Prostate cancer is the most common cancer in men in the UK, with more than 47,000 new cases annually, causing 11,000 deaths, making prostate cancer the second most common cause of death after lung cancer. Nevertheless, if prostate cancer is diagnosed at an early stage, the chances of survival are high.
What is the Prostate?
Only men have a prostate gland. The prostate is a small gland that is part of the male reproductive system. It is about the shape and size of a walnut and is situated just below the bladder, in front of the rectum and is surrounded by the urethra (the tube that carries out urine).
What are the Causes?
Although the origin of this type of cancer remains a mystery, experts recognise the influence of certain factors:
- Age: Undoubtedly the main cause. More the ¾ of prostate cancers are diagnosed in men over the age of 65.
- Genetics: Men, with direct relatives who are victims of prostate cancer, are more likely to be affected by the illness themselves.
- Diet: A diet containing too much fat can increase the risk of this type of cancer.
Screening for Prostate Cancer:
If detected at an early stage, 95% of prostate tumours can be cured, that is why screening is so important. However, the utility of screening remains controversial, both from a sociological and scientific point of view. The first step in detecting prostate cancer is a rectal examination, which is recommended once a year for men over 50 years old.
Unfortunately, most of the time rectal examinations are insufficient to diagnose all cancers. A PSA test (Prostate-Specific Antigen) can be carried out, to see if cancer cells exist in the prostate. This examination consists of a blood test that is used to measure PSA (a protein that increases in blood if touched by cancer). However, this examination is not 100% accurate and is not recommended by the National Cancer Institute.
For reliable results, it is necessary to complete a biopsy to confirm the cancerous character of the tumour.
Symptoms may Include:
- Frequent urination
- Difficulty starting or holding back urination
- Painful or burning sensation when urinating
- Blood in urine
- Difficulty having an erection
- Pain or stiffness in the lower back, hips, pelvis or thighs
Different types of therapeutic options exist to cure prostate cancer, depending on the stage of the cancer.
For younger patients, whose cancer is localised, a radical prostatectomy is recommended. This intervention is a heavy surgical solution which consists of removing the prostate and seminal vesicles. Undesirable effects, such as impotence or involuntary urination, may occur after this type of operation.
For older patients or those with other illnesses, external radiotherapy is recommended. This intervention consists of exposing the prostatic region of the body to irradiation, which can cause some negative effects (intestinal, urinary and sexual inflammations).
Brachytherapy, a form of radiotherapy may also be recommended. Treatment results demonstrate that the cancer cure rates of brachytherapy are comparable with those of chemotherapy and surgery.
There are 2 main forms of prostate brachytherapy treatment:
- Permanent seed implantations (Low-dose rate): Injection of approximately 100 radioactive seeds directly into the prostate gland. These seeds then slowly diffuse their radiation over several weeks or months. The seeds remain in the prostate after treatment has finished.
- High-dose rate (HDR) temporary brachytherapy: Placement of catheters (small tubes) into the prostate gland, which remain during the treatment period. A computer controls the injection of the high-dosed irradiated seed into the catheter, one by one. At the end of treatment, the tubes are removed easily, leaving no radioactive material in the body.
Chemotherapy is also used in the case of metastatic hormone-resistant cancers.
Prostate cancer usually develops slowly, therefore a monitoring phase can be proposed before treatment starts. Regular tests will be given to check whether the prostate cancer is growing or not.
Lastly, prostate cancer is a hormone-sensitive cancer, its development is stimulated by male hormones, such as testosterone. Therefore, hormone therapy is a treatment that is frequently used for high-risk prostate cancers in order to stop the development of the cancer.