By Adaobi Rhema Oguejiofor
Tne of the most common diseases that plague the male gender is prostate cancer, a disease characterized by how slowly it grows and develops in its victims. Available data by the World Cancer Research Fund International (WCRFI) revealed that this disease is the fourth most common cancer in the world and the second most common cancer in men. In 2022, Nigeria recorded about 11,443 deaths as a result of the disease. Therefore, understanding the changes and conditions attached to the ailment goes a long way in preventing fatality.
The prostate is a part of the male reproductive system, which grows larger as a man ages. During a man’s 20s, the normal size of the prostate can be likened to the size of a walnut. But as time goes on, by age 40 there is a possibility of the prostate growing slightly larger, and by age 60, if not kept in check, the prostate is often the size of a lemon. This implies that with age comes an increased risk of prostate problems, such as enlarged prostate or Benign Prostatic Hyperplasia (BPH), Prostatitis and prostate cancer.
To give an overview, in the male reproductive system, the prostate gland is located below the bladder and in front of the rectum. It surrounds part of the urethra, which is a tube that carries urine out of the bladder and through the penis. This gland helps make semen, the white, milky fluid that carries sperm when a man ejaculates. Muscles in the prostate push semen into the urethra and out through ejaculation.
When the prostate begins to enlarge beyond normal, certain changes begin to occur:
Benign Prostatic Hyperplasia
This is also called an enlarged prostate and it results from an overgrowth of the prostate tissue. Its name comes from benign meaning “not cancer” and hyperplasia, which means there are an increased number of cells in the prostate gland. This enlarged prostate presses on the bladder and urethra thereby blocking the flow of urine. As a result of this, urinary symptoms begin to surface such as: the need to urinate more often, especially at night, pushing or straining to begin a urine stream, the feeling that the bladder has not fully emptied, the strong or sudden need to urinate, weak, slow, or dribbling stream of urine, trouble urinating, stopping and starting multiple times while passing urine, painful urination, pain after ejaculation and blood in the urine.
Despite these troubling symptoms, an enlarged prostate does not increase a man’s risk for prostate cancer. However, people with an enlarged prostate have an increased risk of prostatitis, a benign condition that involves inflammation of the prostate. Over time, if it is not treated, BPH can lead to a weak bladder, a backflow of urine that can cause bladder or kidney infections, or a blocked flow of urine, which can further result in kidney failure.
Prostatitis
Prostatitis is another change that can occur in the prostate. It involves the inflammation of the prostate gland. There are four types of prostatitis, and they are characterized by swelling, tenderness and irritation of the tissue in and around the prostate gland. Urinary tract infections (UTIs) and other bacterial infections can cause certain types of prostatitis, but some of them have no cause.
Types of Prostatitis
Acute bacterial prostatitis: This is caused by a bacterial infection, which comes on suddenly. Symptoms of this type include fever and chills. Patients may experience painful and frequent urination or even have trouble urinating. This prostatitis requires medical treatment with antibiotics.
Chronic bacterial prostatitis: Bacteria also cause this type of prostatitis and the symptoms may come on gradually. Unlike acute bacterial prostatitis, this prostatitis type does not usually cause fever and chills, instead, it comes with symptoms like pain when the patient pees or difficulty urinating. It can also take a longer period to treat.
Chronic pelvic pain syndrome (CPPS): This is the most common type of prostatitis. It occurs in approximately 1 out of 3 males. As the name implies, this prostatitis causes chronic pain in the pelvis, perineum (the area between the scrotum and rectum) and genitals. Pain from CPPS can last for months or years. It is not an infection.
Nonbacterial prostatitis (asymptomatic inflammatory prostatitis): This condition causes prostate gland inflammation but has no symptoms. Patients may only find out they have this condition after getting tests to find the cause of other symptoms. This type does not need treatment and is not an infection.
Symptoms of Prostatitis
Prostatitis symptoms differ depending on the type and cause. For instance, patients with nonbacterial prostatitis may not have any symptoms, while patients with the other three types of prostatitis share symptoms, such as: pain in the lower abdomen, genitals or perineum and this pain may spread to the lower back, frequent urge to pee, painful urination (dysuria), blood in your pee (hematuria), blood in semen (hematospermia), pain during sexual intercourse (dyspareunia), painful ejaculation, erectile dysfunction and in the case of Acute bacterial prostatitis, patients may also experience flu-like symptoms like fever, body aches and chills.
Prostate Cancer
According to the United States Centers for Disease Control and Prevention (CDC), for every 100 people with prostates conditions, 13 of them will develop prostate cancer at some point in their lives. However, most will live normal lives and eventually die from causes unrelated to prostate cancer. And among these numbers, some will not need treatment. This however, does not change the fact that prostate cancer is an advanced condition and a serious disease. But fortunately, most people with prostate cancer get diagnosed before it spreads beyond their prostate gland and effective treatment at this stage often eliminates the cancer.
Types of Prostate Cancer
The most common type of prostate cancer that patients are often diagnosed with is adenocarcinoma. It starts in the cells of glands that secrete fluids.
Other less common types of prostate cancers include Small cell carcinomas, Transitional cell carcinomas, Neuroendocrine tumors and Sarcomas.
Symptoms of Prostate Cancer
At the early stages prostate cancer rarely causes any symptoms outside the regular prostate change symptoms. It is important to note however, that not all growths or changes in the prostate are cancer.
Causes of Prostate Cancer
In general, prostate cancer forms when cells divide faster than usual. While normal cells eventually die, cancer cells do not. Instead, they multiply and grow into a lump referred to as a tumor. As the cells continue to multiply, parts of the tumor can break off and spread to other parts of the body.
However, luckily, prostate cancer usually grows slowly. Most tumors are diagnosed before the cancer can spread beyond the prostate. The disease is highly treatable at this stage.
Risk Factors for Prostate Cancer
According to data provided by Cleveland Clinic, the most common risk factors include:
Age: As one gets older, the risk of contracting the disease increases. One is more likely to get diagnosed if they are over 50 as about 60% of prostate cancers occur in people older than 65.
Race and Ethnicity: Those of Black or African descent are at a greater risk. In them, the cancer is most likely to spread faster and form before age 50.
Family history of prostate cancer: One is two to three times more likely to get prostate cancer if a close family member has it.
Prostate Cancer Treatment/Management
Treatment of this disease usually depends on multiple factors ranging from the overall condition to if the cancer has spread and how fast it is spreading. Depending on what a patient requires, they may need to work with various healthcare providers, including urologists, radiation oncologists and medical oncologists. Most prostate cancer diagnosed in the early stages can be cured with treatment.
Some treatment procedures include surveillance, then surgery involving removing a diseased prostate gland that can often successfully eliminate prostate cancers that have not spread. This surgery is called the radical prostatectomy and it is of two types namely: Open radical prostatectomy and Robotic radical prostatectomy.
Other treatment options include radiation therapy, brachytherapy, which is a form of internal radiation therapy involving placing radioactive seeds inside the prostate, systemic therapies, hormone therapy, chemotherapy, immunotherapy, targeted therapies, focal therapy, cryotherapy, photodynamic therapy, high-intensity focused ultrasound (HIFU), and laser ablation.
Prevention
According to experts at the Cleveland Clinic, preventing prostate cancer is not possible however, certain steps can reduce the risk of contracting the disease.
Among these steps include getting regular prostate screenings, maintaining a healthy weight, exercising regularly, eating a nutritious diet including fruits, vegetables and whole grains, avoiding red meats and processed foods, quitting smoking, and avoiding tobacco products.
It is therefore very important for the male gender to be aware of the existence and serious nature of this condition. Regular check-ups are advisable at every point as growth occurs to avoid being taken unawares. It is also important to consciously try to maintain a healthy lifestyle to prevent the occurrence of the disease.