About Prostate Cancer
Prostate cancer occurs when the cells of the prostate begin to grow uncontrollably. When caught and treated early, prostate cancer has a cure rate of over 90%.
Yet being diagnosed with prostate cancer can be a life-altering experience. It requires making some very difficult decisions about treatments that can affect not only the life of the man diagnosed, but also the lives of his family members in significant ways for many years to come.
More than ……………………… men in Jamaica will be diagnosed with prostate cancer this year, and each and every one of them will need to make very personal and individualized decisions about treatment options and diet and lifestyle changes. Most importantly, each and every one of them will have to find a strong, knowledgeable team of physicians, nurses, and other healthcare providers to help guide him through the process at each step of the way.
How Prostate Cancer Grow?
Understanding what happens when prostate cancer begins to grow also helps explain how each of the different treatment options for prostate cancer is utilized.
Normal Anatomy
The prostate is a small, squishy gland about the size of a walnut that sits under the bladder and in front of the rectum. The urethra, the narrow tube that runs the length of the penis and that carries both urine and semen out of the body, runs directly through the prostate; the rectum, or the lower end of the bowel, sits just behind the prostate and the bladder.
Sitting just above the prostate are the seminal vesicles, two little glands that secrete about 60% of the substances that makes up semen; running alongside and attached to the sides of the prostate are the nerves that control erectile function.
Normal Physiology and Treatment-Related Changes
Despite the best efforts of physicians, treatment strategies for prostate cancer can disrupt normal urinary, bowel, and sexual functioning.
Under normal circumstances, the urinary sphincters, bands of muscle tissue at the base of the bladder and at the base of the prostate, remain tightly shut, thereby preventing urine that is stored in the bladder from leaking out. During urination, the sphincters are relaxed and the urine flows from the bladder through the urethra and out of the body.
During prostatectomy, after the prostate is removed, the bladder is pulled downward and is connected to the urethra at the point where the prostate had sat. If the sphincter at the base of the bladder is damaged during this process, or if it is damaged during radiation therapy, some measure of urinary incontinence or leakage will occur.
Solid waste that is filtered out of the body moves slowly downs the intestines, and, under normal circumstances, the resultant stool is excreted through the anus following conscious relaxation of the anal sphincter. Damage to the rectum caused by radiation, or, more rarely, by surgery, can result in a number of bowel problems, including rectal bleeding, diarrhea, or urgency.
If the erectile nerves are damaged during prostatectomy, which was standard during this type of surgery up until the mid 1980s, the ability to achieve erection is lost. Sexual desire is not affected, but severing or otherwise damaging the nerves that stimulate the processes by which erection occurs leads to erectile dysfunction.
Finally, because about 10% of men have what is known as seminal vesicle invasion, meaning that the prostate cancer has either spread into the seminal vesicles or has spread around them, the seminal vesicles are typically removed during prostatectomy and are targeted during radiation therapy. The loss of the prostate and the seminal vesicles renders men infertile.
Diagnosis
Although the DRE and PSA tests cannot diagnose prostate cancer, they can signal the need for a biopsy to examine the prostate cells and determine whether they are cancerous. In some men, changes in urinary or sexual function lead to a full evaluation by the doctor, and, if prostate cancer is suspected, a biopsy will be performed.
The Biopsy
During a biopsy, needles are inserted into the prostate to take small samples of tissue, often under the guidance of ultrasound imaging. The biopsy procedure may cause some discomfort or pain, but the procedure is short, and can usually be performed without an overnight hospital stay.
Detection & Screening
The purpose of screening for cancer is to detect the cancer at its earliest stages, before any symptoms have developed.
Some men, however, will experience symptoms that might indicate the presence of prostate cancer. Because these symptoms can also indicate the presence of other diseases or disorders, these men will undergo a more thorough work-up. Typically, men whose prostate cancer is detected through screening are found to have very early-stage disease that can be treated most effectively.
Screening for prostate cancer can be performed quickly and easily in a physician’s office using two tests: the PSA (prostate specific antigen) blood test, and the digital rectal exam (DRE).
What are the symptoms of prostate cancer?
If the cancer is caught at its earliest stages, most men will not experience any symptoms. Some men, however, will experience symptoms such as frequent, hesitant, or burning urination, difficulty in having an erection, or pain or stiffness in the lower back, hips or upper thighs.
Because these symptoms can also indicate the presence of other diseases or disorders, men who experience any of these symptoms will undergo a thorough work-up to determine the underlying cause of the symptoms.
The PSA Blood Test
Central Medical Laboratories (CML) offer the PSA test, this is done at any of our collection centre where a skilled Lab Technician will collect two tubes of bloods. This will them be send to our Laboratories.
PSA is a protein produced by the prostate and released in very small amounts into the bloodstream. When there’s a problem with the prostate, such as when prostate cancer develops and grows, more and more PSA is released, until it reaches a level where it can be easily detected in the blood.
During a PSA test, a small amount of blood is drawn from the arm, and the level of PSA is measured. PSA levels under 4 ng/mL are usually considered “normal,” results over 10 ng/mL are usually considered “high,” and results between 4 and 10 ng/mL are usually considered “intermediate.”
However, PSA can also be elevated if other prostate problems are present, such as BPH or prostatitis, and some men with prostate cancer have “low” levels of PSA. This is why both the PSA and DRE are used to detect the presence of disease.