What is prostate cancer?
The prostate gland is only found in men and is located between the bladder and the penis. The urethra runs through the centre of the prostate, and it also produces a sperm-protecting fluid which is released as semen.
When the prostate becomes enlarged it can result in problems with the urinary system as the gland squeezes and exerts pressure on the urethra, which mean the bladder is no longer able to empty itself properly. The prostate gland itself grows naturally as you age, almost doubling in size between the ages of 40 and 70.
While in most cases this growth is natural, it is also possible that an enlarged prostate could be caused by the reproduction of cancerous cells. Prostate cancer can develop slowly and is often symptomless. You might also experience mild symptoms over the course of many years that cause little to no concern. Once symptoms become particularly noticeable and begin to impact on your quality of life you should consult a doctor as soon as possible.
The most common noticeable changes include:
- The need for more frequent and urgent urination, particularly during the night time
- Inability to start urinating
- A weak flow whilst urinating, making it difficult to fully empty the bladder
- Straining to urinate
- A feeling that the bladder is not empty after urinating
Less-common, but more serious symptoms include:
- Pain whilst urinating or ejaculating
- Blood in urine
However insignificant you believe it may be, if you are experiencing any of these symptoms to any extent you should make arrangements for a prostate examination. This can determine the root cause of your symptoms and either eliminate or identify the possibility of prostate cancer. Identifying prostate cancer early is vital: although many prostate growths are benign, those that are not can spread quickly to the pelvis, testicles and lower back.
Prostate cancer statistics
- Around 1 in 8 men will encounter prostate cancer during their lifetime
- Prostate cancer is the most common form of cancer found in men
- The average age for a prostate cancer diagnosis is 65
- Prostate cancer has a 5-year survival rate of over 98%
How is prostate cancer diagnosed?
A physical prostate examination is usually the main method with which your doctor can confirm the presence of prostate cancer. This involves the doctor feeling around the rectum and prostate area for any abnormal lumps. A number of blood and urine tests will also be taken. You may also be referred to a urology specialist, who can deliver a final diagnosis.
The decision you make on the next stages of your treatment depend upon the type of prostate cancer you are diagnosed with. You may be diagnosed with:
- Localised prostate cancer – contained inside the prostate gland
- Locally advanced – spread to the area immediately around the prostate
- Advanced – spread far beyond the prostate to other parts of the body
Localised prostate cancer usually grows slowly and has a low risk of spreading. It is for this reason that many doctors advise against treatment at this stage, instead opting to monitor the prostate closely for any signs of change. You may wish to choose to monitor this yourself or attend regular prostate exams with the doctor. Unless symptoms develop it is unlikely that you will need to undergo treatment.
If the prostate cancer is locally advanced, on the other hand, then treatment is needed to prevent it from spreading further. This treatment may aim to eliminate the cancer altogether or simply keep it under control. The type of treatment also depends on how far the cancer has spread.
Prostate cancer which has spread to an advanced staged requires treatment as soon as possible. This occurs when the cancerous cells in the prostate move to other parts of the body in the bloodstream, and usually results in a spread of cancer to the bones. Prostate cancer can also spread to the lymph nodes – usually via the pelvis. A common symptom of advanced prostate cancer, therefore, is weakness and fatigue in the bones, particularly in the lower back and pelvis area. Advanced prostate cancer cannot be fully cured, but can be controlled effectively for a number of years.
How is prostate cancer treated?
There are a range of treatments available for prostate cancer, depending on a number of factors such as the stage of advancement, the age and overall health of the patient, and any history of previous cancer treatments. Survival rates for prostate cancer are at an all-time high, mainly due to advancements in technology and greater understanding of the condition through increased research.
Hormone therapy is often the first step for patients with localised or locally advanced prostate cancer. This works by blocking testosterone, a hormone which can accelerate the speed of cancerous cell reproduction. By stopping the hormone from reaching the cancerous cells the rate of spread can be slowed and new cancerous cells cannot be formed, meaning the cancer will eventually begin to shrink in size. Hormone therapy can help to control prostate cancer, but should be combined with another treatment such a radiotherapy for optimal results.
Chemotherapy is another common treatment for prostate cancer, but only when it has spread beyond the prostate. Chemotherapy is usually not advised for early-stage prostate cancer. The treatment itself involves a course of anti-cancer drugs which aim to halt the reproduction of cancerous drugs and shrink the cancerous growth. The side-effects of chemotherapy such as severe fatigue and nausea mean that it is usually only offered to men in reasonably good health.
Radical prostatectomy (surgery)
If you wish to fully eliminate the cancer from the prostate then surgery is one of the most-effective options. The surgical procedure is knows as radical prostatectomy and is generally only performed on men with localised prostate cancer. In some cases a radical prostatectomy is carried out when the cancer has spread locally, but it depends on the nature and extent of the spread. Radical prostatectomy is a complex surgical procedure with a prolonged recovery period – as a result, it is only offered to men in good health who are under the age of 75.
The surgery involves the total removal of the prostate gland including all of the seminal vessels contained within. If the cancer has spread to the surrounding nerves, the surgeon may need to remove them, which can cause future complications with penis function and sensation. This often means that men become impotent following surgery.
On the other hand, in most cases radical prostatectomy is able to successfully remove the cancer and prevent it spreading further. After the prostate is removed it will be sent away for further analysis, which will determine whether the cancer has spread and if so, how aggressively. If the cancer has spread or the surgeon has not been able to fully remove all cancerous cells around the prostate then you will require more treatment.
External beam radiotherapy
If you are looking for a non-surgical treatment for prostate cancer then you may want to consider external beam radiotherapy, which uses high-intensity beams to damage and destroy the cancerous cells. Although the treatment is painless it can have side-effects similar to chemotherapy. You will also need to make regular visits to the hospital for treatment, usually 3-5 times a week over the course of a month or two. Once the course of radiotherapy is complete you will need to return for regular checkups to assess whether it has been successful.
High intensity focused ultrasound (HIFU)
A similar option to radiotherapy is high intensity focused ultrasound (HIFU). This uses high-frequency ultrasound energy to heat and destroy cancerous cells, which is fed to the prostate by a probe in the rectum. HIFU is a new technology and not so much is known yet about its side-effects or long-term benefit, but many oncologists believe it is one of the most effective cancer treatments currently available.
Cryotherapy is a treatment used for prostate cancer when other treatments such as radiotherapy have failed to fully cure the cancer. Also known as cryosurgery, it involves the insertion of a cryogenic gas through a thin needle into the prostate, which freezes and kills the cancer cells. Cryotherapy does not require lengthy hospital stays or repeat visits, and much less invasive than many other prostate cancer treatments.
For those whose stage of cancer development is T1-T2a, permanent seed brachytherapy is sometimes recommended. This form of treatment is best combined with radiotherapy and hormone therapy, or following a transurethral resection of the prostate (TURP) procedure. Small radioactive seeds are inserted into the prostate via the bladder, which then work to kill the cancer cells. Permanent seed brachytherapy does bring a range of side-effects, the most common being blood in the urine and discomfort around the prostate area.
How much does prostate cancer treatment cost?
With such a range of treatments available, each one depending on the stage of the cancer and how far it has spread, finding an accurate and simple cost quote can be difficult. You may also need to have a number of different complex treatments. In order to get a clear picture of just how much your prostate cancer treatment will cost you will need to speak in depth with an oncology consultant or specialist, who can take you through the possibly options and help you decide on which course of action is best for you.
Increasing numbers of people are choosing to travel abroad for prostate cancer treatment, either to see reputable oncology specialists, to cut down on costs, or to avoid long waiting times back home.