Prostate Cancer - Symptoms, Causes and Treatments

As you reach your mid-40s, life will probably feel different in various ways. Maybe you’re thinking more about your health; if you’re not, you should be. One thing as an Indian man that deserves your attention is prostate cancer. It’s not something we usually talk about, but being aware of it could make all the difference.

Here’s a stat that might surprise you: According to the latest Lancet Commission paper by 2040, prostate cancer cases in India are expected to double, reaching around 71,000 new cases every year. Right now, between 33,000 and 42,000 men in India are diagnosed annually. That’s about 3% of all cancer cases in the country. So, let’s break this down in a way that makes sense—so you can stay informed and take the right steps for yourself and your family.

What is Prostate Cancer?

Prostate cancer develops when prostate cells stop functioning correctly. Normal cells develop, divide, and die at regular intervals. Sometimes something goes wrong with this procedure and the cells do not die as expected. Instead, they develop and divide, resulting in a tumor. Tumors can be benign (non-cancerous) or malignant (cancerous).

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What is a prostate?

The prostate is a tiny, walnut-sized gland located at the base of the bladder in men. It has two symmetrical lobes and surrounds the urethra, which transports urine from the bladder to the penis. The urethra also transports semen, which is the fluid that contains sperm.

(Image Credit: Prostate Cancer Foundation)

Most prostate cancer develops slowly, and many men are unaware they have the disease. However, certain prostate tumors are aggressive and can spread to other parts of the body, including the bones, lymph nodes, and lungs.

What are some symptoms involved with Prostate Cancer?

Prostate cancer can be a bit sneaky, especially in the early stages when it might not show any symptoms. But as it progresses, you might start noticing:

• Needing to pee more often, especially at night
• A weak or interrupted stream when you pee
• A burning sensation or pain when you pee
• Erectile dysfunction or discomfort when ejaculating
• Blood in your urine or semen
• Pain in your lower back, hips, or chest

Now, don’t jump to conclusions—just because you have one of these symptoms doesn’t mean you have cancer. There are other prostate issues, like benign prostatic hyperplasia (BPH) and prostatitis, that can cause similar symptoms but aren’t cancerous. However, if you do notice any of these symptoms, it’s a good idea to check in with your doctor

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What exactly causes prostate cancer?

While it's unclear what causes prostate cancer.

Doctors understand that prostate cancer originates when cells in the prostate undergo DNA alterations. A cell's DNA includes instructions that teach it what to do. The alterations cause the cells to grow and divide faster than normal cells do. When other cells die, the aberrant ones continue to live.

The accumulated aberrant cells form a tumor, which can develop and infiltrate adjacent tissue. Some aberrant cells may eventually break free and spread (metastasize) to other places in the body.

Who’s at Risk for Prostate Cancer?

Certain things can increase your chances of getting prostate cancer:

• Old age: As you become older, your risk of developing prostate cancer increases. It is especially common after age 50.
• Race: Men of African ancestry are more likely to develop prostate cancer than men of other racial backgrounds, though the reasons are not fully understood. Prostate cancer in these men is also more likely to be aggressive or advanced.
• The family history: If a blood relative, such as a parent, sibling, or child, has prostate cancer, your risk may increase. Furthermore, if you have a family history of breast cancer-causing genes (BRCA1 or BRCA2), or a very strong family history of breast cancer, your risk of prostate cancer may be increased.
• Lifestyle: People who are obese might have a higher risk of developing prostate cancer. Obesity is also linked to more aggressive forms of cancer and a higher likelihood of recurrence after treatment, though study results have varied.

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What You Need to Know About Diagnosis of Prostate Cancer

In India, routine screening for prostate cancer isn’t as common as in some other countries, but it’s gaining traction, especially among men at higher risk. If you’re over 45—or 50 with a family history—it’s smart to talk to your doctor about getting screened.

The two main screening tests are:

• Digital Rectal Exam (DRE): Your doctor will feel your prostate through the rectum to check for any abnormalities.
• Prostate-Specific Antigen (PSA) Test: This blood test measures the level of PSA in your blood. High levels could indicate prostate cancer, but they can also result from other conditions like BPH or prostatitis.

If these tests show something unusual, your doctor might suggest further testing, like an MRI or a biopsy, to get a clear diagnosis.

Treatment Options Available For Prostate Cancer

In a scenario, where you’ve been diagnosed with prostate cancer. Take a deep breath. Today's treatment options are highly effective, especially if the cancer is caught early. Your treatment plan will depend on factors like your age, the stage of the cancer, and your overall health. Common treatments include:

• Active Surveillance: If the cancer is slow-growing and not causing symptoms, your doctor might recommend just keeping a close eye on it with regular tests.
• Surgery: A radical prostatectomy, where the entire prostate is removed, is a common option if the cancer hasn’t spread beyond the prostate.
• Radiation Therapy: This can be done with external beams or by placing radioactive seeds inside the prostate (brachytherapy).
• Hormone Therapy: Since prostate cancer cells rely on testosterone to grow, hormone therapy reduces testosterone levels, slowing the cancer’s growth.
• Chemotherapy and Immunotherapy: These are usually for more advanced cases, especially if the cancer has spread to other parts of the body.

Determining whether prostate cancer is aggressive.

When a biopsy confirms the presence of cancer, the next step is to evaluate the aggressiveness (grade) of the tumour cells. A doctor in a lab examines a sample of your cancer cells to evaluate how different they are from healthy cells. A higher grade means that the cancer is more aggressive and will spread quickly.

Techniques for determining the aggressiveness of cancer include:

1. The Gleason score. The Gleason score is the most often used scale for determining the grade of prostate cancer cells. Gleason's score combines two values and ranges from 2 (non-aggressive cancer) to 10 (extremely aggressive cancer), albeit the lower end of the spectrum is rarely employed.
2. Genomic testing. Genomic testing examines your prostate cancer cells to detect which gene alterations exist. This type of test can help you learn more about your prognosis. However, it is unclear who would gain the most from this information, hence the tests are not frequently used. Genomic testing is not required for every person with prostate cancer, but it may provide additional information for making treatment decisions in some instances.

What are the Side Effects of Treatment for Prostate Cancer?

Prostate cancer treatments are effective, but they can also come with side effects that might affect your day-to-day life. Common ones include:

• Incontinence: Some men may have trouble controlling their bladder after treatment, but this usually gets better with time.
• Erectile Dysfunction (ED): Many men find it harder to get or maintain an erection after treatment. Fortunately, there are medications that can help with this.
• Infertility: Treatments like surgery or radiation can affect your ability to father children, so if that’s something you’re concerned about, talk to your doctor about sperm banking.

Can You Prevent Prostate Cancer?

There’s no surefire way to prevent prostate cancer, but there are things you can do to lower your risk:

• Get Screened: Early detection is key. Talk to your doctor about when to start regular prostate screenings.
• Maintain a Healthy Weight: Obesity is linked to a higher risk of aggressive prostate cancer. A balanced diet and regular exercise can help keep your weight in check.
• Quit Smoking: Smoking is linked to various cancers, including prostate cancer. If you smoke, make a plan to quit.
• Eat a Balanced Diet: A diet rich in fruits, vegetables, and whole grains may help lower your cancer risk. Try to cut back on red meat and processed foods as much as possible.

Prostate Cancer in India: How Common Is It?

While prostate cancer is more common in Western countries, but the numbers in India have been creeping up. By 2040, experts believe the number of Indian men with prostate cancer will nearly double. This increase could be due to several factors—people are living longer, lifestyle changes, and maybe even more awareness about the disease leading to more diagnoses.

Prostate cancer is more likely to affect men over 45, especially if you have a family history of the disease or if you’re of African ancestry. So, if you’re in this age group, it’s important to stay clued up.

How do you cope and support from Prostate Cancer?

When you are diagnosed with prostate cancer, you may feel a variety of emotions, including denial, fear, anger, worry, and despair. Each person develops their own coping strategy after receiving a prostate cancer diagnosis.

Until you find what works for you, try these:

1. Learn enough about prostate cancer to feel confident making treatment decisions. Learn everything you can about your cancer and its therapy so that you know what to expect during and after treatment. Ask your doctor, nurse, or other health care professional for recommendations on credible sources of information to get you started.
2. Keep your friends and family near. Friends and relatives can offer support during and after your treatment. They may be eager to assist with tiny things that you will not have the energy to complete throughout treatment. When you're feeling anxious or overwhelmed, talking to a close friend or family member can assist.
3. Connect with other cancer survivors. Friends and relatives can't always comprehend what it's like to have cancer. Other cancer survivors can offer a unique network of support. Ask your doctor about support groups or community organisations that can help you connect with other cancer survivors. Organizations like the Indian Cancer Society https://www.indiancancersociety.org/ provide online chat rooms and discussion forums.
4. Take care of yourself. Eat a fruit and vegetable-rich diet to help you stay healthy during cancer treatment. Try to work out most days of the week. Get enough sleep each night so that you wake up feeling refreshed.
5. Continue sexual expression. If you have erectile dysfunction, your natural reaction may be to avoid all sexual activity. Consider stroking, holding, embracing, and caressing as techniques to maintain sexual intimacy with your spouse.

Final Thoughts on Prostate Cancer

If you’re an Indian man over 45, it’s time to take your health seriously. Prostate cancer might not be the first thing you think about, but it’s definitely something worth paying attention to. The good news is that with early detection and the right treatment, the outlook is very positive. Most men diagnosed with prostate cancer in its early stages go on to live long, healthy lives. So, stay informed, take preventive steps, and work closely with your doctor to catch any potential issues early.

Your health is in your hands—don’t wait until it’s too late to start taking care of yourself.

FAQs on prostate cancer

1. What is prostate cancer?

Prostate cancer is a prevalent type of cancer in men, but it is very treatable in its early stages. It begins in the prostate gland, located between the penis and the bladder. Experts are not sure what causes it, but the risk grows with age.

2. How is prostate cancer controlled and treated?

Your therapy is determined by a variety of circumstances, including your overall health, whether the cancer has spread, and how quickly it is progressing. Depending on your treatment, you may consult with a variety of healthcare professionals, including urologists, radiation oncologists, and medical oncologists. The majority of prostate cancers discovered early on can be cured with treatment.

3. What are the symptoms of prostate cancer?

Males with symptoms may notice:

• Difficulties initiating and maintaining urination.
• Symptoms include frequent urination, particularly at night, a weak urine stream, and blood in the urine or semen.
• Symptoms may include painful urination or ejaculation, as well as discomfort in the back, hips, or pelvis.

Advanced symptoms

People with advanced prostate cancer may also have no symptoms. Potential symptoms will vary depending on the extent of the malignancy and its dissemination throughout the body. In addition to the above, advanced prostate cancer may cause the following symptoms:

Symptoms include 

• bone discomfort, 
• unexpected weight loss, and 
• Weariness.

4. What are the many forms of prostate cancer?

There are five types of prostate cancer. Acinar adenocarcinoma is the most frequent kind of prostate cancer, making up approximately 90% of cases. Ductal adenocarcinoma tends to grow faster than acinar adenocarcinoma. Transitional cell (or urothelial) cancer usually starts in the bladder and progresses to the prostate. Squamous cell cancer typically grows faster than adenocarcinomas. Small cell carcinoma is a neuroendocrine cancer that is extremely rare.

5. What are the stages of prostate cancer?

Cancer staging is complex, taking into consideration a variety of criteria. In general, the smaller the number, the less cancer has spread. Stages might include:

• Stage I: Cancer only affects the prostate gland.
• Stage II: The cancer has not gone beyond the prostate, but the PSA level is higher.
• Stage III: The cancer may have spread to surrounding tissues.
• Stage IV: Cancer may have spread to other parts of the body.