Prostate cancer and what it is


It would be a surprise to most of us to come to understand that prostate cancer is the most common cancer among men, but funny enough most men do not know where the prostate region in our body is found. As the NHS’s ‘Know your Prostate‘ motive states, “Every man has one, it’s important for their sex life, yet few men know anything about their prostate or what can go wrong with it.” The book by Professor Jane Plant, Prostate Cancer – understand, prevent and overcome, has been very helpful in opening up my mind to understand what the cancer is all about from grass roots levels.

If we witness the staggering statistics Professor Plant has indicated, we would be really concerned how this area of cancer has not been given prime importance among the oncology divisions. As one of the most common cancers among men, it affects one in ten men in Western world. In Australia a man dies of cancer every three hours; in the UK it’s at least one every hour. Prostate cancer is the most common cancer in men in the UK, with more than 30,000 men diagnosed annually and kills 10,000 men yet only ten percent of men in the UK know where their prostate gland is and research into the illness has in the past been so underfunded that it is ten years behind research into other cancers.

It is best to start to understand from the basics – where the prostate gland is found, how serious cancers of this type are and what the risk factors are.

According to Patient UK, “The prostate gland is only found in men. It lies just beneath the bladder. It is normally about the size of a chestnut. The urethra (the tube which passes urine from the bladder) runs through the middle of the prostate. The prostate’s main function is to produce fluid which protects and enriches sperm. The prostate gets bigger (enlarges) gradually after the age of about 50. By the age of 70, about 8 in 10 men have an enlarged prostate. Around two million men in the UK have symptoms due to an enlarged prostate.”

In most cases (80%), prostate cancer is classed as a slow-growing cancer and hence is hard to diagnose early, but there is also an aggressive type of prostates, which is commonly referred as secondary cancer, that spreads to the bones.

Symptoms

According to Macmillan Cancer Support, “Men with early prostate cancer are unlikely to have any symptoms, as these only occur when the cancer is large enough to put pressure on the urethra (the tube that drains urine from the bladder). In men over the age of 50, the prostate gland often gets larger due to a non-cancerous condition called Benign Prostatic Hyperplasia or Hypertrophy (BPH).

Hence, the symptoms of both benign enlargement of the prostate gland and malignant tumours (cancer) are similar and can include any of the following:

  • Pain urinating or in sex
  • Passing urine more frequently than usual, especially at night
  • Blood in urine (less common)

Risk factors

  1. Race: For no obvious reasons, but related to unknown genetic factors “Black men are three times more likely to develop     prostate cancer than white men.” Researchers are looking at what may be the cause of this increased risk but genes probably play an important role.
  2. Age: The older one gets, the more likely to get prostate cancer.  It has been found that most men diagnosed with the condition are over 50. However, survival rates of newly diagnosed prostate cancer patients have improved from 30% in the 1970s to 80% today.
  3. Family history of prostate cancer: The report by the NHS states “if you have a father or brother diagnosed with prostate cancer, your risk of getting the disease is 2.5 times higher compared to the average man. The risk increases to 4.3 if the relative was diagnosed before the age of 60.”
  4. Diet: Researchers believe a diet rich in saturated animal fats and red meat may be responsible for the high incidence of prostate cancer in Western countries as reducing the intake may lower the rate at which the cancer either develops or spreads.
Treatment
There are treatments for prostate cancer, the contemporary approach by medical practitioners being the PSA (Prostate Specific Antigen) test to spot prostate cancer. But the current practice carries a risk factor as “while raised levels of the PSA protein can indicate prostate cancer, it doesn’t mean a surefire diagnosis for the disease and hence can indicate less serious conditions, such as an inflamed prostate.”
It has been found in some occasions that the treatments carry a real risk of serious and permanent side effects, including incontinence and impotence. Since there has been no marker to distinguish harmless from aggressive cancer cells, many men prefer to cross their fingers and hope for the best; conversely, many thousands suffer invasive treatments which they may not require. If caught early, prostate cancer has a 90% cure rate – but it occurs more often and is more deadly in African-American men than any other race.

Prospect

Unfortunately, there is currently no prostate cancer screening programme on the NHS. However, the government is committed to introducing one if and when an accurate diagnosis test becomes available and there is a clear treatment process.

In 2004, researchers from Liverpool University in collaboration with Institute of Cancer Research have identified a gene which could identify how aggressive a man’s prostate cancer will be. The new gene identified, E2F3 gene, whose produced protein plays a crucial role in humans by controlling cell division and has earlier been found to also play a role in bladder cancer, could be used as a focus for the development of drugs to treat prostate cancer, as per the expectations of the researchers at Everyman Centre.  Professor Colin Cooper, Institute of Cancer Research said of the extent of this new breakthrough at the time, “A test to distinguish between aggressive tumours, the tigers, and those that are pussycats has been the holy grail of prostate cancer research.”

The urge for a better screening test has galavanised researchers around the globe in search of the genes involved or those that dictate which tumours are plainly killers and those that are not. Recently The Huffington Post reported a new finding by Seattle researchers, published in the journal Cancer Epidemiology, Biomarkers & Prevention, which identified five gene mutations strongly associated with the risk of aggressive, deadly prostate cancer in a way that people with at least four of the five newly discovered gene variations had a 50 percent increased risk of dying from this type of cancer than people who had just two or fewer of the variations. This finding is believed to lead to a blood test for men who test positive for prostate cancer, but aren’t sure whether to undergo treatment for the cancer or just watch and wait to see if it becomes worse as current practices are not able to make a distinction between aggressive tumours and non lethal.

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One Response to Prostate cancer and what it is

  1. Alan says:

    Excellent informative article! And indeed most men do not even know where prostate is and we so often confuse it with testicular cancer. It would have been beneficial, but not the solution, if screening programmes like for cervical cancer are set in place by the NHS.

    Like

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