What is Prostate Cancer?
The prostate is a gland, the size of a chestnut (although the size can vary according to age). The prostate is a male genital gland located in front of the rectum and under the bladder. It is involved in the ejaculation mechanism – although it does not affect the mechanisms of erection or libido. Its function is to secrete most of the fluid that is used to transport sperm. A physician will conduct a prostate exam by inserting a finger inside the rectum to check that the prostate is not enlarged, and to check for any abnormalities including hardness. There are no signs or symptoms in early stages of prostate cancer. If your doctor suspects prostate cancer from a routine investigation, then further test may be done including a blood test to record levels of prostate specific antigen. The PSA test can identify the presence of tumors that are not detected by digital rectal examination. High PSA levels can indicate cancer as it is a measure of the protein produced by normal as well as cancerous prostate cells.
Cells in the body regularly die and are replaced in a process of cell division. When normal cells are defected during division, they are turned into malignant cells. Cancer occurs when these malignant cells grow and eventually form a mass of tissue known as a tumor. Malignant cells grow much faster than healthy ones and can spread to surrounding tissue. Similarly, tumors can start in one organ, known as localized cancer, but then spread to surrounding organs. Doctors will also check to see if the tumor cells are being transported through the blood and lymph systems, otherwise known as metastases, to reach remote organs.
In North America, cancer of the prostate is the most frequently diagnosed cancer. It is the most common cancer in men, and counts for 1 in 3 of all male cancers. Prostate cancer can develop very slowly and have no symptoms in some cases. In other cases, it can quickly spread, invading surrounding tissue and forming metastases. If diagnosed early, there is a very high chance of recovery. If the cancer has spread beyond the prostate, it responds poorly to treatment. Regular screenings for men over 50 are essential, since the risk of prostate cancer increases with age.
How is Cancer of the Prostate Diagnosed?
The only way to confirm a diagnosis is by biopsy. If your doctor gives a definite diagnosis of prostate cancer, the next step is to determine the extent of the disease. This is done by classifying the cancer by clinical stage. If the tumor is confined to the prostate, it will be classified as a T-1 or T-2 localized prostate cancer. Advanced stages of will be categorized as stage T-3 or T-4. In Stage T-3, the tumor may have spread outside the prostate and has reached the seminal vesicles.
Your biopsy will prove the existence of prostate cancer, at which point your physician may order imaging studies including scans. One scan may be a bone scan to rule out the cancer spreading to the bone. Other imaging scans include CT scans or MRI’s, to detect cancer that has spread outside the prostate to other organs. Knowing the clinical stage of the disease will help determine which treatment option is best.
What Treatments Are Available?
There are prostate cancer treatment options available, including traditional ones like surgery or radiation. New, non-surgical and non-invasive treatments are gaining favor, including HIFU or High Intensity Focused Ultrasound. The benefits to treatments like HIFU is recovery is much quicker, cure rates are similar or better to other treatments, and there are fewer side effects. Discuss all your treatment options with your urologist.