Understanding prostate cancer
Prostate cancer is the most common cancer diagnosed in men, and the second-leading cause of cancer deaths in men, after lung cancer. The month of September has been designated as National Prostate Cancer Awareness Month to bring attention to this very common form of cancer that affects so many men.
The prostate is a gland in the male reproductive system located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds part of the urethra, the tube that empties urine from the bladder. The prostate gland produces fluid that makes up part of semen.
Prostate cancer is more common in older men. It is more likely to occur in men with a family history of prostate cancer and in men of African-American descent. Other risk factors include smoking, being overweight, and not getting enough exercise.
According to the Ministry of Health and Wellness, it is estimated that there were 1,561 new cases of prostate cancer in Jamaica in 2020. It is recommended that screening for prostate cancer start at age 40 years. Screening is available through Digital Rectal Examination (DRE) by clinicians at health facilities, as well as the Prostate Specific Antigen (PSA) test (a blood test that measures markers for disease of the prostate).
To perform a DRE, your doctor uses a gloved finger, inserted a few inches into your rectum to check your prostate gland. A prostate-specific antigen test is a blood test that measures the level of PSA in your blood. Many men who have prostate cancer have elevated levels of PSA. However, PSA can also be elevated for less serious causes such as prostate enlargement or infection.
Further testing is needed to diagnose cancer. Additional tests that your doctor may recommend to diagnose cancer include an ultrasound of the prostate and a biopsy of the prostate. A biopsy is when a small piece of the prostate is removed to look for abnormal cells.
Treatment of prostate cancer depends on many factors, including your age, your overall health and the growth and spread of the cancer when it is diagnosed. Some men who have slow-growing tumours may not need treatment right away and some may never need treatment.
Common treatment options include watchful waiting or expectant management (regular testing and check-ups to assess for new signs or symptoms), radiation therapy (high-energy X-rays used to kill cancer cells), chemotherapy, surgery (having the prostate gland removed) and hormone therapy.
SIGNS AND SYMPTOMS:
It is important to note that prostate cancer does not usually have any signs when it is in its early stages. A man can have prostate cancer and experience absolutely no symptoms until the cancer is advanced; at that stage it is no longer readily curable.
Symptoms for locally advanced prostate cancer
- Long time to initiate urinating
- Frequent urination
- Painful urination
- Interrupted urinary flow or weak urine stream (it comes in trickles; doesn’t flow continuously)
- Incomplete empty or double voiding (after urination, he may have the sensation that his bladder is still not empty and the need to urinate immediately after doing so)
– Sudden urgency to pass urine
– Blood in the urine
– Blood in the semen
– And in advanced cases, acute urinary retention (stoppage of water)
WHAT ARE THE TREATMENT OPTIONS FOR PROSTATE CANCER?
The treatment options are dependent on:
• The stage of the disease
• Extent of spread of the disease
• The age of the patient
• Patient’s preferences
• Availability of the treatment
• The presence of comorbidities (pre-existing conditions that may also need treatment) that could determine that patient’s life expectancy.
TREATMENT OF PROSTATE CANCER
The three most common treatment options for prostate cancer detected by screening are:
• Surgery (surgical removal of the prostate gland)
• Active surveillance (regular prostate specific antigen test monitoring)
In some situations where the risks of treatment may outweigh the benefits of treatment, watchful
waiting is employed. In watchful waiting, for example, in frail older men whose life expectancy is
shorter, symptoms and signs are observed as they progress and this guides treatment options.
SOURCE: Jamaica Cancer Society; Ministry of Health and Wellness. Learn more at: https://ncdip.moh.gov.jm