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Prostate Cancer: Causes, Symptoms and Treatment

Prostate cancer is a malignant disease of the prostate gland and the most common cancer in men. Early detection and modern therapies significantly improve treatment outcomes.

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Things worth knowing about "Prostate Cancer"

Prostate cancer is a malignant disease of the prostate gland and the most common cancer in men. Early detection and modern therapies significantly improve treatment outcomes.

What Is Prostate Cancer?

Prostate cancer (medically known as prostatic carcinoma) is a malignant tumor arising from the prostate gland, a small gland in the male reproductive system. The prostate is located below the bladder and surrounds the urethra. It produces part of the seminal fluid. Prostate cancer is the most common cancer in men in many countries worldwide. In most cases it grows slowly and remains confined to the prostate initially, but in advanced stages it can spread to surrounding tissues or other organs.

Causes and Risk Factors

The exact cause of prostate cancer has not yet been fully clarified. However, several risk factors are known to increase the likelihood of developing the disease:

Age: The risk increases significantly from the age of 50 onwards. Most diagnoses are made in men over 65.
Family history: Men with a father or brother who had prostate cancer are at increased risk.
Ethnicity: Men of African descent develop the disease more frequently and often more aggressively.
Diet: A high-fat, low-fiber diet may increase the risk.
Hormonal factors: Male sex hormones (androgens), particularly testosterone, promote the growth of prostate cancer cells.

Symptoms

Prostate cancer often causes no symptoms in its early stages. As the tumor grows, the following symptoms may occur:

Frequent urge to urinate, especially at night
Weak or interrupted urine flow
Burning or pain during urination
Blood in the urine (hematuria) or semen
Erectile dysfunction
Pain in the pelvis, back, or hips (in advanced disease)

These symptoms can also occur in other, non-cancerous prostate conditions such as benign prostatic hyperplasia (BPH). A medical evaluation is strongly recommended if any of these symptoms arise.

Diagnosis

Several methods are available for early detection and diagnosis of prostate cancer:

PSA Test

The PSA test (prostate-specific antigen) is a blood test that measures the level of a protein produced by the prostate. An elevated PSA level may indicate prostate cancer, but it does not necessarily confirm it.

Digital Rectal Examination (DRE)

During this examination, the physician palpates the prostate through the rectum to detect hardening or irregularities.

Biopsy

The only definitive method to confirm a diagnosis is a prostate biopsy, in which small tissue samples are taken from the prostate under ultrasound guidance and examined in a laboratory. The Gleason score is used to evaluate the aggressiveness of the tumor.

Imaging Procedures

MRI (magnetic resonance imaging), CT (computed tomography), and bone scintigraphy are used to assess the extent of the tumor and detect potential spread.

Treatment

Treatment depends on the stage of cancer, the age of the patient, and the overall health condition. The following treatment options are available:

Active Surveillance

For slow-growing, locally confined tumors, close monitoring without immediate treatment may be an option. Regular PSA measurements and repeat biopsies are carried out.

Surgery

Radical prostatectomy involves the surgical removal of the entire prostate gland. It can be performed as open surgery or minimally invasively (laparoscopic or robot-assisted).

Radiation Therapy

The tumor is destroyed using targeted radiation. Options include external percutaneous radiation and brachytherapy, where radioactive seeds are implanted directly into the prostate.

Hormone Therapy

Since prostate cancer growth is driven by testosterone, androgen deprivation therapy (ADT) can inhibit tumor growth. This is achieved through medications or surgical removal of the testes.

Chemotherapy

In advanced, castration-resistant prostate cancer, chemotherapy agents such as docetaxel are used.

Newer Therapies

Modern treatment approaches include immunotherapy, targeted therapies (PARP inhibitors for specific genetic mutations), and PSMA therapy (Lutetium-177-PSMA), which delivers radioactive substances directly to cancer cells.

Prevention and Early Detection

Men aged 45 and older (or 40 and older with a family history) are recommended to have regular prostate screenings. These typically include a physical examination and a digital rectal exam. The PSA test can also be requested and discussed with a physician. Early diagnosis significantly improves the chances of successful treatment and long-term survival.

References

European Association of Urology (EAU) - EAU Guidelines on Prostate Cancer (2023). Available at: https://www.uroweb.org
World Health Organization (WHO) - Cancer Fact Sheet: Prostate Cancer. Available at: https://www.who.int
National Cancer Institute (NCI) - Prostate Cancer Treatment (PDQ). Available at: https://www.cancer.gov

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