What is prostate cancer?

Prostate cancer is the most commonly diagnosed cancer in men. Each year almost 3300 Australian men die from prostate cancer and more than 21,000 new cases are diagnosed. It is the second leading cause of cancer death in men. 

Yet it is highly curable if discovered while still confined to the prostate gland. 

Most prostate cancers grow slowly and usually remain confined within the prostate gland where they cause minimal harm. This type may need minimal or no treatment other than close surveillance. 

However, some prostate cancers are aggressive and can spread quickly. Early detection has a much better chance of successful treatment.

What are the symptoms of prostate cancer?

In its early stages, prostate cancer causes no signs or symptoms. 

Symptoms from prostate cancer may show once it spreads to other parts of the body. Typically, it spread to the bone and causes bone pain. 

Symptoms such as slowing of the urinary stream, increased urinary frequency and walking up at night to urinate are common symptoms associated with ageing and benign prostate enlargement, and often are not related to the presence of prostate cancer. 

Who is more likely to have prostate cancer?

Men with relatives who have had prostate cancer are considered to be at higher risk. Having a father or brother with the disease doubles the risk for prostate cancer.

A man’s risk of developing prostate cancer rises steadily with each passing year, with >90% of all prostate cancers occur in those over the age of 50. However, when it occurs in younger men, it can be aggressive.

Men with high PSA levels at a young age are at higher risk of developing and dying from prostate cancer. 

In the United States, prostate cancer is more common in African Americans by more than double the rate in the general population, and it is less common in men of Asian and Hispanic descent.

How is prostate cancer diagnosed?

Screening or early detection of prostate cancer can be performed using the combination of a blood test for serum prostate specific antigen (PSA) and digital rectal examination (DRE). PSA is a protein produced by cells within the prostate. A DRE is a clinical examination performed by a doctor using a gloved finger placed into the rectum to palpate the surface of the prostate. PSA testing combined with DRE helps identify prostate cancers at their earliest stages.

Prostate cancer screen with PSA remains a controversial topic. You should discuss your situation, the benefits, and the risks of screening with your doctor. Together, you can decide whether prostate cancer screening is right for you.

If an abnormality is detected on a DRE or PSA test, your doctor may recommend tests to determine whether you have prostate cancer. These tests may involve an MRI scan of the prostate or biopsy of the prostate where a thin needle is inserted into the prostate gland to collect tissue for analysis.

What are the treatment options for prostate cancer?

There are many treatment options available for prostate cancer and the treatment is individualised depending on the aggressiveness of the cancer, the staging of the cancer and the general health of the individual. 

These options include and are not limited to: 

Active surveillance
For men diagnosed with low-risk prostate cancer, treatment may not be needed immediately. Some men may never need treatment if the prostate cancer remains low grade. For these men, monitoring of the prostate cancer will be carried out using regular PSA, MRI scans and sometimes biopsies. If the cancer has progressed, definitive curative prostate cancer treatment such as surgery or radiation can still be provided without missing the chance to cure.

Radiation therapy

External beam radiotherapy (EBRT) and brachytherapy (radioactive seeds placed into the prostate gland) are the two main types of radiotherapy used for prostate cancer. 

Hormone therapy
Prostate cancer cells need testosterone (male hormone) to grow. Without testosterone, cancer cells die or grow more slowly. Hormone therapy reduces the levels of testosterone in the body. This can be administered by injections administered every 3 months or permanent surgery to remove the testosterone-producing cells in the testicles. Hormone therapy is used in men with advanced prostate cancer to control cancer cells. In men with early-stage prostate cancer, hormone therapy may be used before radiation therapy. This increases the chances of successful radiation therapy.

Surgery to remove the prostate – Radical Prostatectomy
Surgery involves removing the prostate and seminal vesicles and then joining the bladder neck to the urethra. During the surgery, whenever possible the surgeon will attempt to preserve the nerves around the prostate gland in order to preserve erectile function. In patients with more aggressive prostate cancer, the nerves and surrounding tissues around the prostate gland may have to be removed to ensure complete removal of all cancer cells.

Robotic-Assisted Laparoscopic Radical Prostatectomy

Focal Therapy – Nanoknife

Disclaimer: The information on this website is provided for your general information and is not a substitute for the specific advice of your treating doctor.