According to several sources, prostate cancer is a common disease among men, with varying levels of risk based on race and family history.
The American Cancer Society reports that while prostate cancer is more common among white men, it is less common among Asian men and more common among black men. Early detection and treatment can result in a high survival rate, with a 95% life expectancy when treated in time. However, those with a family history of the disease are at an increased risk.
In Egypt, prostate cancer ranks fourth as the most common cancer among men with over 4,500 new cases reported.
In the United States, more than 180,000 men are expected to be diagnosed with prostate cancer each year, with over 40,000 expected to die from the disease.
Ongoing research suggests lifestyle choices, such as a vegan diet, may help reduce the risk of developing prostate cancer, and new treatments, such as estrogen patches, show promise for those with advanced cases of the disease.
How is the disease dangerous?
Prostate cancer is the second leading cause of cancer-related deaths among men. If not detected and treated early, it can spread to other parts of the body, leading to severe complications and even death.
Causes
- Age: The risk increases with age, especially after 50.
- Family history: Men with a family history of prostate cancer are at higher risk.
- Race: African-American men have a higher incidence of prostate cancer.
- Obesity: A higher body mass index (BMI) may increase the risk.
- Diet and lifestyle factors: Diets high in red or processed meats may contribute to an increased risk.
There are many different prostate cancer causes, and they still need to be fully understood. The following mechanisms of prostate cancer’s molecular origin are noted:
- The proliferation of altered prostate cells is regulated by a variety of changes in gene production (new cell formation). Growth factor and their receptor levels are rising, androgen and estrogen receptor signaling cascades are being activated. Embryonic signaling pathways that are important for stem cell activity are also becoming more active. These elements work together to give the changed prostate cells aggressive characteristics and to encourage their uncontrollable division, migration, and metastatic activity.
- In prostate cells that have begun to malignantly degenerate, the expression of genes and proteins that regulate apoptosis—the mechanism that ensures tumor cells survive and acquire resistance to chemotherapy—is altered.
- Signaling proteins that promote later phases of carcinogenesis, such as carcinomatous neoangiogenesis, are stimulated by genetic mutations and other genetic variables, which play a significant role in the development of prostate cancer (formation of vessels supplying the developing tumor with oxygen and nutrients).
Symptoms
How to recognize the first symptoms of prostate cancer? You should know that prostate cancer in its early stages is completely asymptomatic.
As the tumor spreads and metastases appear, certain clinical symptoms begin to appear:
- frequent, sometimes difficult urination;
- Weak (“sluggish”) urine flow;
- feeling that the bladder has not been emptied completely;
- Delays in normal urination; constipation;
- urinary incontinence;
- pain of varying intensity in the perineum, sacrum, penis head, lower abdomen, lower back;
- presence of blood in the urine and semen;
- swelling of the lower extremities;
- paraplegia (numbness of the lower extremities) in case of spinal cord compression;
- noticeable decrease in body weight, emaciation (cachexia);
- Anemia (decreased hemoglobin) and uremia.
Diagnosis
Diagnosis typically involves a digital rectal exam (DRE) followed by a blood test for prostate-specific antigen (PSA). Additional tests, such as imaging or a biopsy, may be needed for a definitive diagnosis.
Treatment Methods
- Active surveillance: For low-risk cases, regular monitoring without immediate treatment may be advised.
- Surgery: A prostatectomy involves the removal of the prostate gland and surrounding tissue.
- Radiation therapy: Both external beam radiation and brachytherapy utilize radiation to kill cancer cells.
Surgery as a Prostate Cancer Treatment Option
Surgery is one of the treatment options available for prostate cancer. This option is usually recommended when the tumor is localized and has not yet spread.
Prostatectomy, the surgical removal of the prostate gland, seminal vesicles, and part of the urethra, is the standard surgical procedure for prostate cancer. Surgeons can perform the procedure through traditional open surgery or using robotic-assisted laparoscopic techniques, such as the da Vinci Surgery. This robotic surgery offers many advantages over traditional laparoscopic surgery, including better urine and erectile control.
Surgical intervention is usually suitable for younger or healthier men with low-risk prostate cancer. However, each case is unique, and a combination of treatment options may be recommended by physicians based on various factors, including the stage of the cancer, the patient’s general health, and their preferences.
Radiation Therapy for Prostate Cancer
Radiation therapy is a commonly used treatment option for prostate cancer.
High-energy X-rays generated by a machine called a linear accelerator are used to kill cancer cells. This form of treatment can be used alone or in combination with other treatments such as hormonal therapy or brachytherapy.
Recent studies have confirmed that high-tech radiotherapy significantly improves treatment outcomes for patients with prostate cancer. For instance, a Swedish medical study showed that the combined treatment option of radiation and long-term hormone therapy reduced the risk of death.
Another study found that reducing the number of sessions needed to treat cancer from 20 to only two by blasting the prostate resulted in better treatment outcomes. This underscores the importance of considering radiation therapy as a viable option for managing prostate cancer.
Hormonal Therapy for Prostate Cancer
Hormonal therapy is a significant treatment option for prostate cancer that aims to lower the levels of the hormone testosterone in the body. This therapy is also known as androgen deprivation therapy (ADT), and its main objective is to stop or slow down the growth of prostate cancer cells.
Hormonal therapy can shrink the prostate and any cancer inside it, making it easier to treat. It is usually used in conjunction with other treatments because it doesn’t cure prostate cancer on its own.
Hormonal therapy has been shown to improve cure rates of prostate cancer for men receiving radiation therapy and is a part of the standard of care for men.
The FDA has approved several androgen receptor inhibitors for the treatment of prostate cancer, including enzalutamide, apalutamide, and darolutamide. It is essential to note that men who undergo hormonal therapy may experience side effects such as hot flashes, fatigue, weight gain, and loss of muscle mass.
Therefore, it is crucial to consult a healthcare professional to know the right treatment plan for prostate cancer.
Combined Treatment Approaches for Prostate Cancer
Combined treatment approaches for prostate cancer involve using two or more types of treatments to fight the cancer. This approach is often used for advanced stages of prostate cancer, where systemic treatment methods are preferred due to the inability to cure the disease.
The combination of surgery, radiation therapy, and hormonal therapy has been shown to be effective in controlling the spread of the cancer and improving survival rates. In addition to these conventional treatments, patients may also benefit from complementary therapies, such as nutrition and lifestyle changes, which can support the cancer treatment and improve the patient’s overall well-being.
It is important to work closely with a team of healthcare professionals to determine the best combination of treatments for each individual case of prostate cancer. The goal is to provide the most effective treatment options that also minimize potential side effects and optimize quality of life.
Nutrition and Lifestyle Changes to Support Prostate Cancer Treatment
It’s important for men with prostate cancer to understand the pivotal role of nutrition and lifestyle changes in supporting their treatment.
The adoption of a plant-based diet has been shown to significantly reduce the risk of dying from prostate cancer. Consuming foods rich in omega-3 fatty acids, such as salmon, can also reduce the risk of developing prostate tumors. Furthermore, there is evidence that specific nutrients, like pomegranate, may help treat prostate cancer when taken as supplements.
It’s crucial for men with prostate cancer to work with a nutritionist to ensure they are consuming meals that better support their nutritional needs.
Additionally, lifestyle changes, such as regular exercise and avoiding smoking, can further improve their overall health outcomes. By taking a comprehensive approach to their care, patients may increase their hopes of a longer lifespan and better quality of life.
Stages and Prognosis
The prognosis for prostate cancer varies depending on its stage and how early it is detected. Most cases diagnosed early have a favorable prognosis and can be successfully treated.
Stage 1
Prostate cancer in stage 1 is the earliest and most limited stage. The only area where the cancer has currently spread is to the prostate gland. It can be possible to find it through regular tests or by touching the development during a checkup. With a five-year survival rate near to 100%, the prognosis is often good at this point. The cancer can still be aggressive and require treatment, such as surgery or radiation therapy, despite its modest size and minimal metastasis. Particularly if their advanced age puts them at a higher risk, men must be aware of the signs and symptoms of prostate cancer and undergo routine examinations.
It is significant to remember that not all cases of prostate cancer exhibit symptoms; hence, routine tests are essential. Also, the likelihood of effective treatment and recovery can be considerably increased by early identification.
Stage 2
2A and 2B are the two stages of prostate cancer at stage 2. A PSA blood test result between medium and low indicates stage 2A prostate cancer, which is defined as cancer that has spread to one or both sides of the prostate gland. Prostate gland damage has not yet occurred due to the cancer, which is at stage 2B. A minimum Gleason score of 7 and a PSA level of 20 are required. Most men with stage 2 prostate cancer have 10 to 20 years to live and receive a curative therapy. 80% of cases of prostate cancer are discovered at stage 2, and the five-year relative survival rate is over 100%. Prostate cancer is staged based on how far it has spread. It is important to note that early detection and treatment of prostate cancer greatly increases the chances of survival. Therefore, regular screenings and check-ups are recommended for men over the age of 50.
Stage 3
Prostate cancer in stage 3 has spread outside of the prostate gland and is regarded as an advanced form of the condition. Depending on how far the particles are dispersed, stage 3 is further separated into stages IIIA, IIIB, and IIIC. Stage IIIB tumors have spread beyond the prostate gland and have affected nearby organs like the bladder or rectum. Stage IIIA refers to cancer on one or both sides of the prostate. The malignancy has progressed to the nearby lymph nodes, according to stage IIIC. Stage III patients, despite their old age, are still treatable and have access to a range of treatments, including as surgery and external beam radiation therapy. when the sickness hasn’t advanced very far.
Stage 4
Unfortunately, the majority of men with prostate cancer at stage 4 will not survive. The malignancy may, however, be treated or reduced, and advancements in science and healthcare have increased life expectancy by about 5–6 years. The 5-year survival rate for stage 4 prostate cancer varies from 29% to 31% depending on whether it has distant metastases or localized metastases. Although every case is different, the prognosis for prostate cancer in Stage 4 is frequently worse than in earlier stages. But, chances can be increased with early detection and the right care.
Prevention
While no guaranteed prevention methods exist, maintaining a healthy diet, staying physically active, and addressing risk factors such as smoking and obesity may lower the risk of developing prostate cancer. Regular screenings, especially for men over 50 or with a family history, can aid in early detection and treatment.
