The prostate is the gland of the male reproductive system. It’s about the size of a walnut, but it can grow larger as men age. It is located in front of the rectum, which surrounds the upper part of the urethra (a tube that carries urine and semen out of the body) just below the urinary bladder. The prostate gland produces some fluid that is a part of semen.

Prostate Cancer

Prostate cancer is mostly slow-growing. It can spread to other areas of the body, particularly the lymph nodes and bones. Initially, it may not cause any symptoms but in later stages, there may be a pain, difficulty in urination, blood in urine or pain in the pelvis or back.

Prostate cancer in men

Prostate cancer in men is the 3rd most common cancer in India. It is most commonly found in old age, men above 50 years. Some growth in the Prostate cells or tissues can be understood as Prostate cancer. But some of these are not cancer. They can be a benign growth called Benign Prostatic hyperplasia (BPH), Prostatic Intra epithelial Neoplasia (PIN).

Nearly all types of prostate cancer in men start in the gland cells that make the prostate fluid. These are called adenocarcinoma. Adenocarcinoma is the most common type of prostate cancer found in India. Other types of prostate cancer are also found, but are very rare.

Prostate cancer can spread all over the body, mainly or first to bones if not treated in the early stage. The first bone which metastasizes by Prostate cancer is the Spinal cord or backbone, then the pelvic bone.

Top 5 Reasons for Prostate Cancer in Men

There are many reasons or risk factors for prostate cancer in men. Many carcinogens or elements which can lead to cancer are present in the environment. The top 5 reasons for Prostate Cancer in Men are as follows: –

1. Age: –

Age is the most common risk factor of Prostate cancer in Men. Prostate cancer is uncommon in men younger than 40, but the chance of having Prostate Cancer rises rapidly after age 50. Because after 50 years of age, there is some interaction between prostatic hormones and some chemicals in the body, leading to higher chances of Prostatic cancer. About 6 in 10 cases of prostate cancer are found in men older than 65.

2. Genetic or Family History

Family history of prostate cancer is the 2nd most common reason. It is also called familial prostate cancer that runs in the family. It develops because of a combination of shared genes and environmental factors. If a father or brother is suffering from Prostate cancer in family then there would be more chances to develop this disease and chances of developing this cancer in men are higher in those whose brother is having prostate cancer than father with same disease. There are many genes involved in the inherited risk of Prostate cancer. Some gene mutations and genetic variations of Chromosomes also may carry a substantial risk for Prostate cancer.

Presence of following characteristics can be suspect to more chances of Familial Prostate cancer

• Three or more first-degree relatives with Prostate Cancer. If the Persons are related by blood. (Father / Brother)

• Two or more close relatives, such as a parent, sibling, child, grandparent, uncle, or nephew, on the same side of the family diagnosed with prostate cancer before age of 55.

3. Obesity

If Body mass Index (BMI) is more than 30 then it is called obesity (Normal BMI should be in range between 18.5 and 24.9). It is found that if an obese man is diagnosed with Prostate cancer, their prostate cancer is usually a more aggressive type than cancer in non obese man. High subcutaneous fat or belly fat or fat around the organs may increase the chance of fatal Prostate cancer. If man has excess body fat, it increases and changes metabolism, hormonal mediators and inflammatory environment that can lead to insulin resistance which further can lead to cancer of prostate in future.

4. Diet and lifestyle

It is also found that high fat diet also has main role to developing the disease in man called Prostate cancer. With a high-fat diet, men in metro cities like Delhi, Mumbai, Chennai, and Hyderabad tend to eat fewer fruits and vegetables. In the past, If we compare to western countries like the US or Europe, India had sporadic cases of prostate cancer because Indian diets were very healthy. But nowadays, as we Indians are following western food, the new possibilities of Prostate cancer are increasing in India. Apart from this, there is less knowledge or awareness among the people of rural areas. This disease is much more common in countries where meat and dairy products make up a lot of the diet than those where the essential diet consists of rice, soybean products, and vegetables. Alteration in lifestyle, skipping of meal, less Physical activity and increase the usage of machines in daily routine work may often lead to obesity.

5. Smoking

Smoking can cause every cell in the body negatively including prostate gland. Smoking may increase the risk of prostate cancer.

Effects of Prostate Cancer in Men

• Problem in urination – sometimes slow or weak urinating flow or having trouble starting the flow of urine or frequent urinating, especially at night.
• Presence of Blood in urine or semen.
• Having Pain or burning sensation during urination
• Erectile dysfunction- Men with Prostate cancer often have the disability of performing intercourse. They may have trouble with sexual functions.
• Pain in the hips, chest, arms, legs or other areas from cancer. Because bones are the first site to metastasize from Prostate cancer in Men.
• Weakness or numbness in the legs or feet.
• Loss of bladder and bowel control from cancer pressing on the spinal cord. Having trouble emptying the bladder.
• Shortness of breath, fast heartbeat or pale skin.

What we should do if we have these symptoms in our body, but we don’t find the reason? For this, there is a way of screening called Prostate cancer screening. It means we have to find out the reason for these symptoms before getting worse. We can get through it in two ways before it gets worse. First is a Simple Blood test – PSA (Prostate-Specific Antigen).
It is an antigen or chemical which is found in our blood. It remains the same in normal conditions, but it may rise with age and prostate cancer. So, men over 50 years of age should be given a PSA test once a year.

The second is Digital Rectal Examination, which your caretaker would do and correlate with your PSA report if any abnormality or changes are found during the rectal examination.
Prostate cancer Treatment

We can divide prostate cancer treatment into three divisions.
• Localized Prostate cancer in Men – Cancer still presents within the prostate limit.
• Locally Advanced Prostate Cancer in Men-This does not spread all over the body, but gets advanced just outside the prostate limit.
• Metastatic Prostate cancer in Men – Which has already spread to different parts or organs of the body.

Treatment of all these three stages is different.

If the diagnosis indicates low risk or localized prostate cancer, prostate cancer treatment may not be needed immediately. But the doctor may recommend active surveillance. This may include regular follow-up blood tests, Rectal examination and biopsy to keep track of cancer progression.

If you have cancer that is progressing or locally advanced, you may need surgery, radiation therapy or hormone therapy. Surgery may include radical Prostatectomy.

Radiation therapy may include brachytherapy, chemotherapy and external beam radiotherapy.
Hormone therapy may include treatment to stop your body from producing male hormones because cancer cells rely on them to help them grow.

Suppose metastatic Prostatic cancer has spread all over the body. Mainly it spread to bones. Firstly, it will apply to the backbone, followed by ribs, then arms, forearm, legs and feet. Sometimes patients come with complaints of pain in their bones, and doctors conclude that metastatic Prostatic cancer after checking all blood reports. However, it can be controlled in the initial stages. Many medications are available to control the initial phase, including External Beam Radiation Therapy (EBRT) with or without Hormonal therapy, and patients can get better lifestyle modification.

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