The prostate gland is part of the male reproductive system and is located below the bladder and in front of the rectum. The size of the gland changes with age, being smaller in young men and larger in older men. Being a part of the male reproductive system, the prostate gland functions to produce and release a fluid that forms part of the semen.
Cancer is a condition in which the cells in a particular part of the body start growing uncontrollably and crowd out the normal cells. Cells in any part of the body can become cancer cells and spread to the other parts of the body. Prostate cancer begins when cells in the prostate gland, in men, start to multiply uncontrollably. Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland itself, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly. Unlike other forms of cancer, however, if detected early, prostate cancer has a very high rate of survival attached to it.
Despite the high rate of diagnosis for prostate cancer in older men, doctors have not been able to pinpoint one or more exact causes as to why prostate cancer presents itself in some men. What doctors do know is how the process of prostate cancer begins and spreads. Cancer begins when cells in the prostate become abnormal. Mutations present in the DNA of the cells cause them to grow and multiply more rapidly than normal cells would. These mutated cells continue surviving while the normal cells around them perish. The accumulating mutated cells form a tumour that can grow to invade the nearby tissue. These abnormal cells can also break off (metastasize) and spread to other parts of the body.
Although doctors have not identified a direct cause for the advent of prostate cancer in men, they have been able to identify risk factors that increase the chances of getting prostate cancer. These risk factors include:
- Age: Statistics show that the older a person is, the more likely they are to be diagnosed with prostate cancer. The rate of diagnosis for men under 40 is 1 in 10,000. However, this rate shoots up considerably as the age bracket increases. The rate of diagnosis for men between the ages of 40 and 59 is 1 in 38, while the rate of diagnosis for men above the age of 60 is 1 in 14.
- Family history/ Genetics: Another risk factor is the presence of prostate cancer in the family. If men in a family have a history of prostate cancer, then it is likely to be passed down onto the successive generations. Furthermore, if the women have a family history of containing the gene that increases the risk for breast cancer (BRCA 1 or BRCA2), then to the risk of prostate cancer increases for the offspring.
- Obesity: Although there is no direct linkage between a high BMI and the risk of getting prostate cancer, it has been observed that obese men that have been diagnosed with prostate cancer usually suffer from the aggressive form of the disease.
One of the standout features of prostate cancer is also the reason why doctors strongly suggest that men over 40 get regularly screened for the disease, namely, that has no overt symptoms. Since prostate cancer starts in a relatively small gland, located in a relatively obscure position in the body, the disease stays silent for many years. In some cases, it has been seen in autopsies in patients that have died from other causes that they were suffering from prostate cancer as well, without having shown any physical symptoms for the same. However, in more aggressive forms of the disease, there are certain physical discomforts that can arise, these include:
- A need to urinate frequently, especially at night; sometimes urgently
- Difficulty starting or holding back urination
- Weak, dribbling, or interrupted flow of urine
- Painful or burning urination
- A decrease in the amount of fluid ejaculated
- Blood in the urine or semen
- Pain or stiffness in the lower back, hips, pelvis, or thighs
However, these symptoms may also be indicative of the presence of other diseases such as Benign Prostatic Hyperplasia (BPH) or prostatitis.
Almost all forms of prostate cancer are adenocarcinomas, and they might vary between gestating slowly and gestating rapidly. Due to the lack of symptoms, until very late into the disease, physicians and doctors are usually adamant about their male patients above 40 getting checked for prostate cancer. Despite the widespread nature of the disease, there is still a lot of misinformation about it and a general lack of knowledge about it, amongst the general public. In the UAE itself, 20% of all cancer cases were those of the prostate kind. As men get older it is imperative that they get themselves checked for any signs of prostate cancer, because as mentioned earlier, early detection of the disease can go a long way in eliminating it from the body completely.
Dr.Nazeer Ahamed
Specialist Urologist
Aster Clinic, Bur Dubai (AJMC)
