Prostate cancer – Definition, diagnosis and treatment

Prostate cancer is the second most common form of cancer affecting men in the United States, according to the National Cancer Institute.
An estimated 224,733 American men were diagnosed with this disease in 2021.
More than 70% of men diagnosed with prostate cancer each year are over the age of 65.
African American men have a higher risk of the disease than Caucasian men.

There are no noticeable symptoms of prostate cancer while it is still in the early stages, making the PSA test a critical screening tool. The optimal time for prostate cancer treatment is before symptoms appear.
During more advanced stages, symptoms may include difficult or frequent urination, blood in the urine, or bone pain.
Table of contents:
  •  Where is the prostate gland located?
  • What is prostate cancer?
  • Prostate cancer stages and grades
  • Risk factors you should consider
  • Prostate cancer causes
  • Prostate cancer symptoms
  • When seeing a doctor concerning prostate cancer
  • Prostate cancer screening
  • Prostate cancer pathology report
  • Treatment options available for you

Where is the prostate gland located?

The prostate gland is a small, walnut-shaped gland that is located only in men below the bladder and in front of the rectum. The prostate gland produces some of the fluid that makes up semen. 

About Prostate Cancer

It also helps to make sperm move from the testicles to the urethra. The prostate gland also helps to prevent bacteria from entering the urethra and causing an infection.

What is prostate cancer?

Prostate cancer is a disease in which malignant (cancer) cells start building up within the prostate.  Cancer cells appear as a consequence of a DNA mutation. When prostate cells start growing and dividing at a quicker rate than usual, there are more chances for DNA mutations to occur. Male hormones such as testosterone are making prostate cells grow quicker. This is why some men with high levels of testosterone are at a higher risk of developing this disease.

Nonetheless, these are just a few of the risk factors that may trigger the development of cancer. Researchers are still studying the real causes of cancer in men.

Prostate cancer stages and grades

The Gleason score is a system for grading prostate cancer. It measures how different cancer cells are from healthy cells when viewed under a microscope. The more they share their resemblance to healthy cells, the less aggressive cancer cells are and vice versa.

It is used to predict the risk of cancer spreading and the chance of recovery. The higher the Gleason score, the more likely it is that cancer will spread.

The Gleason score ranges from 2 to 10, with 2 being least aggressive and 10 being most aggressive. A Gleason score of 6 or less means that there is a low risk of cancer spreading, while a Gleason score of 8 or more means that there is a high risk of cancer spreading. When Gleason score shows an X, it means that it cannot be determined.

Moreover, the various types of cancer are grouped under four stages:

  • Stage I: The tumor is only in the prostate and has not spread to other parts of the body.
  • Stage II: The tumor remains within the prostate, but the PSA test shows medium levels.
  • Stage III: PSA levels are high and the cancer tumor has reached a considerable size being on the verge of spreading outside the prostate gland.
  • Stage IV: Cancer has spread to other parts of your body, such as your bones, lymph nodes, or lungs.

Risk factors you should consider

Scientists have yet to discover the exact causes of prostate cancer. Nonetheless, there are several risk factors, both controllable and uncontrollable. Studies show that they play a role in cancer occurrence rates.

  • The risk of prostate cancer increases with age. Prostate cancer is rare for men under the age of 40, and most cases occur in men over the age of 65.
  • Men with a father or brother with prostate cancer are 2x as likely to get the disease. Men with 3 relatives diagnosed with prostate cancer are nearly certain to develop prostate cancer.
  • African American men have a 60% higher risk of getting prostate cancer than Caucasian men, and twice the risk of dying from it. 
  • Asian men have a risk of getting prostate cancer similar to the general population. On the other hand, their rates of death due to the disease have not declined over recent years as it happened for Caucasian and African American men.
  • Veterans of Asian Theaters, who were exposed to Agent Orange, are at increased risk.
  • Obese men – those with a body mass index of over 32.5 – are 33% more likely to die from prostate cancer if diagnosed.
  • Heavy smokers are at a greater risk of developing fatal cancer. Those who smoke more than 25 cigarettes a day are between 24% to 30% more likely to develop prostate cancer than non-smokers.
  • Our food choices can also add to the risk factors for cancer. Non-grass-fed beef, non-organic chicken, alcohol, caffeine, baked goods, and spicy foods can worsen your odds of developing cancer. 

Prostate cancer causes

As we’ve mentioned above, cancer occurs when cells in the prostate gland grow uncontrollably. In some cases, this chaotic activity of the system leads to DNA mutations that produce the onset of a malignant tumor.

Scientists are yet to discover the exact event that causes prostate cancer.

For the time being, doctors cannot predict with absolute certainty who is going to have cancer or not. The only measures men can take against a scenario where they get cancer are to learn risk factors, remove them as much as possible from their lifestyle, and get periodical PSA tests. 

Prostate cancer symptoms you need to be aware of

Unlike the usual health problems, our bodies are unable to notify us when a tumor is starting to take shape through anything that can be remotely associated with ”prostate pain.” What individuals feel when their cancer is in advanced stages is the repercussions cancer cells cause to tissue, bones, and organs. 

In its early stages, prostate cancer is not interfering with any tissue or organ around it. That would have triggered some sensors in our bodies, telling us that something is wrong.

In reality, that mass of malignant cells is focused on adding new cells and expanding their volume. Only when its original space, the prostate gland in our case, can no longer contain its size, the tumor finds a way to travel to other parts of the body. Usually, this happens through the lymph nodes.

By the time the first prostate cancer symptoms start surfacing, cancer has already reached life-threatening proportions. This is why doctors urge men to take a preventive stance toward prostate cancer and resort to PSA tests to see if there are any signs of prostate cancer.

However, as the cancer forces the prostate gland to swell or it has already spread outside the prostate, a slew of symptoms emerges:

  • Difficulty urinating or a weak urine flow;
  • Painful or burning sensation when urinating;
  • Blood in urine or semen;
  • Frequent need to urinate, especially at night;
  • Painful ejaculation;
  • Pain in your rectum;
  • Pain in your lower back, hips, pelvis, or thighs;
  • Fatigue;
  • Unexplained weight loss.

When to see a doctor concerning prostate cancer

senior man calls doctor for prostate cancer screening

As we’ve mentioned before, first-stage cancer leaves no empirical signs, meaning you can’t grow suspicious of prostate cancer on your own. Therefore, the National Cancer Institute encourages men to see a doctor when they are in their 30s or 40s. However, these doctor’s visits are preventive only and they aim at cancer screening.

Nonetheless, if you experience any cancer symptoms, you should contact your doctor immediately. 

Dr. David Samadi, one of the best urologists in NYC, is here to help you!