What Are 2 Screenings Performed to Detect Prostate Cancer?

Prostate cancer is the uncontrolled (malignant) growth of the cells of the prostate gland. It is the second most common cancer, estimated to affect one in every eight men in the United States.

The prostate is a walnut-sized gland that surrounds the male urethra (the tube through which urine is voided).

The prostate gland is a part of the male reproductive system and is responsible for secreting various substances that form semen.

The most commonly seen symptoms of prostate cancer include:

• Difficulty or pain while passing urine
• Interrupted urine flow
• Urine urgency 
• Nocturia (increased urine frequency at night)
• A burning sensation during urinating
• Loss of bladder control
• Hematuria (blood in the urine)
• Hematospermia (blood in semen)
• Erectile dysfunction 
• Painful ejaculation
• Decreased ejaculate volume
• Bone pain
• Unexplained weight loss
• Loss of appetite
• Increased risk for fractures
• Back/pelvic/hip pain that does not go away
• Swelling in the legs
• Fatigue
• Weakness or dizziness
• Pale appearance
• Shortness of breath
• Palpitations

Although the exact cause of prostate cancer is unknown; however, researchers speculate the following reasons:

• Mutation (an abnormal change) in the genetic material in a cell in the prostate gland.
• The abnormal cell grows and produces more cells of its kind uncontrollably, forming cancer or a tumor.
• The consequent abnormal cells have an increased need for nutrients that deprive the healthy cells of nourishment causing metabolic starvation.

Certain factors that may increase the risk of prostate cancer include:

• Advancing age: 60 percent of prostate cancer cases are diagnosed in men who are 65 years or older.
• Genetics: Abnormal mutations in BRCA or BRCA2, CHECK2, RAD15, or ATM genes may increase the risk of prostate cancer.
• Family history: The risk is higher in men whose brothers and fathers may have prostate cancer.
• Ethnicity: African American and Caribbean men and men of African ancestry are more vulnerable to getting the disease.
• Smoking: Is directly linked to an increase in the risk of death from prostate cancer.
• Obesity: Obese men are at a higher risk of getting an aggressive form of prostate cancer.
• Diet: Men who consume dairy products and red meats in excess may have a higher risk of prostate cancer.
• Chemical exposure: Men frequently exposed to metal cadmium, such as welders, battery manufacturers, and rubber workers, are more vulnerable to prostate cancer.

Depending on the cells from which it arises, prostate cancer is categorized into the following five types:

1. Adenocarcinoma
2. Small cell carcinomas
3. Neuroendocrine tumors
4. Transitional cell carcinomas
5. Sarcomas

Prostate cancer can be categorized into the following four stages:

1. Stage I: The tumor involves one-half of the prostate.
2. Stage II: The tumor is localized to the prostate.
   • It can be further divided into three substages:
     • Stage II A: The tumor involves the half side of the prostate that has well-differentiated cancer cells.
     • Stage II B: The cancer cells are moderately differentiated.
     • Stage II C: The cancer cells are moderately or poorly differentiated.
3. Stage III: A high-grade locally advanced type of prostate cancer.
   • It can be classified into three substages:
     • Stage III A: Cancer has spread beyond the outer layer of the prostate into nearby tissues or the seminal vesicles.
     • Stage IIIB: The tumor has spread outside of the prostate gland and has invaded nearby structures including the bladder or rectum.
     • Stage IIIC: The cancer cells are poorly differentiated.
4. Stage IV: The tumor has spread beyond the prostate gland.
   • It can be further divided into two substages:
     • Stage IVA: The tumor has spread to the regional lymph nodes.
     • Stage IVB: Cancer has spread to distant lymph nodes or other parts of the body such as the bones.

Treatment of prostate cancer usually includes the following:

• Active surveillance: In cases of localized and slow-growing cancer, the doctor regularly conducts tests to check for the growth of cancer and initiates timely treatment if cancer turns aggressive. 
• Watchful waiting: Symptomatic treatment is provided without doing any tests. It is typically done in men who are expected to live for less than 10 years.
• Surgery: Involves the removal of the entire prostate gland, with or without the removal of the surrounding tissues.
• Radiation therapy: High-energy radiation is administered to destroy cancer cells.
• Chemotherapy: Cancer cells are killed using drugs.
• Hormone therapy: Involves medications to block the effect of androgens responsible for cancer growth.
• Targeted therapy: Cancer cells are targeted using medications without harming healthy cells.
• Biological therapy: The body’s immunity is used to kill cancer cells.
• Internal radiation therapy or brachytherapy: Small radioactive pellets are inserted into or near a prostate tumor.
• Cryotherapy: Little needles or probes are inserted into the prostate to inject extremely cold gasses that kill the cells.
• High-intensity focused ultrasound: Cancer cells are killed using high-energy sound waves.

The five-year survival rate for localized cancer that hasn’t spread outside of the prostate is 97 to 98 percent. However, if cancer has spread outside of the gland, the five-year survival rate drops significantly to about 33 percent.