Prostate Cancer

The prostate is a walnut-shaped gland in men that produces seminal fluid that nourishes and transports sperm.

Prostate cancer is one of the most common cancers in men. It usually grows slowly and may spread to other organs if left undetected and untreated.

Prostate cancer may cause no signs or symptoms in its early stages.

Symptoms

Prostate cancer that is more advanced may cause signs and symptoms such as:

• Burning or pain during urination
• Trouble starting and stopping urination
• Increased frequency of urination, especially at night
• Loss of bladder control, so there may be incontinence
• Decreased force in the stream of urine
• Blood in semen or urine
• Discomfort in the pelvic area
• Bone pain
• Erectile dysfunction

Risk factors

• Age: risk increases with age.
• Family history of prostate or breast cancer increases risk.
• Obesity increases the risk of getting a more aggressive cancer that is difficult to treat.

Complications

• Cancer spreads (metastasises) to nearby organs, such as your bladder or travels through your bloodstream or lymphatic system to your bones or other organs.
• Incontinence: Both prostate cancer and its treatment can cause urinary incontinence.
• Erectile dysfunction: It can result from prostate cancer or its treatment, including surgery, radiation or hormone treatments.

Prevention

• A healthy diet: with plenty of fruits, vegetables and whole grains. Avoid high-fat foods.
• Regular exercise
• Maintain a healthy weight

Screening

• Screening to commence at:
  1. Age 50 for men who are at average risk and expected to live at least 10 more years
  2. Age 45 for men at high risk; who have first degree relatives with prostate cancer at younger ages below 65 years
  3. Age 40 for men at very high risk; who have many first degree relatives with prostate cancer at an early age
• Digital rectal examination
• Prostate specific antigen test

If no prostate cancer is found as a result of screening, the time between future screenings depends on the results of the PSA blood test:

• Men who have a PSA of less than 2.5 ng / mL may only need to be retested every 2 years.
• Screening should be done yearly for men whose PSA level is 2.5 ng / mL or higher.
• Because prostate cancer often grows slowly, men without symptoms of prostate cancer who do not have a 10-year life expectancy need not undergo testing since they are not likely to benefit.

If the screening tests suggest prostate cancer, the following is done:

• Transrectal ultra sound (TRUS): A small probe is passed into the rectum and images visualised
• A prostate biopsy is done using a small needle which is passed through the rectal wall using transrectal ultrasound to visualise the prostate.