What is Prostate Cancer?
Like other cancers, prostate cancer occurs when abnormal cells mutate and subsequently multiply uncontrollably and more rapidly than normal cells do. These abnormal cells will deprive healthy cells of nutrients and oxygen, causing healthy cells to die. If left uncontrolled, the cancer cells may eventually travel to other parts of the body like the bones or other organs and start to grow there as well.
Prostate cancer occurs in the prostate gland. The prostate gland is a walnut-sized organ beneath the urinary bladder that is responsible for producing semen and helps regulate urine flow. Most prostate cancers start in the outer gland cells of the prostate; these are called adenocarcinomas.
In Malaysia, prostate cancer is the 4th most common form of cancer. It generally affects people above the age of 50, and those with a family history of prostate cancer. While common, it is still treatable in its early stages.
It is important to learn about prostate cancer and its warning signs, as early detection can lead to immediate treatment that can save lives.
Stages of Prostate Cancer
There are four stages to prostate cancer. Depending on the stage, doctors will need to formulate different treatment plans to effectively treat the cancer.
Do note that this is a summary of the four stages of cancer to help you understand how it changes and affects you or your loved one.
- Stage I: This is when the cancer is considered to be in its early stages. Patients may not be able to detect symptoms as the tumour cannot be felt. The cancer cells are well-differentiated and are indistinguishable from normal, healthy cells.
- Stage II: At this point, the cancer is growing slowly and can only be found in the prostate. The tumour may be small, but there is still a risk of growing and spreading outside of the prostate gland.
- Stage III: The tumour is growing rapidly and is likely to grow, spread, and develop in other parts of your body.
- Stage IV: At this stage, the cancer cells have spread beyond the prostate and into other parts of the body; this is also known as advanced, or metastatic, prostate cancer.
There is also the possibility of the cancer recurring after treatment, either in the prostate gland or affecting another part of the body.
Prostate cancer does share some symptoms with other medical issues, such as those that cause the prostate to become enlarged. The similarities of symptoms between prostate cancer and these conditions can be rather confusing at first, but we will provide additional information to help you be informed.
Because of how benign the tumour starts out, it will take time before it grows to a size that causes pain when it pushes against whatever is in its way.
Early detection is thus the key factor in determining if it is indeed prostate cancer. However, if you do experience any of the following warning signs, be sure to take notes of how you feel and how it may have changed before you see a doctor for a diagnosis.
The prostate gland will slowly grow in size as a person ages. The gland itself is located just at the base of the bladder, surrounding the first part of the tube that carries urine from the bladder to the penis. This tube is called the urethra, which also carries semen, the fluid containing sperm.
When the cancerous tumour in the prostate gland grows in size, it may begin to press on the urethra or even the bladder. You may find yourself having to urinate more often than usual, especially at night. Urinary incontinence could be a major inconvenience to your daily activities, and it could even affect your emotional state, such as how others will perceive your constant need to use the washroom.
Because of how the tumour can grow as the cancer advances, the tumour may eventually begin to compress the urethra. This may first present itself as a slow, interrupted flow of urine or semen (during sexual activity). Over time, it could eventually lead to the retention of urine or semen in the urethra, which can cause long term issues if left untreated.
In some instances, this difficulty can potentially lead to the sudden onset of erectile dysfunction, even if you have had no prior complications.
Pain During Urination/Ejaculation
In the event of difficulties in urinating or ejaculating, there is the inherent danger of the tumour growing to such an extent that it blocks off the urethra almost entirely, which can lead to retention, blockage or other urinary problems.
You may thus experience pain when urinating or ejaculating. Depending on the severity of your condition, you may experience mild to significant pain every time you urinate/ejaculate. The pain may either subside quickly once you are done, or may persist some time after.
As this is a possible sign of advanced prostate cancer, you should seek immediate medical attention if this symptom occurs.
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Blood in Urine/Semen
Hematuria usually occurs when there may be complications in the urinary system, including your kidneys since the kidneys produce urine. You may find your urine is a pink, red, brownish-red, or tea-like colour; this is known as gross hematuria. In other cases, you may not see any blood in your urine, but your lab results may show that it is present; this is called microscopic hematuria.
Meanwhile, hematospermia could be caused by something affecting the tubes that distribute semen from the testicles, called the seminal vesicles, or the prostate gland; one such cause could be inflammation of either organ.
Frequent Lower Back/Pelvic Pain
Advanced prostate cancer can spread to other parts of your body, including your bones. This usually affects the bones and lymph nodes. Cancer cells may break away from the tumour and spread to other parts of the body via blood or lymph vessels, attaching themselves to whatever tissue they can find. However, some cancer cells may become inactive and will lie dormant for years, or even cause a recurrence of cancer.
If you begin to exhibit back or pelvic pains without warning, it may be a possibility of advanced prostate cancer. Other risks may also include low-impact fractures not caused by physical trauma, or even very minor trauma like an accidental bump into a hard surface.
The Importance of Early Screening
As mentioned earlier, prostate cancer symptoms may not necessarily be a sign that you or your loved one have prostate cancer. Other prostate problems include:
- Benign prostatic hyperplasia (BPH): non-cancerous, abnormal cell growth in the prostate gland, which causes it to become enlarged.
- Prostatitis: inflammation of the prostate gland possibly due to bacterial infection.
Some symptoms due to these conditions also include difficulty urinating or ejaculating, pain during urination or ejaculation, and pain in the lower back or pelvis.
Having either one of these conditions does not increase your risk of getting cancer, nor is it a risk indicator of cancer.
To determine if it really is prostate cancer, you or your loved one will need to undergo a prostate screening. There are two types of tests that are commonly performed.
Digital Rectal Exam (DRE)
This test is a simple check by your doctor to determine the size, firmness and texture of your prostate. Using a gloved, lubricated finger, the doctor will feel the prostate via the rectum. The test aims to look for any hard areas, lumps or growths that may have spread beyond the prostate. If you or your loved one feels any pain while the doctor is performing the check, inform them as well.
PSA (Prostate-Specific Antigen) Test
The DRE may not be able to check your prostate thoroughly, so a PSA test may be done after the DRE is complete. This blood test measures PSA levels in your body; these PSAs are proteins made by both normal and cancerous prostate cells. PSA is normally secreted into ducts within the prostate, but can also leak into the blood. Because these levels are not fixed, it is common for your doctor to use results from more than one blood test, over time, as a basis of your diagnosis.
In prostate cancer, more PSA is found in the blood than normal. Be warned, though, that a high PSA blood level is not proof of cancer, as there are other factors that could cause a false-positive test result.
Another test used in conjunction with the PSA test is the free PSA test. ‘Free PSA’ refers to PSA that is not bound to any proteins in your body; the standard PSA test includes both free PSA and PSA bound/attached to other proteins.
Prevention is always better than cure, as the saying goes. Be sure that you or your loved one gets an early screening to help you treat the cancer before it becomes serious.
Quality Cancer Care At Home
If you prefer to consult a medical professional in the privacy of your home, consider engaging at-home nursing care services like Homage. Our trained care professionals are equipped to provide care for you or your loved ones at any stage of cancer — companionship for activities of daily living, nursing care, night caregiving, home therapy and more.
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