by Dr Akutu Munyika
What is prostate cancer?
Prostate cancer is cancer that occurs in a man’s prostate — a small walnut-shaped gland found deep inside the men’s pelvis. The purpose of the prostate is to produce fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of cancer in men. It usually grows slowly and initially remains confined to the prostate gland, but with time may spread to other parts of the body. If prostate cancer is detected early, while confined to the gland, the patient has a better chance of successful treatment.
How does it present?
In its early stages, it may cause no signs or symptoms. But in its advanced stages may cause the following:
– Trouble urinating
– Decreased force in the stream of urine
– Blood in the semen or urine
– Discomfort in the pelvic area
– Bone pain
– Erectile dysfunction
NB: If you are experiencing any of these symptoms, go and see your doctor immediately.
What are the causes of prostate cancer?
It is still not very clear what causes prostate cancer. It is only known that it begins when some cells in the prostate start to behave abnormally and become uncontrollable by the body signals. As a result, these cells start to multiply in an abnormal way and spread to other structures in the body.
Who is at risk for prostate cancer?
Older age. Your risk of prostate cancer increases as you age.
Being black. Black men have a greater risk of prostate cancer than do men of other races. Prostate cancer has been found to be more aggressive or advanced in black men than in men of other races. The reasons for this are not well known.
Family history of prostate or breast cancer. Men with a family history of prostate cancer or breast cancer have a higher risk of prostate cancer.
Obesity. Obese men diagnosed with prostate cancer may be more likely to have advanced disease that’s more difficult to treat.
What are the complications of prostate cancer?
Cancer that spreads (metastasizes). Prostate cancer can spread to other structures and organs in the body.
Incontinence. Prostate cancer and its treatment can cause urinary incontinence.
Erectile dysfunction. Prostate cancer or its treatment can also cause erectile dysfunction.
What about screening for prostate cancer?
It is generally recommended that men should get screened for prostate cancer when they are around the age of 50 years. This can be done sooner in those men who are at high risk of prostate cancer e.g. those with a family history of prostate cancer. It is advisable to discuss with your doctor the benefit of getting screened for prostate cancer.
Screening tests may include:
Digital rectal exam (DRE). During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which can be felt just adjacent to the rectum. If your doctor finds any abnormalities in the texture, shape or size of your gland, you may need more tests.
Prostate-specific antigen (PSA) test. A blood sample is drawn from you to test the PSA. PSA is a substance that’s naturally produced by your prostate gland. When it is abnormally high it may be an indication of prostate infection, inflammation, enlargement or cancer.
How is prostate cancer diagnosed?
If an abnormality is detected on a DRE or PSA test, your doctor may recommend tests to determine whether you have prostate cancer, such as:
Collecting a sample (biopsy) of prostate tissue. Prostate biopsy is often done using a thin needle that’s inserted through the rectum into the prostate to collect tissue. The tissue sample is analyzed in a lab to determine whether cancer cells are present
Ultrasound. Ultrasound is a machine that uses sound waves to make a picture of internal organs. This can be used to look at the size of the prostate and other internal organs.
What is the treatment for prostate cancer?
The treatment of prostate cancer will depend on how fast the cancer is growing, how much it has spread to other structures, and the overall health, as well as the benefits and the potential side effects of the treatment. Options may include:
Monitoring the patient, if detected early enough
Radiotherapy
Chemotherapy
Freezing prostate tissue
Surgery to remove the prostate
Use of some hormones to prevent the cancer from growing
Biological therapy that make use of adjusting the immune system cells to fight the cancer
* Dr Akutu Munyika is a specialist surgeon based in Ondangwa. He can be reached on mbwale@yahoo.com or 065 241113