Understanding the Prostate and Cancer

What is “The Prostate”?

The prostate is a small gland in male approximately the size of a walnut. The gland is situated deep within the pelvic region, between the root of the penis and the rectum.

Crucial for the process of reproduction, it plays a vital role in supplying a portion of the seminal fluid (semen). This fluid, when combined with sperm from the testes, facilitates the transportation and viability of the sperm.

How Prostate enlargement affect urine flow?

Due to it location, the prostate, when enlarged, can restrict urine flow. This is seen in a condition called BPH or Benign Prostatic Hyperplasia (BPH), which is a noncancerous enlargement of the prostate.

Other noncancerous conditions may include Prostatitis, that can be caused by bacteria. Note that, having these noncancerous conditions does not necessarily increase the chance of having prostate cancer.

What is a Cancer?

Cancer is a condition characterized by uncontrolled cell growth within the body. When this abnormal growth initiates in the prostate, it is specifically referred to as prostate cancer.

Prostate Cancer

Prostate cancer is among the most prevalent cancers affecting men and a significant threat to the Western world. It stands as a leading cause of cancer-related mortality in males, and the global burden of this disease is on the rise. According to the Center for Disease Control and Prevention (CDC), prostate cancer is the second most seen cancer amongst men in the United States. Additionally, it stands as a primary contributor to cancer-related fatalities among men of diverse racial backgrounds and Hispanic origin populations.

Risk Factors

The incidence of prostate cancer tends to rise gradually with advancing age. While the exact causes of prostate cancer remain unknown, researchers have identified numerous risk factors that may contribute to its development. Some of these risk factors, such as age, race, and family history, are beyond individual control. However, factors like diet, medications, lifestyle choices, and early detection through methods like PSA screening are within one’s influence. Managing these controllable factors may play a crucial role in reducing the risk and mortality rate associated with prostate cancer.

Symptoms of Prostate Cancer

Prostate cancer symptoms vary among individuals, with a significant number of men not experiencing any symptoms especially at early stage. Nevertheless, if symptoms appear, they generally comprise one or more of the following:

• • Difficulty beginning and maintaining urination.
• • Blood passed in the urine.
• • Regular urges to urinate.
• • Painful urine
• • Difficulty reaching or sustaining an erection.

In the advanced stage, the following symptoms may be present:

• • Painful bones
• • Bone Fractures
• • Leg weakness
• • Urinary incontinence and / or Faecal incontinency

Prostate Cancer screening, the benefit of early detection

Prostate cancer screening involves routine examinations and tests designed to identify prostate cancer in its early stages, often before noticeable symptoms emerge. The commonly used method is the prostate-specific antigen (PSA) blood test.

Benefit of early detection

The advantages of early detection are substantial. Pinpointing prostate cancer early increases the likelihood of successful treatment and improved outcomes.

Early intervention provides individuals with more treatment options, potentially including less invasive procedures, and a greater chance of maintaining overall quality of life.

Regular screening is particularly important for those with risk factors like age, family history, or specific genetic predispositions.

However, it’s crucial to note that prostate cancer screening has considerations and potential drawbacks. Despite this, the positive impact of early detection on treatment efficacy underscores its importance in promoting better health outcomes for men. It is recommended that individuals discuss the potential benefits and risks of prostate cancer screening with their healthcare providers to make informed decisions based on their unique circumstances. Some of the test in screening for prostate cancer are:

1. PROSTATE-SPECIFIC ANTIGEN (PSA)

Prostate cancer is often detected early with a simple blood test and Prostate-specific antigen (PSA) is a substance produced by cells inside the prostate gland by both normal and cancer cells.

The antigen (PSA) is released by the prostate into the semen where it acts to liquefy the semen following ejaculation.

It is therefore generally found in semen, but a slight quantity is also found in the blood.

The PSA level can fluctuate and normal range still a debate. Nevertheless, in most case blood levels under 4 nanograms per milliliter (4.0 ng/mL) is the normal. Chance of developing prostate cancer are higher as the PSA level increases above that limit.

Levels lower than 4ng/mL is not a guarantee that you do not have cancer. Studies reveal that around some men with a PSA lower than 4ng/mL will develop prostate cancer on biopsy.

Men tested with a PSA between 4 and 10 present 25 percent or more chances of developing a cancer.

What factors may affect PSA levels?

PSA test has some limitations since besides prostate cancer, there are many factors that can raise or decrease PSA levels.

What increases PSA levels?

• Age: PSA levels may go up slightly as you advance in age, even with no prostate abnormality.

• Benign prostatic hyperplasia (BPH) on an enlarged prostate that affects several men as they get older, can affect PSA levels.
• Prostatitis or a Urinary Tract infection: can also increase PSA levels.
• Ejaculation: This can raise PSA levels for a short period of time and bring it down later. Reason why sometimes doctors recommend that men refrain from ejaculation at least for a day or two prior to testing.
• Urological procedures: such as prostate biopsy, cystoscopy or prostate surgery may rise PSA levels for a short period of time.

Since some studies have argued that a digital rectal exam (DRE) might affect PSA levels by rising it up, some doctors advise drawing blood for the PSA prior to performing a DRE.

• Medicines: such as male hormones like testosterone may cause a rise in PSA.

What decreases PSA levels?

• Group of medication known as 5-alpha reductase inhibitors: These are medications used to treat an enlarged prostate (Benign Prostatic Hyperplasia) male hair loss, such as finasteride or dutasteride, can lower PSA levels.

It is advisable to inform your doctor in case you are taking these medications since they can affect the outcome of the test.

Same applies for some Herbal mixtures because some of them may interact with the PSA levels reading and disguise a high level.

• Some other medication involved are Aspirin, Statins (used to treat high cholesterol) and Thiazide diuretics (used to treat Hypertension).
• Obesity: Men tend to show low levels of PSA when they are obese.

2. DIGITAL RECTAL EXAM (DRE)

A Digital Rectal Exam (DRE) is generally the first step in examining prostate well-being and most of the time is done as part of routine screening.

To perform a digital rectal exam (DRE), the clinician inserts a lubricated and gloved finger into the rectum to check if the prostate has proper shape, size and texture. If he or she feels anything suspicious, he or she may then recommend a diagnostic test.

During the exam the patient may feel uncomfortable particularly if he has some inflammations such as haemorrhoids.

How to prevent Prostate Cancer?

In terms of prevention, a complete prostate cancer prevention is not possible, but research mentions that diet may play a key role.

1. Fruits and vegetables

Fruits and vegetables contain nutrients that may lower the risk of getting prostate cancer. In fact, most fruits contain vitamin C which is an antioxidant.

Although the use of high dose of Vitamin C in the treatment of cancer has not yet been approved, trials show an improvement in the quality of life.

2. Tomatoes and other red foods

This includes tomatoes and other red fruits, such as watermelons, red carrots and papayas. Not counting strawberries or cherries.

They contain a substance named lycopene, an antioxidant that gives them the bright red color. Especially for tomatoes, besides lycopene, it is a good source of vitamin A and C.

Research show that men who eat more tomatoes, tomato-based products and these red fruits have less risk of developing prostate cancer.

3. Soybeans

Soybeans contain isoflavones, a nutrient associated to a to a lower risk of prostate cancer.

According to research men who consume products containing soy isoflavones have less risk of prostate cancer.

Besides these foods, to prevent prostate cancer, it is advisable to keep a good lifestyle which includes:

• Staying physically active: Regular exercises such as walking, running, cycling, etc helps you stay fit and burn fat.
• Keeping the body at a healthy weight: With a good diet and regular exercise you can achieve an optimal weight loss.

Early detection might present itself as a good choice toward lowering mortality related to prostate cancer. Do not wait too long to have yourself tested.

Once again, it is advisable to let your doctor know of any diet, medication or other condition you have. This will allow him or her to do proper examination.