Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.
Causes
- Age
The risk of prostate cancer rises with age, from about 50 years
- Ethnic group
It is more common among men of African-Caribbean and African descent.
- Family history
Having a close male relative who had prostate cancer increases the risk of developing prostate cancer.
- Diet
Diet high in calcium is linked to an increased risk of developing prostate cancer.
Symptoms and signs
- Blood in semen
- Bone and back pain
- Haematuria
- Hard and bumpy gland
- Hesitancy
- Incomplete voiding
- loss of appetite
- Nocturia
- Pain in the testicles
- Straining
- Unexplained weight loss
- Urgency
- Weak flow
Investigations
- Prostate-specific antigen (PSA) testing
- Digital rectal examination
- Transrectal ultrasound-guided biopsy (TRUS)
- Gleason score of 7 -moderate chance of the cancer spreading
- Gleason score of 8 or above -significant chance of spreading cancer
- MRI (Magnetic resonance imaging)
- CT (computed tomography scan)
- Isotope bone scan
Stages of Prostate Cancer
| AJCC Stage | Stage grouping | Stage description |
| I | cT1, N0, M0Grade Group 1 (Gleason score 6 or less)PSA less than 10 | The doctor can’t feel the tumour or see it with an imaging test such as transrectal ultrasound (it was either found during transurethral resection of the prostate (TURP) or was diagnosed by needle biopsy done for a high PSA) [cT1]. Cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1, and the PSA level is less than 10. |
| OR | ||
| cT2a, N0, M0Grade Group 1 (Gleason score 6 or less) PSA less than 10 | The tumour can be felt by digital rectal exam or seen with imaging such as transrectal ultrasound and is in one half or less of only one side (left or right) of the prostate [cT2a]. Cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1, and the PSA level is less than 10. | |
| OR | ||
| pT2, N0, M0Grade Group 1 (Gleason score 6 or less)PSA less than 10 | The prostate has been removed with surgery, and the tumour was still only in the prostate [pT2]. Cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1, and the PSA level is less than 10. | |
| II A | cT1, N0, M0Grade Group 1 (Gleason score 6 or less)PSA at least 10 but less than 20 | The doctor can’t feel the tumour or see it with imaging such as transrectal ultrasound (it was either found during transurethral resection of the prostate (TURP) or was diagnosed by needle biopsy done for a high PSA level) [cT1]. Cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1. The PSA level is at least 10 but less than 20. |
| OR | ||
| cT2a or pT2, N0, M0Grade Group 1 (Gleason score 6 or less)PSA at least 10 but less than 20 | The tumour can be felt by digital rectal exam or seen with imaging such as transrectal ultrasound and is in one half or less of only one side (left or right) of the prostate [cT2a]. OR the prostate has been removed with surgery, and the tumour was still only in the prostate [pT2]. Cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1. The PSA level is at least 10 but less than 20. | |
| OR | ||
| cT2b or cT2c, N0, M0Grade Group 1 (Gleason score 6 or less)PSA less than 20 | The tumour can be felt by digital rectal exam or seen with imaging such as transrectal ultrasound. It is in more than half of one side of the prostate [cT2b] or it is on both sides of the prostate [cT2c]. Cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1. The PSA level is less than 20. | |
| II B | T1 or T2, N0, M0Grade Group 2 (Gleason score 3+4=7)PSA less than 20 | Cancer has not yet spread outside the prostate. It might (or might not) be felt by digital rectal exam or seen with imaging such as transrectal ultrasound [T1 or T2]. Cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 2. The PSA level is less than 20. |
| II C | T1 or T2, N0, M0Grade Group 3 or 4 (Gleason score 4+3=7 or 8)PSA less than 20 | Cancer has not yet spread outside the prostate. It might (or might not) be felt by digital rectal exam or seen with imaging such as transrectal ultrasound [T1 or T2]. Cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 3 or 4. The PSA level is less than 20. |
| IIIA | T1 or T2, N0, M0Grade Group 1 to 4 (Gleason score 8 or less)PSA at least 20 | Cancer has not yet spread outside the prostate. It might (or might not) be felt by digital rectal exam or seen with imaging such as transrectal ultrasound [T1 or T2]. Cancer has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1 to 4. The PSA level is at least 20. |
| IIIB | T3 or T4, N0, M0Grade Group 1 to 4 (Gleason score 8 or less)Any PSA | Cancer has grown outside the prostate and might have spread to the seminal vesicles [T3], or it has spread into other tissues next to the prostate, such as the urethral sphincter (the muscle that helps control urination), rectum, bladder, and/or the wall of the pelvis [T4]. It has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 1 to 4, and the PSA can be of any value. |
| III C | Any T, N0, M0Grade Group 5 (Gleason score 9 or 10)Any PSA | Cancer might or might not be growing outside the prostate and into nearby tissues [any T]. It has not spread to nearby lymph nodes [N0] or elsewhere in the body [M0]. The Grade Group is 5. The PSA can be of any value. |
| IV A | Any T, N1, M0Any Grade GroupAny PSA | The tumour might or might not be growing into tissues near the prostate [any T]. Cancer has spread to nearby lymph nodes [N1] but has not spread elsewhere in the body [M0]. The Grade Group can be any value, and the PSA can be any value. |
| IV B | Any T, any N, M1Any Grade GroupAny PSA | Cancer might or might not be growing into tissues near the prostate [any T] and might or might not have spread to nearby lymph nodes [any N]. It has spread to other parts of the body, such as distant lymph nodes, bones, or other organs [M1]. The Grade Group can be any value, and the PSA can be any value. |
Treatment
- Surgery
Radical prostatectomy. It can also be done with robotic surgery.
- Radiation therapy
External beam radiation therapy uses high-powered x-rays pointed at the prostate gland.
- Proton therapy
- Hormone therapy
Complications
- Metastasis to bones or other organs
- Erectile dysfunction
Prevention
- Diet
- Vegetarian
- Low-fat(high in omega-3 fatty acids)
- Contain lycopene (tomatoes and other red fruit) and selenium( brazil nuts)
- Regular exercise reduces the risk of prostate cancer