Prostate cancer or prostate carcinoma is a tumor disease of the male prostate gland. It is one of the most common cancers in men and can usually be treated well if detected early.
What is prostate cancer?
Schematic diagram showing the anatomy of a healthy prostate and an enlarged prostate. Click to enlarge. The prostate, also called the prostate gland, is a gland belonging to the male reproductive organs. It is about the size of a walnut and the shape of a chestnut and is located below the urinary bladder in front of the rectum. The prostate is largely made up of connective tissue and muscle and produces some of the fluid that is expelled during ejaculation. Prostate cancers mostly develop in the outer part of the gland and are considered the most common type of cancer in men. Prostate cancer usually occurs in older men after the age of seventy, but can also be diagnosed in younger men. However, enlargements of the prostate are not always prostate cancer – benign tumors and harmless inflammation of the prostate are also common.
Causes
Prostate cancer develops because of a combination of risk factors. One significant factor that can lead to this disease is heredity. If a family member has already had prostate cancer, the likelihood of developing prostate cancer oneself is increased about twofold. Another risk factor for prostate cancer is age. Men under the age of fifty are less likely to develop prostate cancer than men who have already passed this age limit. Diet and general lifestyle can also trigger the onset of prostate cancer. Men who eat a high-fat, low-fiber diet are more likely to be at risk than those who eat plenty of vegetables and fruits. This suggests that high body mass index is a particular risk factor of prostate cancer.
Symptoms, complaints, and signs
In most cases, there are no prominent symptoms at first. The first signs are usually noticed only when the tumor in the prostate (prostate gland) has reached a certain size. However, these are often not very characteristic. In advanced disease, problems with urination (voiding dysfunction) are most common, as the urethra is constricted by the tumor, blocking the flow of urine. This usually includes a delayed onset of urination, urinary retention (inability to urinate) or increased dripping. Often, residual urine remains in the bladder after micturition. This is accompanied by a general increased urge to urinate, which occurs mainly at night. Occasionally there are abnormalities in the urine stream. This may be very weak or frequently interrupted. In addition, erectile dysfunction, painful ejaculations and low seminal discharges may occur. If there is nerve damage, there is sometimes pain in the genital area. Some affected individuals have difficulty emptying their bowels. There may be visible blood in the urine or seminal fluid. In addition, a number of general symptoms of cancer may occur. These include fever, night sweats, poor performance, general fatigue and tiredness, weight loss or anemia. If metastases have already formed in the bones, there is severe pain in the lower back, pelvis or hips.
Diagnosis and progression
Prostate cancer is detected in many cases in the course of a screening examination, because in the early stages of the disease there is no pain and hardly any discomfort. Symptoms that may nevertheless indicate prostate cancer include problems with urination, disturbances in bowel emptying, unexplained weight loss, blood in the urine, and bone pain. However, symptoms of this type are usually only noticed when the prostate cancer has already metastasized. The most common examination of the prostate is the digital rectal examination – here the doctor palpates the prostate through the wall of the rectum and assesses the size, shape and condition of the prostate gland. The PSA test can also provide information about a prostate carcinoma, in which the release of the protein molecule of the prostate-specific antigen is monitored. Other diagnostic procedures include tissue sampling, ultrasound examinations and computer tomography.
Complications
Prostate cancer that is detected too late can significantly impair bladder function if it continues to progress. Possible complications include overactivity of the bladder with a constant urge to urinate, occasional involuntary loss of urine, or complete incontinence. If the tumor damages the nerves surrounding the prostate, erectile dysfunction occurs. In advanced stages, prostate cancer often forms daughter tumors (metastases) in lymph nodes and bones, especially in the pelvis, thighs, ribs, and back. Bone metastases are very painful and often result in bone fractures. Metastatic prostate cancer is usually treated with radiation therapy or chemotherapy, and possible side effects include inflammation of the bladder and rectum, nausea, vomiting, diarrhea, hair loss, and increased susceptibility to infection. Hormone therapy is often accompanied by a reduction in bone density, hot flashes and potency disorders, and in the long term the risk of metabolic disorders and cardiovascular disease increases. In the case of complete surgical removal of the prostate, a complication may be temporary or long-term urinary incontinence as well as a narrowing at the bladder outlet, making it difficult to urinate. Damage to certain nerve cords during surgery causes loss of erectile function. If prostate cancer is not treated or if treatment begins too late, daughter tumors can spread throughout the body and eventually cause the patient’s death.
When should you see a doctor?
Men who experience irregularities or changes in libido should get checked out. If there are abnormalities in going to the toilet, peculiarities in urination or a general feeling of discomfort, a doctor is needed. Swelling, a feeling of tightness in the abdomen or pain indicate a health impairment. A visit to the doctor is necessary as soon as the complaints persist or increase. Erectile dysfunction, pain during ejaculation, or a loss of urinary control should be investigated and treated. If pain spreads over the genital area into the back, there is an acute need for action. In these cases, the disease is already in an advanced stage. Since prostate cancer leads to premature death if left untreated, a check-up with a doctor is indicated at the first signs of the disease. In addition, men should always take part in regular cancer screening examinations to enable early detection of the disease. A decrease in body weight, fatigue, tiredness or rapid fatigue are signs of an existing disease. If there is a formation of unusual night sweats, reduced physical performance or bleeding, a doctor is needed. A pale complexion, internal weakness or listlessness are further indications of a health disorder. If discomfort with bowel movements occurs, a physician should be consulted as soon as possible.
Treatment and therapy
Prostate cancer can be treated in a variety of ways, and the therapy chosen depends on the stage of the disease, the age and general health of the individual, and the rate of growth of the tumor. Treatment may consist of one or more therapeutic approaches. One of the treatment methods for prostate cancer is radiation therapy, and there are two different types of this therapy. On the one hand, the patient can be irradiated from the outside and, on the other hand, radiation by means of radiation source implants can be used, in which the affected person is implanted with small radiation sources that act directly on the tissue of the prostate. Other methods used in the treatment of prostate cancer include hormone therapies in which the body is deprived of testosterone, surgery in which the carcinoma can be completely removed at an early stage, immunotherapies and chemotherapies. Treatment success is even more likely if the prostate cancer was detected early.
Prevention
Prostate cancer is a disease that can be prevented only to a limited extent. However, it is important to lead a healthy life with plenty of exercise and a healthy diet. One should also pay attention to a normal body weight and counteract if the body mass index is higher than 30.In addition, men should go for screening at the latest from the age of 50. Men who have had cases of prostate cancer in their family should start screening even earlier to have prostate cancer diagnosed at an early stage.
Follow-up
Once the treatment of the disease caused by prostate cancer is finished, it is usually not possible for the patient to live and organize normal everyday life afterwards. Physical and psychological impairments often place a great burden on the patient. Therefore, after the completion of the treatment of the patient’s prostate cancer, the follow-up care takes place. It begins about a quarter of a year after completion of treatment. The patient should be examined regularly by the treating urologist. This is the only way to detect the recurrence of the cancer in time to intervene early with appropriate treatment. During the follow-up examinations, the determination of the PSA value is of high importance. If this value is harmless, further examinations are unnecessary. In addition, it is necessary to recognize and treat the concomitant symptoms and side effects of the treatment during the follow-up. For example, there may be a risk of thrombosis or long-term defects in urination. Furthermore, psychological, physical and social problems are addressed and treated during aftercare. Aftercare treatments aim to accompany and support the patient as best as possible on the way back to normal life. If necessary, the patient is of working age, for whom optimal earning capacity should be restored.
Here’s what you can do yourself
Prostate cancer is a serious disease that must be treated by a medical team. Nevertheless, those affected can take some steps to lessen the signs of the disease and promote recovery. First, gentleness and rest apply. During or after treatment, the body is severely weakened and must not be subjected to stress, sports or strenuous physical work. A suitable diet and compliance with the suggested hygiene measures additionally support healing and prevent any complications such as chronic fatigue, bleeding or wound healing disorders. Patients should also go through the medications they are currently taking together with the doctor in charge. Certain preparations have a dehydrating effect or influence the bladder muscles and must therefore be avoided. Anyone who regularly takes diuretics, antidepressants, anti-allergics, Parkinson’s medications or antispasmodics should inform the doctor. The doctor can clarify the risks and point out possible alternatives. In consultation with the doctor, various homeopathic remedies can also be tried. These include pumpkin seeds, nettle root and sawtooth palm, as well as various extracts and ointments from medicinal herbs. If side effects occur after taking these preparations, the family doctor must be informed.
