What to know about prostate cancer?
Prostate cancer is a common type of cancer in males, but it is highly treatable in the early stages. It begins in the prostate gland, which sits between the penis and the bladder.
The prostate has various functions, including:
- producing the fluid that nourishes and transports sperm
- secreting prostate specific antigen (PSA), a protein that helps semen retain its liquid state
- helping aid urine control
Prostate cancer is the most common cancer to affect males in the United States.
In fact, in 2019, the American Cancer Society (ACS) predict that there will be around 174,650 new diagnoses of prostate cancer and around 31,620 deaths from this type of cancer.
Around 1 in 9 males will receive a diagnosis of prostate cancer at some point in their life. However, only 1 in 41 of these will die as a result of it.
This is because treatment is effective, especially in the early stages. Routine screening enables doctors to detect many cases of prostate cancer before they spread.
There are often no symptoms during the early stages of prostate cancer, but screening can detect changes that can indicate cancer.
Screening involves a test that measures levels of PSA in the blood. High levels suggest that cancer may be present.
Males who do experience symptoms may notice:
- difficulty starting and maintaining urination
- a frequent urge to urinate, especially at night
- blood in the urine or semen
- painful urination
- in some cases, pain on ejaculation
- difficulty getting or maintaining an erection
- pain or discomfort when sitting, if the prostate is enlarged
Is prostate cancer the only cause of blood in the urine? Learn more here.
Advanced symptoms
Advanced prostate cancer can involve the following symptoms:
- bone fracture or bone pain, especially in the hips, thighs, or shoulders
- edema, or swelling in the legs or feet
- weight loss
- tiredness
- changes in bowel habits
- back pain
How likely is back pain to indicate later stage prostate cancer? Learn more here.
For more research-backed information and resources for men’s health, please visit our dedicated hub.
Treatment will depend on the stage of the cancer, among other factors.
In the sections below, we list some treatment options for each stage of prostate cancer, as well as some new approaches and what treatment means for fertility:
Early stage prostate cancer
If the cancer is small and localized, a doctor may recommend:
Watchful waiting or monitoring
The doctor may check PSA blood levels regularly but take no immediate action.
Prostate cancer grows slowly, and the risk of side effects may outweigh the need for immediate treatment.
Surgery
A surgeon may carry out a prostatectomy. They can remove the prostate gland using either laparoscopic or open surgery.
Radiation therapy
Options include:
Brachytherapy: A doctor will implant radioactive seeds into the prostate to deliver targeted radiation treatment.
Conformal radiation therapy: This targets a specific area, minimizing the risk to healthy tissue. Another type, called intensity modulated radiation therapy, uses beams with variable intensity.
Treatment will depend on various factors. A doctor will discuss the best option for the individual.
Advanced prostate cancer
As cancer grows, it can spread throughout the body. If it spreads, or if it comes back after remission, the treatment options will change.
Options include:
Chemotherapy: This can kill cancer cells around the body, but it can cause adverse effects.
Hormonal therapy: Androgens are male hormones. The main androgens are testosterone and dihydrotestosterone. Blocking or reducing these hormones appears to stop or delay the growth of cancer cells. One option is to undergo surgery to remove the testicles, which produce most of the body’s hormones. Various drugs can also help.
Lupron is a kind of hormone therapy that doctors use to treat prostate cancer. What does this treatment involve?
Most doctors
New treatments
Some newer approaches aim to treat prostate cancer without the side effects that other treatment options can bring.
These include:
- cryotherapy
- high intensity focused ultrasound
After surgery, a doctor will continue to monitor PSA levels. Learn more here about what to expect.
Effects on fertility
The prostate gland plays a role in sexual reproduction. Prostate cancer and many of its treatments affect fertility in several ways.
For example, if a male has surgery to remove either the prostate gland or the testicles, it will affect semen production and fertility.
Also, radiation therapy can affect prostate tissue, damaging sperm and reducing the amount of semen for transporting it.
Hormonal treatment can also affect fertility.
However, some options for preserving these functions include:
- banking sperm before surgery
- extracting sperm directly from the testicles for artificial insemination
However, there is no guarantee that fertility will remain intact after treatment for prostate cancer. Anyone who would like to have children after treatment should discuss fertility options with their doctor when they devise their treatment plan.
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