Prostate cancer is a common disease in men, caused by uncontrolled growth of cells in the prostate, and it usually causes no symptoms in its early stages. It is diagnosed with a PSA test, digital rectal examination, MRI and biopsy. Depending on the stage, treatment is planned as active surveillance, surgery, radiotherapy, hormone therapy, chemotherapy or targeted therapies.
Prostate cancer may stay within the prostate, or it may spread to surrounding tissues and other organs. Because it usually causes no symptoms early on, regular check-ups are the most reliable way of picking it up.
Symptoms
In the early stages there are usually no symptoms. As the disease progresses, the following may appear:
- Needing to pass urine often or at night
- Difficulty passing urine
- Blood in the urine or semen
- Erection problems
- Bone pain
These symptoms also occur with benign prostate conditions, so on their own they do not mean cancer.
Risk Factors
Although the exact cause is not known, the following increase the risk:
- Age: the risk rises markedly after the age of 50.
- Family history: prostate, breast or ovarian cancer in first-degree relatives raises the risk.
- Hormones: the effect of male hormones on prostate cells may play a part in the development of the disease.
- Diet: a diet high in fat and red meat and low in vegetables and fruit may increase the risk.
- Excess weight and inactivity: linked in particular with more aggressive prostate cancer.
Diagnosis
Screening is based on the PSA level measured in the blood. A high PSA does not always mean cancer, but it does call for further investigation. During the digital rectal examination, the size and consistency of the prostate are assessed, along with any irregularity. MRI is used to show suspicious areas in the prostate. A definite diagnosis is made by pathological examination of tissue samples taken at biopsy.
Treatment Methods
Treatment is planned according to the stage of the disease, how aggressive the tumour is, and the patient's age and general health.
Active surveillance
For low-risk, early-stage tumours, instead of immediate treatment, regular monitoring is carried out with PSA, MRI and biopsy, moving on to treatment if needed.
Surgery
In radical prostatectomy the whole prostate is removed. The operation can be performed as open, laparoscopic or robotic surgery.
Radiotherapy
The tumour is targeted with high-energy radiation. External beam radiotherapy or brachytherapy can be used.
Drug treatments
Hormone therapy slows the growth of the tumour by lowering testosterone levels and is mostly used in advanced stages. Chemotherapy is preferred when the cancer has spread to other organs. Targeted therapies and immunotherapy are newer approaches chosen according to the genetic features of the tumour.
When the disease is caught at an early stage, there are more treatment options and the results are better.
Frequently asked questions
Does prostate cancer cause symptoms at an early stage?
Does a high PSA mean I have cancer?
Does every patient with prostate cancer need surgery?
At what age should prostate cancer screening start?
Is a prostate biopsy painful?
How is follow-up carried out after prostate cancer treatment?
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