The prostate is a part of the male urinary and reproductive systems. It produces a portion of the fluid that comprises sperm. It is situated beneath the bladder and before the rectum. The urethra (the tube that transports urine and sperm out of the body via the penis) passes via the prostate. In younger men, the prostate is typically approximately the size of a walnut, although it can get larger as men age. 
Prostate cancer grows in the prostate gland. It is the second major cause of cancer deaths in men. When prostate cancer occurs, it begins in the prostate gland and spreads to the seminal vesicles. Prostate cancer cells can spread by escaping from a prostate tumor. They can pass via lymph nodes or blood vessels to reach other body areas. Cancer cells may adhere to other tissues and develop to form new tumors after spreading, causing damage to other body organs. The new tumor contains the same type of abnormal cells and has the same name as the old tumor when prostate cancer spreads from its original location to another portion of the body. [1,2,3]
The most prevalent form of prostate cancer is prostate adenocarcinoma. It is responsible for 95% of prostate malignancies. Adenocarcinoma originates in gland cells. The prostate gland cells produce mucus and prostatic fluid, which combine with sperm and other fluids to form semen. Most adenocarcinomas are detected in the prostate’s outermost layer.
Typically, adenocarcinoma develops in multiple areas (sites) in the prostate. When cancer is discovered in multiple areas of an organ, it is referred to as multifocal cancer. Each prostate site can have its own grade. [1,2]
The following types of prostate cancers are extremely uncommon:
- Urothelial carcinoma (transitional cell carcinoma)
- Carcinoid Tumors
- Squamous Cell Carcinoma
Symptoms of Prostate Cancer:
In its early stages, prostate cancer often shows no symptoms. When symptoms appear, they can be like an enlarged prostate. Prostate cancer can also cause symptoms irrelevant to BPH. Symptoms of prostate cancer can be: [3,4]
- Pain in the lower pelvic area
- Abnormally frequent urination
- Difficulty urinating, pain, burning, or weak urine flow
- Blood in the urine (hematuria)
- Painful ejaculation
- Pain in the lower back
- Weight loss
- Pain in the bones. [4,5]
5 Warning Signs of Prostate Cancer
1. A weak or sluggish urine flow
As male individuals age, most have difficulty urinating; however, this is typically not because of prostate cancer. If one has a weak or slow urine flow or if their pee flow starts and stops without their control, it is still a good idea to get the prostate tested.
2. Recurring urge to urinate
Pay attention if someone begins to have a regular and occasionally urgent need to urinate, especially at night. For example, a prostate tumor can exert pressure on the bladder and urethra.
3. Urination that hurts or burns
While urinary tract infections are most frequently linked to this disorder, also known as dysuria, it can occasionally indicate prostate cancer.
4. Urine with blood
Hematuria, or blood in the urine, is yet another potential prostate cancer warning sign. However, it is worth getting checked out, even though this may be related to other medical conditions, such as a urinary tract infection.
5. Male genital soreness
Unexplained pain in the vicinity of the prostate, particularly when sitting down, is a rare but early indicator of prostate problems. Only a urologist can determine whether this also points to prostate cancer. [2,3,6,7]
Other Symptoms of Prostate Cancer:
- Pain in the hips, spine, chest, as well as other body areas when cancer spreads to the bones.
- One is experiencing weakness or numbness in the legs or feet or even loss of bladder or bowel control from cancer pressing on the spinal cord.
Treatment for Prostate Cancer:
Radical Prostatectomy (Surgery) for Prostate Cancer – Three types of radical prostatectomy surgery are as follows:
(a) Robotic Assisted Laparoscopic Radical Prostatectomy (RALP): The most common type of prostate cancer surgery performed nowadays is Robotic Assisted Laparoscopic Radical Prostatectomy. Through microscopic tubes positioned in the belly, it also enables prostate removal, and there is no or little blood loss with robotic surgery.
(b) Retropubic Open Radical Prostatectomy: The surgeon will cut the lower belly and remove the prostate through this opening. The surgeon can simultaneously assess the prostate gland and surrounding tissue while reducing injury to nearby organs. A transfusion may be required if there is significant blood loss. [4,5,7]
(c) Laparoscopic Radical Prostatectomy: Small cuts are made in the abdomen during this procedure, and a camera and small tools are used to remove the prostate area affected with cancer. Robotic-assisted laparoscopic surgery has mostly taken the place of this procedure.
High-energy rays are used in radiation therapy to kill or slow cancer cells’ growth. In place of surgery, radiation is used as the primary treatment for prostate cancer. If the tumor is not entirely removed or returns, it can also be used after the surgery. Most often, photon beams or proton beams are used in radiation therapy. They convey a deficient radiation charge and mass and can disperse into nearby healthy tissue. Instead, proton beams have more control and a heavier mass and can attack deep tissue. In addition, a physician can administer proton radiation treatment to the particular cancer site, minimizing damage to nearby healthy tissue. [2,3,7]
HIFU and Focal Therapy
HIFU uses sound waves to target and heats the tumor to destroy cells with the help of MRI scans. Focal therapy destroys small tumors present inside the prostate without destroying the whole gland.
Hormonal Therapy or Androgen Deprivation Therapy (ADT)
Androgen deprivation therapy is another name for hormonal treatment. It uses drugs to block testosterone and other male sex hormones that fuel cancer. ADT dramatically reduces testosterone production in prostate cancer cells. After receiving initial local aggressive therapy, malignancies that are progressed or have returned are treated with ADT to slow their growth. Additionally, it is applied briefly before, during, and following radiation therapy. Hormone therapy can be done surgically or with medication.
Chemotherapy is used for the late stages of prostate cancer. The drugs circulate in the bloodstream. They attack cancerous and non-cancerous cells because they kill any rapidly growing cell. Dose and frequency are cautiously controlled to reduce the side effects this may cause. [1,5,6]
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