Prostate Cancer – Signs, Symptoms, Causes, Diagnosis & Treatment

What Is Prostate Cancer?

Prostate cancer begins when abnormal cells in the prostate gland multiply uncontrollably. These cells form a tumor that may remain localized or spread beyond the prostate.
Most prostate cancers are adenocarcinomas, meaning they originate in the glandular cells that produce prostate fluid. Rarely, other types such as small cell carcinoma or sarcoma can occur.

Doctors categorize prostate cancer as:       

• Localized: confined within the prostate
• Locally advanced: spread to nearby tissues or seminal vesicle
• Metastatic: spread to distant organs like bones or lymph nodes

The earlier it’s detected, the better the chances of cure.

Symptoms of Prostate Cancer:

In its early stages, prostate cancer often causes no noticeable symptoms — that’s why regular screening is crucial. As the disease progresses, the tumor may press on the urethra or surrounding tissues, leading to urinary and sexual problems.

Here are the common signs and symptoms of prostate cancer in males:

1. Urinary Problems

• Frequent urination: especially at night (nocturia).
• Urgency: sudden, strong need to urinate.
• Difficulty starting urination (hesitancy): a weak or delayed start.
• Weak or interrupted urine stream: urine flow starts and stops repeatedly.
• Dribbling after urination: leakage even after finishing.
• Feeling of incomplete bladder emptying: sensation that urine remains after voiding.
• Urinary retention: severe blockage causing inability to urinate.

These symptoms occur because the growing tumor compresses the urethra.

2. Blood-Related Symptoms

• Hematuria: blood in urine, giving it a reddish or brownish color.
• Hematospermia: blood in semen after ejaculation.

Both can signal prostate or urinary tract issues that require immediate medical attention.

3. Pain & Discomfort

•  Pelvic or perineal pain: dull ache in the lower pelvic region.
•  Painful urination (dysuria) or painful ejaculation.
• Lower back, hip, or thigh pain: may suggest spread to nearby bones or nerves.
• Bone pain: when prostate cancer metastasizes to bones, it often causes deep, persistent pain in hips, ribs, or spine.

4. Sexual Dysfunction

• Erectile dysfunction (ED): difficulty achieving or maintaining an erection.
• Reduced semen volume or painful ejaculation may also appear in some cases.

5. Advanced Stage Symptoms

• Swelling in legs (lymphedema): due to lymph node involvement.
• Fatigue, weakness, or unexplained weight loss.
• Anemia: resulting from chronic disease or bone marrow involvement.
• Loss of appetite or general malaise.
• Spinal cord compression: in severe metastatic cases, may cause leg weakness, numbness, or even paralysis.

These symptoms don’t always mean cancer — benign conditions like benign prostatic hyperplasia (BPH) or prostatitis can cause similar signs. However, any persistent change should be evaluated by a urologist.

Causes and Risk Factors:

The exact cause of prostate cancer remains unclear, but it develops due to genetic mutations that cause prostate cells to divide uncontrollably. Certain factors increase risk:

• Age: Risk increases sharply after age 50; most cases occur after 65.
• Family History: Men with a father or brother who had prostate cancer have up to 2–3× higher risk.
• Genetics: Mutations in BRCA1, BRCA2, or genes linked with Lynch syndrome may raise risk.
• Ethnicity: Black men and those of African descent face higher risk and often develop more aggressive cancers.
• Obesity: Linked with higher-grade prostate cancer and poorer outcomes.
• Dietary Factors: High intake of red meat, dairy, and fatty foods may increase risk.
• Hormonal Imbalance: High testosterone levels may fuel cancer growth.
• Smoking & Sedentary Lifestyle: Associated with more aggressive disease.

While not all risk factors are controllable, maintaining a healthy lifestyle helps reduce risk

Diagnosis and Tests:

Early detection saves lives. Screening allows doctors to identify prostate cancer before symptoms appear.

Common diagnostic tests include:

• Digital Rectal Exam (DRE):

The doctor inserts a gloved finger into the rectum to feel for hard or irregular areas on the prostate.

• Prostate-Specific Antigen (PSA) Test:

A simple blood test that measures PSA levels. Elevated PSA may suggest cancer, though infection or enlargement can also cause high levels.

• Imaging Tests:

1. Transrectal Ultrasound (TRUS): uses sound waves to visualize the prostate.
2. MRI of the Prostate: helps pinpoint suspicious lesions.
3. CT or Bone Scan: checks for cancer spread.

• Prostate Biopsy:

Tissue samples are taken from the prostate and examined under a microscope. The Gleason score helps grade the cancer’s aggressiveness.

• Staging:

Once diagnosed, staging determines if the cancer is localized, locally advanced, or metastatic, guiding treatment decisions.

Treatment Options for Prostate Cancer:

Treatment depends on the stage, patient’s health, and how fast the cancer is growing. Paras Health follows a multidisciplinary approach, combining urology, oncology, and radiology expertise.

1. Active Surveillance / Watchful Waiting

For small, slow-growing cancers without symptoms, doctors may recommend regular monitoring through PSA tests and biopsies rather than immediate treatment.

2. Surgery (Radical Prostatectomy)

The most definitive option for localized cancer, where the prostate gland (and sometimes nearby lymph nodes) is removed.

·         Can be done through open, laparoscopic, or robot-assisted (Da Vinci) surgery for precision and faster recovery.

·         Possible side effects: temporary urinary incontinence or erectile dysfunction.

3. Radiation Therapy

Uses high-energy rays to destroy cancer cells.

• External Beam Radiation Therapy (EBRT) – targets the prostate from outside the body.
• Brachytherapy – implants tiny radioactive seeds directly into the prostate.

Often combined with hormone therapy for advanced stages.

4. Hormone Therapy (Androgen Deprivation Therapy)

Reduces male hormones (testosterone) that promote cancer growth. Used for advanced or recurrent cancer.

5. Chemotherapy

Administers cancer-killing drugs through the bloodstream, usually for metastatic cases.

6. Targeted and Immunotherapy

For cancers with specific gene mutations, targeted drugs or immune checkpoint inhibitors may help slow disease progression.

7. Palliative or Supportive Care

For advanced cases, palliative therapy relieves symptoms and improves quality of life.

Prevention and Lifestyle Tips:

While not all cases are preventable, you can lower your risk by:

• Eating a diet rich in fruits, vegetables, and whole grains.
• Limiting red and processed meats.
• Staying physically active and maintaining a healthy weight.
• Avoiding smoking and excessive alcohol.
• Getting regular check-ups after age 45, especially with family history.

Prognosis (Outlook):

When caught early, prostate cancer has an excellent survival rate - nearly 100% for localized disease. Even in advanced stages, new therapies can help men live longer and maintain good quality of life.
Follow-up care with regular PSA monitoring is essential to detect recurrence early.

When to See a Doctor:

If you notice urinary changes, blood in urine or semen, or persistent pelvic pain, consult a urologist or oncologist promptly. Early evaluation can rule out cancer or ensure timely treatment.

Frequently Asked Questions (FAQs):

What is the first sign of prostate cancer?

Early prostate cancer often has no symptoms. As it grows, you may notice frequent urination, weak urine flow, or difficulty starting and stopping urination.

Can prostate cancer cause pain?

Yes, advanced prostate cancer can cause pain in the lower back, hips, thighs, or bones due to cancer spread.

Is prostate cancer curable?

Yes — if detected early, prostate cancer is highly treatable and often curable with surgery, radiation, or active surveillance.

How is prostate cancer diagnosed?

Doctors use a combination of PSA blood test, digital rectal exam (DRE), MRI, and prostate biopsy to confirm the diagnosis.

What causes prostate cancer?

The exact cause is unknown, but age, family history, obesity, and certain genetic changes increase the risk.

Who is at highest risk for prostate cancer?

Men above 50 years, those with a family history, and African or Asian ancestry are at higher risk.

Can prostate cancer affect sexual function?

Yes. Treatments like surgery or radiation can sometimes cause erectile dysfunction, but therapies and medications can help.

What is the survival rate of prostate cancer?

When caught early, the five-year survival rate is nearly 100%. Advanced stages have lower survival but can still be managed effectively.

How can I prevent prostate cancer?

Maintaining a healthy weight, eating more fruits and vegetables, limiting red meat, and regular screening after age 45 can help reduce risk.

What is the difference between prostate enlargement and prostate cancer?

Prostate enlargement (BPH) is a benign condition, while prostate cancer involves abnormal cell growth that can spread. Both can cause similar urinary symptoms.