Prostate Cancer: Causes, Symptoms, Prognosis of Treatment

Prostate cancer is one of the most common male cancers. Why does it occur and what are its symptoms? Prevention and seeing a urologist is important, especially in men at a certain time of life.

The male reproductive system at a glance

The main function of the male reproductive system is spermatogenesis (the formation of sex cells sperm). The sexual organs of the male are divided into external and internal.

Internal anatomically include the testes, epididymis, seminiferous duct and unpaired prostate gland.

The prostate is a gland with a shape resembling a walnut. It is localized at the base of the pelvic cavity and its upper surface is adjacent to the bladder. 

The function of the prostate gland is to produce a cloudy secretion that combines with the sperm, the milky secretion, and together they form the fluid of the ejaculate - semen. The primary role of the prostate gland is to moisten the urethra for better sperm mobility.

With increasing age, the prostate gland gradually enlarges, which can cause problems with urination.  

Prostate cancer

Prostate cancer, adenocarcinoma, arises from the formation and growth of abnormal cells in the tissue of the prostate gland. The formation and subsequent proliferation of carcinogenic cells of the lining of the prostate gland occurs.

Due to the nature of the development of the disease, adenocarcinoma of the prostate is divided into non-aggressive (slow-growing) and aggressive (fast-growing) types.

In the non-aggressive type, the tumour occurs directly in the prostate and does not affect other surrounding structures. In most cases, the progression of the disease is slow.

Conversely, when aggressive, growth into nearby areas such as bone tissue or the liver organ can be expected.

The first stages of prostate cancer are mostly asymptomatic (without symptoms).

The first manifestations are usually felt only when the gland tumour presses on the bladder. Hyperplasia (enlargement) of the prostate gland occurs.

Learn more: Benign (non-cancerous) form of prostate enlargement

The characteristic symptoms of prostate cancer are mainly difficulty urinating, frequent urination, blood in the urine, pelvic pain and erectile dysfunction. The prognosis of the disease itself always depends on early diagnosis of the tumor.

The extent of prostate cancer is divided into four basic stages:

• Stage I: the tumour is palpably non-palpable, localised only in the prostate and may not cause the patient any health problems.
• Stage II: the tumor is localized in the prostate, as a rule, it is palpable through the anus. It is referred to as localized carcinoma.
• Stage III: the tumor grows through the prostate into the surrounding tissues. It is referred to as locally advanced carcinoma.
• Stage IV: the disease has spread to the lymph nodes and distant parts of the body. It is referred to as metastatic carcinoma.

The cause of prostate cancer is not clearly established. The main factor of occurrence is genetic predisposition. There is an increased risk for men with direct relatives of men with prostate cancer.

The second biggest risk factor is increasing age. Above the age of 45-50, the diagnosis of prostate cancer in men increases, with most patients diagnosed in their 70s.

Risk factors include hormonal imbalance and a possible disorder of the sex hormone testosterone, which can stimulate the development of prostate cancer.

Other hazardous factors include contact with certain chemicals such as mercury, cobalt, cadmium or radioactive material.

Excessive alcohol consumption, smoking, unhealthy diet and, last but not least, contracting sexually transmitted diseases are also risk factors.

Risk factors for prostate cancer:

• Genetic predisposition
• Advanced age
• Hormonal imbalance
• Alcohol consumption
• Smoking
• Sexually transmitted diseases
• Obesity
• High-fat diet

In many cases, the first stages of the disease are asymptomatic. They may be accidentally detected during a preventive check-up with a urologist or as a finding in the diagnosis and treatment of another disease of the excretory system.

The first symptoms tend to appear only when the prostate gland starts to press on the bladder.

The most common symptom is frequent urination and difficulty passing urine.

There is an increased urge to urinate, during which the man may experience pain/pressure or a change in the urine stream. In the case of advanced tumours, metastasis to nearby bone tissue may also occur, resulting in pain in the area.

Like other cancers, prostate cancer manifests with increased fatigue, malaise, weakness, lack of appetite and eventual weight loss.

It is recommended that men after the age of 40 undergo regular preventive checkups with a urologist.

The most common symptoms:

• Problems with urination
• Frequent urination
• Pain in the pelvic area
• Pain in the lumbar spine
• Erectile dysfunction
• Painful ejaculation
• Blood in the power
• Increased fatigue
• Lack of appetite
• General weakness

How to spot prostate cancer as early as possible and what are the treatment options? 

Early diagnosis plays an important role in terms of successful prognosis. This consists in a regular preventive examination by a urologist. The examination includes taking a urine sample, palpation examination through the anus and ultrasound of the excretory system.

In some cases, a CT (computed tomography) or MRI (magnetic resonance imaging) scan is indicated to get a better view of the soft structures of the area.

If the doctor suspects a prostate tumour, he or she may also take a sample directly from the prostate gland using a thin biopsy needle, called a biopsy. When the results of the biopsy are evaluated, the Gleason scale - a classification of the extent of prostate cancer cells - is determined.

In men over 40 years of age with a positive family history, a preventive PSA test is performed. In men over 50 years of age as a preventive measure.

The test can detect elevated levels of the prostate cancer-specific antigen PSA in the blood, and the higher the stage of the cancer, the higher the PSA levels.

However, in some cases, an elevated PSA antigen may not immediately indicate malignant disease of the foreskin. It may be a benign (non-cancerous) enlargement of the prostate gland - hyperplasia.

Prostate cancer treatment prognosis

The prognosis and success of prostate cancer treatment depends on the time and stage of diagnosis of the disease. Early diagnosis is an immense advantage.

In local findings where the carcinoma does not extend beyond the surrounding prostate structures, the prognosis is favourable in many cases.

A favourable prognosis means undergoing hormone therapy, radiotherapy or surgery that leads to the removal of abnormal prostate tissue cells.

The prognosis is worse in the advanced stage of the disease, where there is a high degree of malignancy and metastasis to surrounding structures. The aim of treatment is primarily to slow down the disease and eliminate unpleasant symptoms (pain, urinary problems...).

However, it is always individual according to the patient's state of health and the location and nature of the cancer.

Some studies show that most cases are curable if caught and treated early. Regular checkups are a major step towards successful treatment.

Learn more: Are tumour and cancer the same thing? 

Prevention of prostate cancer

As such, there is no prevention against the formation of abnormal carcinogenic cells. However, tumour formation is conditioned by a number of factors that can be influenced to some extent.

Although a man's increasing age and genetic susceptibility is not a controllable factor, it is advisable to have regular preventive checkups with a urologist to detect prostate cancer at an early, curable stage.

Influencing factors for prostate cancer include limiting alcohol consumption, stopping smoking tobacco products and also modifying an unhealthy diet.

As part of an appropriate diet, it is recommended to limit excessively high-fat foods containing saturated fat (red meat, highly processed foods, dairy products, fatty foods and dressings). It is advisable to limit the intake of simple sugars.

Avoid excessive supplementation of Omega-3 fatty acids, as they contain stearic acid, high intake of which, according to some studies, may potentially increase the risk of prostate cancer. This is despite their myriad health benefits.

Instead, eat vegetables (especially tomatoes, broccoli, cabbage, kale), fruits (especially berries and wild berries), non-fatty fish, lean meats, vegetable fats, legumes or soy.

Movember – Prostate Cancer Awareness Month

November is Prostate Cancer Awareness Month to educate men about the risks and prevention of prostate cancer. People use lectures, events and various walks to appeal for men to see a urologist for preventive check-ups.

It is known as Prostate Cancer Awareness Month - Movember.

Movember is a portmanteau of the Australian-English diminutive word for moustache, "mo", and "November". Men grow beards during this month, highlighting the importance of prevention. 

The main idea is early diagnosis of the disease through preventive screening and support for men with prostate cancer. The representative colour of Movember is blue, with the symbol being the moustache and the blue ribbon.