Prostate Cancer

• Family history: Having a father or brother with prostate cancer increases the risk
• Age: Older age increases risk
• Ethnicity: African and Coloured men have a higher risk
• Diet: Possibly an increased risk with diets high in unsaturated animal fats

Because prostate cancer is slow growing it may be asymptomatic for a few years.
The main symptoms include changes in urinary and sexual function:

• More frequent urination
• Weak or slow urination and dribbling
• Burning urination
• Blood in urine and semen
• Difficulty in getting an erection
• Painful ejaculation
• Pain or stiffness in the lower back, thighs or hips

Many of these symptoms are also associated with a non-cancerous enlargement of the prostate (benign prostatic hyperplasia). If you experience any of the above symptoms,
discuss those with your doctor.

Diagnostic methods might include:
Digital Rectal Exam (DRE): ^1,3,4,6
The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate through the rectal wall to check for hard or lumpy areas.
PSA Blood test:⁶
The blood test will determine the level of Prostate Specific Antigen (PSA). PSA is a protein specifically produced by prostate cells. An elevated level may indicate a higher chance of having cancer.
Biopsy:⁶
Based on the outcome of the DRE and PSA level from the bloodtest, a biopsy will be performed to confirm a prostate cancer diagnosis. During a biopsy a tissue sample is taken using a needle and examined by a pathologist.
After a diagnosis is confirmed the cancer will be graded (based on degree of cell abnormality) and staged (localized in prostate, local spread to surrounding tissue & lymph and distant spread to other organs and bone). Further tests like a computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, bone scan or ultrasound will be performed to establish whether the cancer has spread outside of the prostate gland.^4,5

The treatment of prostate cancer will differ from patient to patient based on age, risk factors, stage of disease and grade.
Treatment options include: Surgery, radiotherapy, hormone therapy and chemotherapy.
Surgery:
Removal of the prostate can be done at an early stage, but has the potential for side effects like erectile dysfunction.
Radiotherapy:
External radiotherapy: uses radiation to target and destroy the cancer.
Internal radiotherapy (brachytherapy): small radio-active implants are placed in the prostate gland to destroy the cancer.
Hormone therapy:
Prostate cancer cells need the hormone testosterone to grow. Hormone therapy works by stopping the production of testosterone or by blocking the action of the testosterone on the prostate cancer cells. Both these methods mean that the hormone is not available for the cancer cells to use, and they cannot grow and survive.
Chemotherapy:
This form of treatment using anti-cancer (cytotoxic = killing cells) medications is usually used in advanced stages of cancer, when the cancer has spread to surrounding tissue and distant organs and bone.