All you need to know about: prostate cancer
Former United States president Joe Biden was diagnosed with prostate cancer last week, with his office announcing that it was an 'aggressive' form of the disease, as cancer cells had spread to the bone. His office however, also said that the cancer appeared to be hormone-sensitive which 'allows for effective management' and that the president and his family are reviewing treatment options with his physicians.' Many political leaders, including current U.S. President Donal Trump sent Mr. Biden wishes for his recovery.
What is prostate cancer?
Prostate cancer is a cancer that develops in the prostate gland, which is part of the male reproductive system. The prostate gland is about the size of a walnut but tends to grows with age. It is located just below the bladder, in front of the rectum. The main job of the prostate gland is to produce a fluid that becomes part of the semen.
Prostate cancer is a common cancer: according to 'The Lancet Commission on prostate cancer: planning for the surge in cases', 2024, prostate cancer is the most common cancer by incidence in men in 112 countries (as of 2020), and accounts for one in every 14 cancers diagnosed globally, and 15% of all male cancers. Among men, the disease ranks second only to lung cancer in terms of cancer mortality. In the United States, it is second only to skin cancer among men, while in India, it is third-most common cancer among men as of 2022.
What are the risk factors of prostate cancer?
Risk factors for prostate cancer include: age -- as men grow older, their risk of getting prostate cancer increases; family history -- men who have had a close family member with prostate cancer have an increased chance of getting it; obesity -- studies have linked being overweight to having a greater chance of getting prostate cancer. Other risk factors include ethnicity as African American men are at greater risk.
What are the signs and symptoms of prostate cancer?
In the early stages, prostate cancer may not always cause symptoms. When symptoms do occur, they may include: a frequent need to urinate, trouble passing urine or a weak flow or pain and burning while urinating, blood in the urine (making it look pink or red), blood in the semen, pain in the lower back, hips or thighs and painful ejaculation.
Severity of symptoms may depend on where the cancer is located and how advanced it is. Changes in urinary functions could also be symptoms of a common condition, an enlarged prostate -- it is important to consult a doctor for the right diagnosis.
What are the stages of prostate cancer?
Healthcare providers may use a scale known as the Gleason score to determine how serious the cancer is. Under the Gleason score, the more abnormal cells you have, the higher your score. These scores range from 2 to 10. A score of below of 5 is not considered cancer. Scores from 6 to 10 are considered cancer -- with 6 being a slow-growing cancer and 10 being a fast-growing cancer.
The cancer is also staged. In the early stages (stages 1 and 2), the cancer is localised and has not spread beyond the prostate. In the locally advanced stage or stage 3, it has spread outside the prostate but only to nearby tissue and structures. In the advanced or metastasised stage or stage 4, it has spread to other parts, possibly lymph nodes, bones, liver, lungs or other organs.
What is the treatment for prostate cancer?
Treatment depends on several factors including age and overall health condition, the stage and grade of the cancer and its spread. Early-stage cancers can have a good outcome with treatment.
One treatment option for small and slow-growing cancers may be active surveillance, where the patients gets screened and tested regularly to monitor the cancer grow. If tests show that the cancer is growing, then other treatment options may be considered.
Other treatment options include surgery, radiation therapy and systemic therapies.
Surgery, known as prostatectomy, is the removal of the prostate gland. It may be used when the cancer is just in the prostate gland and has not spread. Radiation therapy uses high-energy beams to kills the cancer. It may be offered in combination with other treatments as well.
Systemic therapies can include hormone therapy, which involves using medication to stop the hormone testosterone from boosting cancer cell growth. Chemotherapy uses medication to destroy cancer cancer. In immunotherapy, medicines are used to strengthen the immune system to fight off cancer cells. Targeted therapy involves finding the specific mutations that cause healthy cells to become cancerous and prevent this. Other, newer forms of therapy, some of which are still considered experimental, such as focal therapy involve destroying the tumour inside the prostate without having to remove it.
What are the projections for prostate cancer?
The Lancet Commission projects that the number of new cases of prostate cancer annually, will rise from 1·4 million in 2020 to 2·9 million by 2040. Changing age structures and improving life expectancy are predicted to drive big increases in the disease, it says.
The Commission also states that late diagnosis of prostate cancer is widespread worldwide but especially in low and middle income countries (LMICs), where late diagnosis is the norm. 'The only way to mitigate the harm caused by rising case numbers is to urgently set up systems for earlier diagnosis in LMICs. Trials of screening are urgently needed in LMICs to better inform ways to improve early diagnosis,' it says.
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