What is prostate cancer?
Prostate cancer starts in the prostate — a small, walnut-shaped gland below the bladder that helps produce seminal fluid. Most prostate cancers grow slowly and may stay confined to the prostate for years, while a smaller number are aggressive and can spread to bones, lymph nodes, or other organs. Early detection greatly improves treatment success and long-term outlook.
Symptoms to watch for
Early prostate cancer often has no symptoms. When symptoms do appear, they commonly relate to the urinary and reproductive systems:
- Frequent urination, especially at night (nocturia).
- Difficulty starting or maintaining urine flow, or a weak stream.
- Pain, burning, or discomfort while urinating.
- Blood in the urine or semen.
- Problems with erection (erectile dysfunction) or reduced sexual performance.
- Persistent pain or stiffness in the hips, pelvis, or lower back (mayindicate spread to bone).
Causes & risk factors
The exact trigger for prostate cancer is unclear, but several factors increase risk:
- Age: Risk rises sharply after age 50; most cases occur in older men.
- Family history: Having a father, brother, or close relative with prostate cancer raises your risk two- to three-fold. Genetic changes — such as BRCA1/BRCA2 mutations — also increase risk.
- Ethnicity: Men of African ancestry have higher incidence and, in some settings, higher mortality.
- Diet & lifestyle: High intake of fatty foods, obesity, and a sedentary lifestyle are linked with higher risk.
- Hormones: Androgens (male hormones such as testosterone) influence prostate cell growth and can affect cancer behaviour.
How prostate cancer is diagnosed
Doctors combine tests to make an accurate diagnosis:
1. PSA blood test
The prostate-specific antigen (PSA) test measures a protein made by prostate cells. Raised PSA can suggest cancer but also rises with infection or benign enlargement; it is a screening and monitoring tool, not a definitive test.
2. Digital rectal examination (DRE)
During a DRE the clinician feels the prostate through the rectal wall to check for lumps, hard areas, or irregularities.
3. Imaging tests
MRI, CT scans, and transrectal ultrasound can visualize the prostate and surrounding tissues to help guide biopsies and staging.
4. Biopsy
To confirm cancer, a small tissue sample is taken from the prostate and examined microscopically. Modern biopsies may be MRI-guided for greater accuracy.
Treatment options — how doctors decide
Treatment depends on cancer stage, grade (how aggressive it looks under the microscope), patient age, general health, and personal preferences. Typical options include:
Active surveillance (watchful waiting)
Low-risk cancers that are slow-growing may be safely monitored with regular PSA checks, DREs, imaging, and occasional biopsies — avoiding or delaying treatment side effects.
Surgery (radical prostatectomy)
Removal of the prostate is an option for localised disease. Techniques include open surgery, laparoscopy, and robot-assisted surgery. Possible side effects: urinary incontinence and sexual dysfunction.
Radiation therapy
External beam radiation or brachytherapy (radioactive seeds placed into the prostate) can treat localised or locally advanced disease. Radiation may be combined with hormone therapy in certain situations.
Hormone (androgen-deprivation) therapy
Lowering or blocking testosterone slows the growth of prostate cancer cells and is used for advanced or recurrent disease.
Chemotherapy
Used when cancer has spread beyond the prostate or when hormone therapy stops working.
Targeted & immunotherapy
Newer approaches — including targeted agents and immunotherapies — are available for certain advanced cancers and in clinical trials. Discuss options with your oncology team.
How to reduce your risk
No strategy guarantees prevention, but evidence supports lifestyle measures that can lower overall cancer risk and improve health:
- Eat more plant foods — fruits, vegetables, whole grains, legumes, nuts; include lycopene-rich foods such as tomatoes and watermelon.
- Limit red and processed meat and reduce dietary saturated fat.
- Maintain a healthy weight and exercise regularly (aim for at least 30 minutes of moderate activity most days).
- Don't smoke; limit alcohol consumption.
- Know your family history — men with close relatives who had prostate or related cancers may need earlier screening and genetic counselling.
- Discuss screening timing with your doctor: men with family risk may start earlier (around 40–45 years), while average-risk screening commonly begins at 50; guidelines vary by country and organisation.
Living well with prostate cancer
A diagnosis affects more than the body — it impacts emotions, relationships, and daily life. Ways to stay resilient:
- Seek counselling or join support groups to manage anxiety and stress.
- Follow a balanced diet and stay physically active to reduce fatigue and improve recovery.
- Talk with partners and family — emotional support and shared decision-making help recovery.
- Ask your care team about pelvic floor exercises and sexual health clinics to manage side effects such as incontinence or erectile dysfunction.
Frequently Asked Questions (FAQ)
- What is the earliest sign of prostate cancer?
- Often there is none. Urinary changes (slow stream, nocturia) may occur, but many early cancers are found through PSA testing or during exams.
- Is prostate cancer curable?
- Yes — especially when found early and still confined to the prostate. Surgery or radiation can be curative for many men.
- When should men start testing?
- Men with a family history or higher risk may consider starting discussions about screening at age 40–45; average-risk men typically start at 50. Check national guidelines and talk with your doctor.
- Can diet make a difference?
- Healthy, plant-rich diets and weight control are associated with lower risk and better outcomes, though they don’t eliminate risk entirely. Including lycopene-rich foods is commonly recommended.
- How fast does prostate cancer spread?
- Most prostate cancers grow slowly over many years; a minority are aggressive and spread more quickly to bone and other organs. Staging and grading at diagnosis determine prognosis.
Trusted external resources
Use these reputable organizations for up-to-date guidance and patient resources:
- World Health Organization (WHO) – Cancer resources.
- IARC / GLOBOCAN Prostate Cancer Fact Sheet (global stats).
- American Cancer Society – Prostate cancer overview & statistics.
- NHS — Symptoms, diagnosis & treatment.
- Centers for Disease Control & Prevention (CDC) — Screening information.
- Mayo Clinic — Symptoms, causes, treatments.
- Cancer Research UK — facts, risk and support.
- Urology Care Foundation — patient guides.
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