According to the National Cancer Institute, USA, one in eight women will get breast cancer in their lifetimes, while one in seven men will get prostate cancer. But, unlike breast cancer, no media outlet has been brave enough to start a media discussion/campaign about prostate cancer. Why is it so neglected? We would like to discuss just that.

What is Prostate Cancer?

Prostate cancer is a disease where malignant cancer cells form in the tissues of the prostate gland. The prostate gland is one of the glands in the male reproductive system. It lies just below the urinary bladder; in front of the rectum. It’s about the size of a walnut and surrounds a part of the urethra. The prostate gland makes a fluid that forms a part of the semen. For the early detection of prostate cancer, the most effective tests are DRE and the prostate-specific antigen (PSA) blood test.

Prostate cancer symptoms include:

• Weak or interrupted flow of urine.
• Persistent urge to urinate, mostly at night.
• Trouble starting the urine-flow and emptying the bladder completely.
• Feeling pain or a burning sensation while urinating.
• Presence of blood in the urine or even, in the semen.
• Consistent pain in the back, hips, or pelvis.

How common is it? And, why should we worry?

Prostate cancer is the 3^rd leading cause of cancer death in the United States, and nearly 10,000 men in the United States get diagnosed with testicular cancer each year. But you wouldn’t gauge it, from the cancer research funding. The National Cancer Institute spends 2 times as much funding research on breast cancer than it does on prostate cancer. 

A November 29, 2018 article published in NDTV claims that researchers believe that the incidence rate of prostate cancer was likely to double by 2020. We don’t know the updated figures yet but there is certainly an urgent need to increase talks and discussions regarding early signs, symptoms, risk factors, and detection of prostate cancer. Experts are saying that prostate cancer is cancer that grows slowly and that it can be cured if it is detected at an early stage. As per the Indian Medical Council of Research (ICMR), prostate cancer is the second leading cancer among males in cities like Pune, Kolkata, Delhi, and Thiruvananthapuram, and the third leading cancer among males in cities like Mumbai and Bengaluru.

Prostate cancer is more likely to go undetected and undiagnosed as the symptoms include difficulty in passing urine, burning sensation while passing urine, and increased frequency of urination. All these symptoms are generally ignored since they are thought to be a normal part of ageing. It is thus important for people above the age of 40 to get screening for prostate cancer every year, particularly if you have a family history of it.

Prostate Cancer is Extremely Common

Prostate cancer can sometimes occur with enlargement of the prostate – which is quite a normal physiological process. It usually starts after 40 years of age, and can sometimes become cancerous. It usually affects men above 65+ years of age. However, recently there has been an increase in reports of prostate cancer in younger men in the age group of 35-44 and 55-64, particularly in those residing in the metropolitan cities. 

There are several risk factors indicated in the causation of prostate cancer, namely, positive family history, history of diabetes mellitus, height, weight and obesity, smoking habit, physical activity, body mass index (BMI), and vasectomy. According to Dr. P N Dogra, HOD, Urology, AIIMS, a sedentary lifestyle with obesity can trigger the chances of getting prostate cancer.

Prostate Cancer Causes

People with the following pre-conditions are more susceptible than other:

1. History of diabetes
2. Hypertension
3. BMI of less than 25
4. Chronic smokers
5. Alcohol consumption

The risk of prostate cancer is reduced with the increase in dietary consumption of tea, citrus fruits, melons, eggs, fish, and sunflower oil. 

Treatment for Prostate Cancer

A transrectal biopsy is often used to diagnose prostate cancer. A transrectal biopsy is basically the removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure may be done using transrectal ultrasound or transrectal MRI to help guide from where samples of tissue are taken from. If cancer is found, the pathologist will give cancer a grade, which is called the Gleason score. 

The Gleason score can range from 6 to 10. The higher the Gleason score, the quicker cancer will grow and spread. A Gleason score of 6 is categorized as low-grade cancer; a score of 7 is medium-grade cancer; and a score of 8, 9, or 10 is high-grade cancer. Treatment depends upon the stage of cancer, the patient’s age, and whether prostate cancer has just been diagnosed or recurred. There are different types of treatment options available for patients with prostate cancer. Seven types of standard treatment are used:

1. Active surveillance
2. Surgery
3. Radiation therapy and radiopharmaceutical therapy
4. Hormone therapy
5. Chemotherapy
6. Immunotherapy
7. Bisphosphonate therapy

New types of treatment are also being tested in clinical trials like-

1. Cryosurgery
2. High-intensity–focused ultrasound therapy
3. Proton beam radiation therapy
4. Photodynamic therapy

Dr Anup Kumar, Head of Department, Department of Urology and Renal Transplant, VMMC and Safdarjang Hospital, believes that though it was previously thought that the prevalence of prostate cancer in India is far lower as compared to the western countries, with the increased urban-migration of the rural populace, changing lifestyles, increased awareness, and easy access to medical facilities, more cases of prostate cancer are being diagnosed and it is becoming evident that we are not very far behind the rate from western countries. 

Thus, it becomes absolutely essential to start a discussion about prostate cancer. It has surely been neglected for far too long and thus we found it our duty to highlight this issue plaguing men across the world. Let’s try and create awareness as much as we can. Who knows, maybe someday we will be able to prevent many more of our fathers and grandfathers from succumbing to this disease! It’s time we hold a blue ribbon next to this pink one, isn’t it?

Also Read: A Guide On The Stages Of Prostate Cancer