Understanding Prostate Cancer: What Every Man Should Know

By: Sandeep Singh, MD

 

 What is prostate cancer?

Prostate cancer starts in a small gland called the prostate. This gland is part of the male body and helps make the fluid in semen. You can find the prostate just under the bladder.

Prostate cancer is one of the most common cancers in men. Most men who get this cancer catch it early and are cured. It often grows very slowly. Many men live a long time even if they have prostate cancer.

Signs and Symptoms:

In the early stages, prostate cancer usually does not cause any symptoms. That is why many men do not know they have it. But if signs do appear, they may include:

• Blood in your urine or semen
• Needing to pee more often
• Trouble starting to pee
• Waking up at night to pee

If the cancer spreads to other parts of the body, like bones or the back, you may notice:

• Back or bone pain
• Weak legs or arms
• Trouble getting an erection
• Feeling very tired
• Losing weight without trying
• Leaking urine by accident

 

When to See a Doctor

If you notice any of these signs, it is important to talk to a doctor. Even if the signs are small, it is better to get checked early.

 

What Causes It?

Doctors do not always know why prostate cancer happens. But some things can raise your chances:

• Getting older (most cases happen after age 50)
• Ethnic make-up (African American men have higher risk)
• Family history (if a close relative had it)
• DNA changes passed down in families (like BRCA1 or BRCA2 genes)
• Being overweight
• Smoking

 

Problems It Can Cause:

Prostate cancer can spread to other parts of the body. This makes it harder to treat. It can also lead to:

• Trouble controlling urine (incontinence)
• Problems with erections (erectile dysfunction)

 

Can You Prevent It?

There is no sure way to stop prostate cancer, but some things might help:

• Eat fruits and veggies like tomatoes, broccoli and soy
• Avoid too much red meat and fatty foods
• Exercise regularly
• Stay at a healthy weight
• Do not smoke

*Some men who are at high risk might take medicine to lower their chances, like finasteride or dutasteride. Talk to your doctor to see if this is right for you.

 

How It is Found:

Doctors usually start with a blood test called PSA and a physical check called a digital rectal exam. If these are not normal, you may need:

• MRI or ultrasound
• A biopsy (where they take a small piece of your prostate to test it)

 

PSA Test

This blood test checks for prostate-specific antigen. High levels can mean cancer, but also other things like infection. If the result is high, the test may be done again or followed by other exams.

 

MRI and Ultrasound

These imaging tests help show the size and shape of the prostate. If anything looks odd, your doctor may suggest a biopsy.

 

Biopsy

A biopsy is the only way to know for sure if you have cancer. A small needle removes tissue from your prostate, which is tested in a lab.

 

Understanding Your Cancer Type

Doctors give prostate cancer a Gleason score and grade group. This             shows how fast the cancer is growing:

• Scores go from six (slow growing) to ten (fast growing)
• Grade groups go from one to five

 

Biomarker Tests

These are special tests to look at cancer cells and help:

• Decide if you need a biopsy
• Decide if treatment should start now or later
• Find out which treatments may work best for you

 

Has It Spread?

Sometimes doctors need to see if the cancer has moved to bones or lymph nodes. They may use:

• Bone scans
• CT scans
• PET scans
• PSMA PET scans

 

Stages of Prostate Cancer

Cancer is grouped by stage:

• Stage 1: Small, only in the prostate
• Stage 2: Still in the prostate but growing
• Stage 3: Starting to move beyond the prostate
• Stage 4: Spread to lymph nodes or other parts like bones

 

What Are Your Chances?

If caught early, prostate cancer is very treatable. When the cancer is only in the prostate, nearly 100% of men live at least five more years. If it spreads, survival rates go down, but many men still live a long time.

 

Treatment Choices

You may not need treatment right away. Options include:

 

Active Surveillance

Doctors may simply watch the cancer closely with regular tests. This is common if the cancer is small and growing slowly.

 

Surgery

The prostate can be removed with surgery. This is often done if cancer has not spread. There are different types of surgery:

• Laparoscopic: small cuts and tools
• Robotic: surgery guided by robotic arms
• Open: one big cut in the belly

*Surgery can cause short-term issues like pain or infection. Long-term problems may include trouble with urine control and erections.

 

Radiation Therapy

This uses high-energy beams to kill cancer. It can be:

• External beam: a machine targets the prostate from outside
• Brachytherapy: tiny radioactive seeds are placed inside the prostate

*Radiation can also be used after surgery or for advanced cancer to ease symptoms like bone pain.

 

Ablation Therapy

This treatment freezes or heats cancer cells to kill them. It is not common but may help if surgery is not an option.

• Cryoablation: uses cold to freeze cancer
• HIFU: uses sound waves to heat and kill cancer cells

 

Hormone Therapy

This lowers or blocks testosterone, which helps prostate cancer grow. It can involve:

• Shots or pills
• Surgery to remove the testicles

*Side effects can include hot flashes, weight gain, loss of sex drive  and higher risks for heart problems.

 

Chemotherapy

Strong medicines are used when cancer has spread or hormone therapy is or is not working. Common drugs include docetaxel ™ and cabazitaxel ™. *Side effects may include tiredness, infections and numb fingers or
toes.

 

Targeted Therapy

These drugs attack specific parts of cancer cells. They work best if your cancer has certain gene changes. They come as pills and may cause nausea, fatigue or infections.

 

Immunotherapy

This boosts your immune system to fight cancer. Types include:

• Cell therapy (like Provenge™): uses your own immune cells
• Checkpoint inhibitors (like Keytruda™): remove the brakes from your immune system so it can fight cancer

*Only some prostate cancers respond to these treatments. Side effects            include rash, diarrhea and tiredness.

 

Radiopharmaceuticals

These medicines carry radiation straight to the cancer. Types include:

• Pluvicto™: sticks to prostate cancer cells anywhere in the body
• Xofigo™: targets cancer that has spread to bones

*These are used when the cancer has spread widely.

 

Get Expert Care for Prostate Cancer. If you think you may have prostate cancer or symptoms like frequent urination, back pain or blood in your urine, I am here to help.

As a hematologist and oncologist, I specialize in diagnosing and treating blood disorders and cancer.

To schedule an appointment with Dr. Sandeep Singh: Call: 601-518-7054

Your health is important. Let’s work together to manage it.