What Is the Main Cause of Prostate Cancer?

Prostate cancer may not cause any signs and symptoms in the early stages. Hence, men older than 50 years of age with or without other risk factors should consult a doctor to get screened for prostate cancer.

Prostate cancer can cause the following signs and symptoms in the later stages:

• Difficulty urinating
• Decreased force in the stream of urine or dribbling of urine
• Blood in the urine
• Blood in the semen
• Bone pain
• Loss of weight
• Erectile dysfunction
• Lower back pain

Many doctors recommend asymptomatic men older than 50 years of age, especially those with other risk factors, to get screened for prostate cancer routinely because there are often no symptoms in the early stages. The advantage of screening routinely is early detection of cancer and treatment with the possibility of complete cure.

Prostate screening tests might include:

• Digital rectal exam (DRE): This is part of a physical examination performed by a doctor on outpatient basis. The doctor, with gloves on, inserts a finger into the rectum to examine the prostate, feel the texture and assess the shape and size because the prostate is situated adjacent to the rectum. The doctor uses a numbing lubricant to reduce discomfort during examination.
• Prostate-specific antigen (PSA) test: This is a blood test performed to detect the levels of PSA, a substance that's naturally produced by the prostate gland. If the PSA level is higher than normal, it indicates prostate abnormalities. PSA levels are also increased in prostate infection or benign enlargement of the prostate. The PSA test is also done to monitor disease progression and response to treatment.

Diagnostic tests for prostate cancer:

If there are abnormal findings in screening tests, the doctor may advise the following diagnostic tests:

• Ultrasound: The doctor performs a trans-rectal (through the rectum) ultrasound by inserting a small probe into your rectum to study the prostate gland.
• Magnetic resonance imaging (MRI) scan
• Prostate biopsy: The doctor collects a small sample of the prostate tissue by inserting a thin needle into the prostate.
• Detecting the presence of metastasis with a bone scan, an ultrasound, a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan, and a positron emission tomography (PET) scan for the whole body.

Treatment options for prostate cancer depend on the aggressiveness of the tumor, whether it is metastasized, and overall health of the patient. Treatment may involve one or a combination multiple treatment modalities.

Treatment options include

• Observation and follow-up: Low-grade prostate cancer may not require immediate treatment. Hence, the doctor may recommend observation and regular follow-up. This may be an option for those who have a very small, slow-growing tumor confined to a small area in the prostate that is not causing any symptoms or for those with other serious medical conditions or very advanced age, making them medically unfit for other treatment options.
• Surgery: Surgery to remove the prostate is called prostatectomy, where the entire prostate gland is removed. Radical prostatectomy may be performed that involves removal of the prostate along with the surrounding tissues and lymph nodes. Surgery may be curative in most cases (if there is no metastasis) and may be combined with other treatments.
• Radiation therapy: Radiation therapy involves using high-powered energy to kill the cancer cells. It is a good option for treating cancer confined to the prostate.
• Cryotherapy: This involves freezing the prostate tissue using cold gas that can kill the cancer cells.
• Heating the prostate tissue: A high-intensity focused ultrasound (HIFU) uses concentrated heat generated by ultrasound energy causing cell death.
• Hormone therapy: This involves taking medications to stop the production of the male hormone, testosterone, or block the action of testosterone. Prostate cancer cells require testosterone to grow; hence, cutting off the supply of testosterone can cause the cancer cells to die and/or decrease the growth rate.
• Chemotherapy: Chemotherapy involves using medications to kill the cancer cells. It can also help kill the cancer cells that have metastasized.
• Immunotherapy: Immunotherapy modulates the body’s immune system to help fight cancer.
• Targeted drug therapy: It targets and blocks specific abnormalities present within the cancer cells, causing them to die.
• Pain management: Large prostate cancer and metastasis can cause significant pain for which the doctor would prescribe appropriate painkillers.