What Are the Symptoms of Prostate Cancer? Stages and Treatment

The prostate gland is an organ of the male reproductive system, located just below the bladder, with its base in contact with the bladder, and has a pyramidal structure. The prostate surrounds the prostatic urethra, which is the channel responsible for the flow of urine from the bladder. In males who have not yet reached puberty, the prostate weighs about 2 grams, but it grows with age, reaching up to 20 grams in adult males before the age of 52. The prostate is a gland that plays a significant role in male fertility. Its primary function is to produce the fluid that nourishes sperm and ensures their protection within the seminal fluid. Prostate cancer is the uncontrolled division, proliferation, and growth of cells within the prostate gland, leading to cancer. Since prostate cancer often does not show symptoms in its early stages, diagnosis can be delayed, increasing the likelihood of metastasis.

What is Prostate Cancer?

What Are the Symptoms of Prostate Cancer?

Symptoms of prostate cancer usually appear in the later stages of the disease. The symptoms of prostate cancer include:

• A frequent urge to urinate but being unable to do so,
• Decreased urine output and pain during urination,
• Reduced urinary flow rate,
• Presence of blood in the urine,
• Urinary incontinence, especially at night,
• Pain or burning sensation during ejaculation,
• Sperm being mixed with blood upon ejaculation,
• Widespread muscle and bone pain throughout the body,
• Decreased appetite and weight loss,
• Chronic fatigue,
• Unexplained nausea and similar gastrointestinal complaints.

What Causes Prostate Cancer?

The exact causes of prostate cancer are still not fully understood. However, certain risk factors have been identified that may trigger the disease. Factors known to influence the development of prostate cancer include:

• Older Age: The incidence of prostate cancer is known to increase with advancing age.
• Race and Ethnicity: Studies conducted on African American men suggest that racial differences play a significant role in both the development and mortality rates of prostate cancer.
• Genetic Factors: Individuals with family members who have prostate cancer are known to have a higher risk of developing the disease. It has been found that those with a family history of prostate cancer have a 50% higher risk of developing the disease compared to those without such a history.
• Hormonal Changes: Abnormal changes in hormones, particularly glucocorticoids and sex steroids, may trigger the development of prostate cancer. Many studies have demonstrated a link between hormonal signaling disruptions and cancer.
• Infection and Inflammation: Inflammation of the prostate gland is one of the known factors contributing to the development of prostate cancer. Chronic infections, in particular, have been associated with prostate cancer.
• Obesity: Obesity plays an important role in the development of prostate cancer. It causes imbalances in insulin levels, disruptions in inflammatory cytokine signaling, and increases in oxidative stress, making it a significant risk factor for prostate cancer.

Stages of Prostate Cancer

The classification of cancers based on characteristics such as whether they remain localized within the organ, metastasize to lymph organs, or spread to distant sites is known as staging. Accurate staging is essential for determining and implementing appropriate treatment for prostate cancer. Staging is typically performed using imaging techniques. Parameters used in staging include the Gleason score and prostate-specific antigen (PSA) levels. PSA is an enzyme produced in the prostate, and measuring its level is utilized in both diagnosis and staging. The Gleason score indicates the aggressiveness of the cancer, with the most aggressive and metastatic cancers scored as 10, while the least aggressive tumors are scored as 2. Prostate cancer is divided into four stages, which are as follows:

• Stage 1: In this stage, the tumor is located on one side of the prostate. Cancer cells typically multiply slowly. PSA levels have not yet significantly increased, and there is no evidence of metastasis to lymph nodes or other systems.
• Stage 2: The cancer has not metastasized to other tissues or organs. Cancer cells are only found in the prostate gland. The cancer may be present on one or both sides of the prostate. The Gleason score ranges from 6 to 7, and PSA levels are below 20.
• Stage 3: In this stage, the cancer shows signs of spreading. There is a significant increase in the rate of growth and proliferation. PSA levels have risen above 20, and the Gleason score ranges from 8 to 10.
• Stage 4: In this stage, the cancer has spread to the lymphatic system and is rapidly metastasizing. The cancer has metastasized to both nearby and distant tissues and organs.

How is Prostate Cancer Diagnosed?

The diagnosis of prostate cancer involves the use of both imaging methods and invasive techniques. The methods used for diagnosing prostate cancer include:

• Measurement of PSA (Prostate-Specific Antigen) Levels: PSA is a glycoprotein enzyme specific to the prostate gland. In prostate cancer, PSA levels in the blood are generally elevated.
• Digital Rectal Examination (DRE): A rectal examination provides information about the volume, shape, and hardness of the prostate.
• Biopsy: Prostate biopsies are performed using ultrasound tools and biopsy needles. This procedure is usually done under local anesthesia and does not require hospitalization.
• Transrectal Ultrasonography: In this method, a suitably sized probe is inserted into the rectum. The high-frequency waves emitted by this probe strike the prostate and return. The returning waves are processed into visual data through computer-assisted programs.

How is Prostate Cancer Treated?

There are several methods used for the treatment of prostate cancer, including:

• Watchful Waiting: This method is preferred for patients with early-stage prostate cancer. In this stage, no treatment is administered; the patient is only monitored. When clinical progression is observed, symptomatic treatment is provided to facilitate the patient's quality of life.
• Active Surveillance: This method is applied in stages where the cancer is localized and shows no signs of spreading. This approach aims to protect the patient from the side effects of cancer treatments while preventing the waste of effective treatments, known as the gold standard, in the early stages.
• Radical Prostatectomy: This surgical intervention is applicable when prostate cancer has not yet metastasized to other tissues and organs. This procedure involves the removal of the cancerous prostate gland.
• Radiotherapy: This cancer treatment method uses ionizing radiation. These rays affect the DNA of cancerous cells, destroying them.

Due to the insidious nature of prostate cancer, which often does not show symptoms in early stages, early diagnosis is crucial. If you are experiencing any prostate-related issues and are unsure of the cause, you can consult the nearest healthcare facilities to undergo the necessary tests.