastatic cancer.
Cancers can also be graded based on the rate of growth and how likely they are to spread:
- Gradea description of how abnormal cancer cells and tissue look under a microscope when compared to healthy cells I: cancer cells present as slightly abnormal and are usually slow growing. This is also known as a low-grade tumour.
- Grade II: cancer cells present as abnormal and grow faster than grade-I tumours. This is also known as an intermediate-grade tumour.
- Grade III: cancer cells present as very abnormal and grow quickly. This is also known as a high-grade tumour.
Once your tumour has been staged and graded, your doctor may recommend genetic testinga procedure that analyses DNA to identify changes in genes, chromosomes and proteins, which can be used to analyse tumour DNA to help determine which treatment has the greatest chance of success, which analyses your tumour DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.
Treatment is dependent on several factors, including location, stage of disease and overall health.
Treatment options for prostate cancer may include:
- Surgerytreatment involving removal of cancerous tissue and/or tumours and a margin of healthy tissue around it to reduce recurrence to remove the prostate (prostatectomycomplete or partial removal of the prostate gland), potentially including:
- Retropubic prostatectomyremoval of the prostate through an incision in the abdomen.
- Perineal prostatectomyremoval of the prostate through an incision made in the skin between the anus and scotum.
- Chemotherapya cancer treatment that uses drugs to kill or slow the growth of cancer cells, while minimising damage to healthy cells.
- Radiation therapya treatment that uses controlled doses of radiation to damage or kill cancer cells.
- Hormone therapymedication that alters the levels of certain hormones in the body, such as oestrogen and progesterone, such as androgen deprivation therapy (ADT)a type of hormone therapy used to reduce testosterone levels to treat prostate cancer.
- Watch and waitthe close monitoring of a cancer without giving treatment until symptoms appear or worsen.
- Clinical trialsresearch studies performed to test new treatments, tests or procedures and evaluate their effectiveness on various diseases.
- Palliative carea variety of practices and exercises used to provide pain relief and improve quality of life without curing the disease.
Prostate Cancer Treatment and Fertility
Treatment for prostate cancer may make in difficult to conceive a child. If fertility is important to you, discuss your options with your doctor and a fertility specialist prior to the commencement of treatment.
Risk factors
While the cause of prostate cancer remains unknown, the following factors may increase your riskthe possibility that something bad will happen of developing the disease:
- Being over 55 years of age.
- Having a family history of prostate cancer.
- Having a family history of breast and/or ovarian cancer.
- Having BRCA1 and/or BRAC2 genetic mutations.
- Being if African American descent.
Not everyone with these risk factors will develop the disease, and some people who have the disease may have none of these risk factors. See your general practitioner (GP) if you are concerned.
Symptoms
Symptoms of prostate cancer may include:
- Changes in urination, such as:
- Polyuriafrequent urination.
- Feeling like your bladder isn’t empty after urination.
- Slow urine flow.
- Weaker bladder.
- Loss of bladder control.
- Incontinenceloss of control over release of urine or faeces.
- Bloodthe red bodily fluid that transports oxygen and other nutrients around the body in urine and/or semen.
- Erectile dysfunctionimpaired or abnormal function; not working properly.
- Pain when ejaculating.
- Unexplained weight loss.
- Bone pain.
Not everyone with the symptoms above will have cancer but see your general practitioner (GP) if you are concerned.
Diagnosis
If your doctor suspects you have prostate cancer, they may order the following tests to confirm the diagnosisthe process of identifying a disease based on signs and symptoms, patient history and medical test results and refer you to a specialist for treatment:
- Physical examinationan examination of your current symptoms, affected area(s) and overall medical history.
- Digital rectal examinationan examination conducted by a urologist where a finger (or digit) is inserted into the rectum to feel the anus (DRE).
- Imagingtests that create detailed images of areas inside the body tests, potentially including:
- TRUS (transrectal ultrasound)a type of ultrasound that involves inserting a device (known as a transducer) into the rectum to produce sound waves and create images of the rectum, prostate gland and surrounding tissues in greater detail; also known as an endorectal ultrasound.
- MRI (magnetic resonance imaging)a type of medical imaging that uses radiowaves, a strong magnet and computer technology to create detailed images of the body.
- CT (computed tomography) scana type of medical imaging that uses x-rays and computer technology to create detailed images of the body.
- Blood teststesting done to measure the levels of certain substances in the blood, such as to check your PSA level.
- Biopsyremoval of a section of tissue to analyse for cancer cells.
