The symptoms of prostate cancer are:
- difficulty in starting to urinate.
- frequent urination especially at night.
- pain while urinating.
- blood in urine.
- hip lower back pain.
- pain with ejaculation.
- pain in lower part of pelvis.
- weight loss.
- loss of appetite.

The cause of prostate cancer is not exactly known but there are some factors that increase the likelihood of developing prostate cancer. These factors include:
- A family history of prostate cancer in father or brother are at higher risk.
- Risk increases if several relatives are affected especially when they are young at time of diagnosis.
- High fat diet adds the risk of developing prostate cancer.
- A diet with high lycopenes and curcumin reduces the risk of developing prostate cancer.

Diagnosis of prostate cancer involves following steps:
- Physical examination reveals an in-duration of nodule of the prostate.
- PSA blood test detects prostate cancer of low volume and is a step in initial diagnosis of prostate cancer.
- True cut prostate biopsy after positive PSA test confirms prostate cancer.

Treating early stages of prostate cancer involves watchful waiting. To treat prostate cancer, options available are:
- Surgery
- Radiation therapy
- Drug therapy
They can cause some side effects like impotence and incontinence but they tend to disappear after the treatment.

To prevent prostate cancer:
- Undergo examination and PSA test every 1-2 years interval.
- Limit animal fat consumption.
- Increase dietary consumption of lycopenes and curcumin rich food.

Incontinence

The inability to control urination affects about 10 percent of men who have been treated for prostate cancer.
- Stress incontinence
- Overflow incontinence
- Urge incontinence
Normal bladder function often returns within weeks after surgery or after radiation treatments have stopped.

Impotence

Impotence, also known as erectile dysfunction, is the inability to have an erection. Impotence can result from surgery, radiation therapy, or hormone therapies. In the months following surgery, some potency may return.
- Drugs such as sildenafil (Viagra) can help a man achieve an erection.
- Vacuum devices also assist in achieving an erection.
- Penile implants can be inserted surgically to help create an erection.

Physical Discomfort

Physical discomfort after treatment for prostate cancer may include:
- Fatigue caused by radiation therapy, chemotherapy, or hormone therapies.
- Nausea and vomiting caused by radiation therapy or chemotherapy.
- Hair loss from chemotherapy.

Watchful waiting

Watchful waiting is closely monitoring a patient’s condition without giving any treatment until symptoms appear or change. This is usually used in older men with other medical problems and early- stage disease.

Prostatectomy

It is the most common treatment option for localised prostate cancer. It involves surgical removal of prostate gland and some other near by tissues and reattaching the urethra and bladder. It will prevent further spread of the cancer. If the prostate cancer is in the early stages, prostatectomy can treat the cancer completely. This procedure also produce side effects like impotency, Urinary incontinence, narrowing of the urethra and difficulty in urination.

Radiation therapy

It is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. Impotence and urinary problems may occur in men treated with radiation therapy.

Hormone Therapy

It is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. The purpose of hormone therapy is to lower the level of male hormones, called androgens, which are produced mostly in the testicles. Androgens, such as testosterone, help the prostate tumor grow. Shots or pills can be given over a period of several months, or the testicles can be surgically removed. Some of the more serious side effects include loss of sex drive, weakened bones, erectile dysfunction, fatigue and osteoporosis.

Chemotherapy

It is a combination of drugs which is effective to kill or slow the growth of rapidly multiplying cells. Chemotherapy is usually prescribed to men with advanced prostate cancer. Side effects include hair loss, nausea, vomiting, diarrhea, lowered blood counts, reduced ability of the blood to clot, and an increased risk of infection.

Cryotherapy

an ultrasound probe is inserted into the rectum to produce a picture that the physician will watch on a monitor. The physician will insert probes into the prostate through small incisions between the rectum and scrotum. These probes deliver liquid nitrogen to the prostate, which freezes the tissue and kills cancer cells.

TURP

A procedure called transurethral resection of the prostate (TURP) removes just a portion of the prostate, with an instrument that is inserted through the urethra. The cancer is removed from the prostate by electricity that passes through the end of this special instrument.

Biologic therapy

Biologic therapy is a treatment that uses the patient’s immune system to fight cancer.

Doctors’ recommendations for screening vary. Some encourage yearly screening for men over age 50, and some advise men who are at a higher risk for prostate cancer to begin screening at age 40 or 45. Others caution against routine screening. Although specific recommendations regarding PSA screening vary, there is general agreement that men should be informed about the potential risks and benefits of PSA screening before being tested.

Thus, there is no specific normal or abnormal PSA level. In addition, various factors, such as inflammation (e.g., prostatitis), can cause a man’s PSA level to fluctuate. It is also common for PSA values to vary somewhat from laboratory to laboratory. Consequently, one abnormal PSA test result does not necessarily indicate the need for a prostate biopsy.
A man should discuss an elevated PSA test result with his doctor. There can be different reasons for an elevated PSA level, including prostate cancer, benign prostate enlargement, inflammation, infection, age, and race. If no symptoms to suggest cancer are present, the doctor may recommend repeating DRE and PSA tests regularly to watch for any changes. If a man’s PSA level has been increasing or if a suspicious lump is detected during a DRE, the doctor may recommend other tests like urine test, imaging tests, CT Scan, MRI, ultrasound to determine if there is cancer or another problem in the prostate. If cancer is suspected, a biopsy is needed to determine whether cancer is present in the prostate.

Limitations of the PSA test

- Detecting tumors does not always mean saving lives : When used in screening, the PSA test can detect small tumors.
- False-positive tests : False-positive test results (also called false positives) occur when the PSA level is elevated but no cancer is actually present.
- False-negative tests : False-negative test results occur when the PSA level is in the normal range even though prostate cancer is actually present.

Need To Know

An elevated PSA does not automatically mean a man has prostate cancer. Conditions other than cancer, including an infection or a benign enlargement of the prostate, can result in higher-than-normal PSA levels.The PSA test is not foolproof.

Nice To Know

Recent studies have shown that a variation of the PSA test, called the percent-free PSA test, may be better at detecting prostate cancer.

The percent-free PSA looks at how much PSA circulates alone (free) in the blood and how much is clinging to other proteins. A low percentage of free PSA, even if the total PSA is not especially high, may mean that prostate cancer is more likely.
The percent-free PSA test is not available at all testing facilities.

- By growing into neighboring tissues (invasion).
- By spreading through the lymph system of lymph nodes and lymph vessels.
- By traveling to distant tissues through the blood (metastasis).

The TNM System for Prostate Cancer Stages

The prostate cancer stages are described using three different aspects of tumor growth and spread. It’s called the TNM system for tumor, nodes, and metastasis.
T : for tumor – describes the size of the main area of prostate cancer.
N : for nodes – describes whether prostate cancer has spread to any lymph nodes and to what extent.
M : for metastasis – means distant spread of prostate cancer, for example, to the bones or liver.

Prostate Cancer Stage I

In stage I, prostate cancer is found in the prostate only. Stage I prostate cancer is microscopic; it can’t be felt on a digital rectal exam (DRE), and it isn’t seen on imaging of the prostate.

Prostate Cancer Stage II

The cancer is more advanced than in stage I, but has not spread outside the prostate. The Gleason score can range from 2-10. Stage II prostate cancer may also be called stage A2, stage B1, or stage B2 prostate cancer.

Prostate Cancer Stage III

Stage III prostate cancer has spread outside the prostate, but only barely. Prostate cancer in stage III may involve nearby tissues, like the seminal vesicles.

Prostate Cancer Stage IV

cancer has metastasized (spread) to lymph nodes near or far from the prostate or to other parts of the body, such as the bladder, rectum, bones, liver, or lungs. Metastatic prostate cancer often spreads to the bones. The Gleason score can range from 2-10. Stage IV prostate cancer may also be called stage D1 or stage D2 prostate cancer.

Prostate-specific antigen (PSA) test

A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate or BPH.

Digital Rectal Exam (DRE)

During this exam, the physician inserts a lubricated, gloved finger (digit) into the rectum. Because of the prostate’s location just in front of the rectum, the physician is able to feel the edge of the prostate where the majority of cancers begin. Abnormalities such as bumps or hardness of the prostate can be detected in this way.

MRI Scan

A magnetic resonance imaging (MRI) scan is a computerized picture made by magnetic fields that can show detailed, cross-sectional images of the inner body. MRI scans can create a clear picture of the prostate gland.

Ultrasound

The prostate can be examined through a type of ultrasound called transrectal ultrasonography. In this exam, a tube is inserted into the rectum that carries the sound waves to the nearby prostate, producing a better image.

CT Scan

A CT (computed tomography) scan is a sophisticated x-ray producedure that uses a computer and rotating x-ray beams to produce images of soft tissue, bone, and blood vessels.

Prostate Biopsy

If an abnormality is found on the DRE or the PSA test, the physician will typically order a biopsy of the prostate.
A biopsy involves taking a very small sample of tissue from the prostate. This is done using a thin needle that is placed into the prostate. A tiny amount of tissue is trapped in the needle while it is in the prostate and then the needle is pulled out. This procedure is usually done by an urologist or other surgeon. The pathologist will examine the biopsy sample to check for cancer cells and determine the Gleason score. The Gleason score ranges from 2-10 and describes how likely it is that a tumor will spread. The lower the number, the less likely the tumor is to spread.
There are 2 types of biopsy procedures used to diagnose prostate cancer:
- Transrectal biopsy : The removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate.
- Transperineal biopsy: The removal of tissue from the prostate by inserting a thin needle through the skin between the scrotum and rectum and into the prostate.

Causes of Prostate Cancer

- Prostate cancer is caused by changes in the DNA of a prostate cancer cell. DNA makes up our genes, which control how cells behave.
- Prostate cancer may also be linked to higher levels of certain hormones. High levels of male hormones (androgens) may play a part in prostate cancer risk in some men.
- The risk (predisposing) factors for prostate cancer include advancing age, genetics (heredity), hormonal influences, and such environmental factors as toxins, chemicals, and industrial products.
- It develops in the outer part of the gland as distinct from Benign Prostatic Hyperplasia (BPH), which develops in the centre of the gland. Therefore, it is possible to get prostatic cancer even after one has had a prostatectomy for BPH.

Symptoms of Prostate Cancer

Levels of a substance called prostate specific antigen (PSA) is often high in men with prostate cancer. However, PSA can also be high with other prostate conditions. Since the PSA test became common, most prostate cancers are found before they cause symptoms. In the later stages, prostate cancer can spread locally into the surrounding tissue or the nearby lymph nodes, called the pelvic nodes. The cancer then can spread even farther (metastasize) to other areas of the body. Symptoms of prostate cancer may include :

- A need to urinate frequently, especially at night.
- Difficulty in starting urination or inability to urinate.
- Weak or interrupted flow of urine.
- Painful or burning urination.
- Difficulty in having an erection.
- Pain during ejaculation.
- Blood in the urine or semen.
- Pain or stiffness in the lower back, hips, or thighs.
- Pain with bowel movement.
- Unintentional weight loss.
- Lethargy.
It is advised to consult a doctor immediately if you have experienced any of the above symptoms. Men aged 50 and above have the chances of developing prostate cancer.

What is prostate enlargement, or BPH?

Prostate cancer is an abnormal, uncontrolled growth of cells that results in the formation of a tumor in the prostate gland. Prostate cancer is found mainly in older men. As men age, the prostate may get bigger and block the urethra or bladder. This may cause difficulty in urination or can interfere with sexual function. The condition is called benign prostatic hyperplasia (BPH), and although it is not cancer, surgery may be needed to correct it. Prostate cancer begins most often in the outer part of the prostate.
- A frequent and urgent need to urinate.
- Trouble starting a urine stream.
- A weak stream of urine.
- A small amount of urine each time you go.
- The feeling that you still have to go, even when you have just finished urinating.
- Leaking or dribbling urine
- Small amounts of blood in your urine
It’s true that some men with prostate cancer also have BPH, but that doesn’t mean that the two conditions are always linked. Most men with BPH don’t develop prostate cancer.

What is prostatitis?

Prostatitis means the prostate might be inflamed or irritated. If you have prostatitis, you may have a burning feeling when you urinate, or you may have to urinate more often. Or you may have a fever or just feel tired.