Prostate Cancer

"Prostate cancer is the 3rd most common cancer among Singaporean men. Prostate specific tumor antigen (PSA) blood testing can be done in men with symptoms suggestive of prostate cancer or in men at high risk of developing prostate cancer."

Causes

The cause prostate cancer is not clear.
A combination of factors may play a role in prostate cancer such as family history, ethnicity, hormones, diet and the environment.

Risk factors

The main risk factors include:

• Age. The risk of prostate cancer increases after the age of 50 years.
• Race or ethnicity. Dark skinned men have a higher risk of developing and dying of prostate cancer.
• Family history of prostate cancer increases the risk of prostate cancer.
• Diet. A high-fat diet and obesity may increase your risk of prostate cancer.
• High testosterone levels in men who use testosterone therapy.

Symptoms

In the early stages of prostate cancer, there may be no symptoms.
In the later stages, symptoms of prostate cancer may include urinary symptoms such as:

• Difficulty passing urine or slowing of the flow of urine to a trickle
• Decreased force in the stream of urine
• Blood in your urine or semen

Advanced prostate cancer which has spread to:

• Bones may cause bone pain, fractures and compression of the spine.
• Lymph nodes may cause swelling of the leg or discomfort.

Diagnosis

These include:

• Digital rectal examination (DRE) to detect any abnormalities in the texture, shape or size of the prostate gland.
• Prostate-specific antigen (PSA) test involves taking a blood sample from a vein and testing for PSA, a substance that is naturally produced by the prostate gland to help liquefy semen. High levels will warrant further investigation.
• Tran rectal ultrasound to detect any abnormalities in the prostate gland.
• Prostate biopsy involves taking thin sections of tissue from the prostate gland.

Additional tests include:

• Bone scan
• Ultrasound
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Lymph node biopsy

Complications

The typical complications of prostate cancer and its treatments include:

• Spread of cancer to nearby organs or travel through the bloodstream or lymphatic system affecting the bones or other organs.
• Pain when the cancer spreads to bones it can cause excruciating pain.
• Difficulty urinating (urinary incontinence).
• Erectile dysfunction (ED) or impotence.
• Depression after a diagnosis of prostate cancer or after trying to cope with the side effects of treatment.

Treatment

The most common treatments for prostate cancer include the following:

• External beam radiation therapy: uses high-powered X-rays to kill cancer cells.
• Radioactive seed implant: also known as brachytherapy, deliver a higher dose of radiation than do external beams.
• Hormone therapy: using drugs to stop the body from producing the male sex hormones testosterone, which can stimulate the growth of cancer cells.
• Radical prostatectomy: surgical removal of prostate gland is used to treat cancer that is confined to the prostate gland.
• Chemotherapy: uses drugs to destroy rapidly growing cancer cells.

Prevention

Prostate cancer cannot be prevented. In general, men are advised to make choices that benefit their overall health such as regular exercise, avoiding high-fat diets, and consuming fruits and vegetables rich in antioxidants.

The established risk factors are increasing age (>50 years), family history and ethnicity (African). So, men aged over 50 years with a normal risk of prostate cancer should discuss with their doctors the risks and benefits of prostate cancer screening. Men who have a strong family history, for example, a brother or father with prostate cancer should be aware of the symptoms of prostate cancer, and discuss management options with their doctor.

This article was originally published on http://www.hpb.gov.sg