Prostate cancer: Your need-to-know

Prostate cancer is the second most common cancer among men. A positive diagnosis can mean the patient needs to make significant lifestyle changes, but with early detection there is hope for a full recovery.

What is the prostate?

The prostate is a walnut-sized gland positioned below the bladder outlet, with the urethra (the tube that carries urine from the bladder) running through it. It secretes seminal fluid and is responsible for about 80% of the ejaculate volume.

Cancer risks

Dr Bradley Wood, a urologist at Life Fourways Hospital in Johannesburg, outlines the risks for developing prostate cancer:

  •  Genetic predisposition
  • Smoking
  • Obesity
  • Low testosterone levels
  • A diet high in fat
  • Ageing – but that doesn’t mean prostate cancer affects only older men

If detected early, there’s a 98% chance of survival beyond 5 years, while late detection statistically offers a 26% survival rate over the same period.

In terms of prevention, Dr Wood says that a healthy lifestyle is key. ‘Regular exercise and a balanced, low-fat diet of fresh fruit and vegetables contribute to lessening your chances of developing the disease,’ he says. ‘Increased intake of anthocyanins (red pigments) from foods such as tomatoes, berries and grapes also helps, and a Harvard study showed a marked reduction in prostate cancer in men who had more than 21 ejaculations per month.’

Prostate cancer signs

The proximity of the prostate gland to the bladder and urethra often means that cancer presents with urinary symptoms, especially in the early stages. Depending on its size and location, a tumour may inhibit the flow of urine. Other symptoms include:

  • Burning or pain during urination
  • Difficulty urinating, or trouble starting and stopping while urinating
  • More frequent urges to urinate at night
  • Loss of bladder control
  • Decreased flow or velocity of urine stream
  • Blood in the urine (hematuria)
  • Blood in semen
  • Erectile dysfunction
  • Painful ejaculation

Screening is key to early detection

Regular screening remains pivotal to early detection. ‘Early detection means Stage 1 disease or prostate cancer confined to the prostate,’ says Dr Wood.

  • Annual routine prostate-specific antigen (PSA) testing is recommended for men from age 40 onwards – and twice a year, beyond the age of 50.
  • Those at high risk (men with first-degree relatives who have been diagnosed with prostate cancer), require an annual digital rectal exam from the age of 40 – but in others, starting at age 50 should be fine.

Dr Wood says that the presence of symptoms is often too late a warning sign, as the cancer is often already relatively advanced by the time secondary symptoms like backache, blood in the urine or semen, or loss of weight present.

Treatment options vary

Medical interventions for prostate cancer are determined by the progress of the disease and whether it has spread or not. Prostate cancer is slow-growing and may not require surgery: options include active surveillance, prostatectomy, radiotherapy, hormone therapy and chemotherapy.

While a prostate cancer diagnosis is stressful, it’s not necessarily a death sentence. ‘Find a urologist with whom you’re comfortable, who can walk you through all the potential treatment options and the side effects of each,’ Dr Wood says. ‘It’s important to advise your male relatives that they should get screened, too.’

The information is shared on condition that readers will make their own determination, including seeking advice from a healthcare professional. E&OE.

References:

  • Adapted from Life Healthcare magazine (2019). Prostate Cancer is Not a Death Sentence by Crighton, T. p.52. Adapted with permission.
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