Prostate Cancer: Symptoms, Treatment Options & Medications

Prostate cancer is common, but it’s also a silent yet fatal threat. If left unchecked, it can severely impact your health and finances. 

Don’t let it take control – you can understand the risks, watch for symptoms, and explore treatment options. 

Being prepared and detecting early gives you the power to protect your future, ensuring a healthier retirement or more precious moments with your loved ones that may have it. 

We will explore all these in this post.

What is Prostate Cancer?

Prostate cancer develops in the prostate gland, a part of the male reproductive system responsible for producing seminal fluid. It is one of the most common cancers among men, often growing slowly and staying localized within the prostate. While some prostate cancers pose minimal risk, others can be aggressive and spread rapidly.

In the following sections, we will explore the risk factors and early symptoms of prostate cancer in more depth. Early detection through screenings like PSA tests can significantly improve treatment outcomes and prognosis.

Types of Prostate Cancer

Prostate cancer can vary in how it behaves and how it affects the body. Your treatment will change up based on the type of cancer it is. 

1. Adenocarcinoma

The most common kind, it starts in the gland cells that make prostate fluid.

2. Small Cell Carcinoma

A rare, aggressive type that grows fast. It usually doesn’t raise PSA levels, making it tough to catch early.

3. Squamous Cell Carcinoma

Even rarer than small cells, it forms in the flat cells of the prostate and spreads quicker than adenocarcinoma.

4. Transitional Cell Carcinoma

This type often begins in the bladder and spreads to the prostate. It’s less common and needs a different approach than other prostate cancers.

5. Neuroendocrine Tumors (NETs)

These rare tumors come from hormone-producing cells. In the prostate, they’re aggressive and don’t show up in PSA tests.

6. Sarcomas

Sarcomas start in the connective tissue. They’re rare in the prostate but grow quickly, needing different treatment from typical prostate cancer.

Main Risk Factors for Prostate Cancer

Prostate cancer affects roughly 13 out of every 100 American men, with 2 to 3 losing their lives to it. Getting older increases the likelihood of developing it. There are other risk factors, too. If you know these factors, you might be able to react to the cancer better and be more well equipped to handle it.

• Age: The older you get, the higher your risk. Most cases occur after age 50, with a sharp increase after 60 all the way up to 70.

• Family History: Men with a father or brother who had prostate cancer have a higher chance of developing it. Genetics play a big role in this.

• Ethnicity: African American men face a higher risk of getting prostate cancer and often experience more aggressive forms of it. Men of Asian or Hispanic descent have a lower risk.

• Diet and Lifestyle: Diets heavy in red meat, processed foods, and high-fat dairy increase the risk of prostate cancer. A healthy diet full of fruits, vegetables, and lean proteins can help lower it. Being overweight or not getting enough exercise also raises the risk.

• Genetic Mutations: Mutations in genes like BRCA1 and BRCA2, commonly linked to breast cancer, can also raise prostate cancer risk in men.

Early Symptoms of Prostate Cancer

Early-stage prostate cancer often doesn’t cause noticeable symptoms. As the disease advances though, you might still notice certain things:

• Urinary Problems: You might have trouble starting to pee, notice a weak flow, or need to go more often, especially at night. It can be painful too—because of Dysuria.

• Blood in Urine or Semen: Though less common, blood may appear if cancer disrupts normal prostate function. This is called Hematospermia.

• Pelvic or Back Pain: Persistent pain in the hips, pelvis, or lower back could mean cancer has spread to bones (Bone Metastases).

• Erectile Dysfunction: Cancer or treatment may lead to Erectile Dysfunction (ED), affecting ability to get or keep an erection.

• Loss of Bladder Control: Some men may experience Urinary Incontinence, where it becomes hard to control the bladder.

• Loss of Bowel Control: Fecal incontinence, or difficulty controlling bowel movements, can happen if cancer affects nearby tissues.

These symptoms don’t always mean prostate cancer, but they should prompt a doctor’s visit.

How Prostate Cancer is Diagnosed

Healthcare professionals use several methods to detect prostate cancer early and accurately. Here’s a summary of these diagnostic methods.

PSA Test

The prostate-specific antigen (PSA) test checks your blood for PSA levels. High PSA levels might indicate cancer, though other conditions like infections can also cause this. Doctors often use this test as an early screening tool.

Digital Rectal Exam (DRE)

In a DRE, the doctor feels the prostate through the rectum to check for lumps or changes in size. If they find something unusual, they will usually order more tests.

Additional Testing

If your PSA levels are high or the DRE shows something unusual, doctors may suggest further testing.

• Prostate Biopsy: The doctor removes small samples of prostate tissue to check for cancer cells under a microscope.

• Imaging Scans: Doctors use MRI or CT scans to see if cancer has spread to other parts of the body.

Prostate Cancer Stages And Grading Score

Doctors determine the prostate cancer's stage (extent of spread) and grade (aggressiveness) once it is confirmed.

Stages

• Stage I: Cancer is small and still confined to the prostate.

• Stage II: The cancer is larger but hasn’t spread outside the prostate.

• Stage III: Cancer has started to invade nearby tissues, like the seminal vesicles.

• Stage IV: The cancer has spread to distant areas, such as bones or lymph nodes.

Gleason Score

The Gleason score measures how abnormal the cancer cells look. Higher scores mean more aggressive cancer that’s likely to spread quickly.

Treatment Options for Prostate Cancer

Doctors treat prostate cancer based on its stage and how fast it’s growing. They consider your age, overall health, and preferences when suggesting a treatment plan.

1. Active Surveillance or Watchful Waiting

For men with slow-growing cancer, active surveillance means regular PSA tests and exams to monitor the cancer. Treatment begins only if the cancer changes or grows. Watchful waiting is a more relaxed approach where doctors treat symptoms as they come up but don’t monitor the cancer closely. This is often used for older men with other serious health issues.

2. Surgery

In radical prostatectomy, the surgeon removes the prostate and surrounding tissues. This surgery is most effective when the cancer is confined to the prostate. Robotic-assisted surgery helps the surgeon perform this operation with great precision.

3. Radiation Therapy

Doctors use radiation therapy to kill cancer cells. It’s often used for early-stage cancer or when the cancer is localized in the prostate or nearby tissues.

• External Beam Radiation Therapy (EBRT): Radiation is aimed at the prostate from outside the body over several weeks.

• Brachytherapy: Tiny radioactive seeds are implanted inside the prostate. These seeds release radiation over time to target cancer cells.

4. Hormone Therapy

Prostate cancer grows by using testosterone. Hormone therapy lowers testosterone levels or blocks it from reaching cancer cells. This treatment can slow or stop the cancer’s growth.

• LHRH Agonists and Antagonists: Drugs like leuprolide or degarelix stop testosterone production from the testes.

• Anti-Androgens: Medications like bicalutamide block testosterone from attaching to cancer cells.

5. Chemotherapy

Doctors use chemotherapy to target and kill fast-growing cancer cells. It’s often reserved for advanced cancer that doesn’t respond to hormone therapy.

6. Immunotherapy

Immunotherapy boosts your immune system so it can fight cancer more effectively. Sipuleucel-T (Provenge) uses your own immune cells, modified to attack prostate cancer cells. Doctors often recommend this for men with advanced cancer that has stopped responding to hormone therapy.

Medications for Advanced Prostate Cancer

The below medications help treat advanced prostate cancer, especially when standard hormone therapies stop working.

• Abiraterone Acetate (Zytiga): This medication blocks testosterone production from sources other than the testicles. It’s usually combined with prednisone to reduce side effects. Being one of the oldest medications, Abiraterone cost is also one of the cheapest, thanks to generics.

• Apalutamide (Erleada): Apalutamide also prescribing for prostate cancer patients. Similar to enzalutamide, it blocks testosterone's impact on cancer cells. Some data shown that Apalutamide patients is doing some more well than Enzalutamide.

• Darolutamide (Nubeqa): This drug also stops testosterone from affecting cancer and is used when the cancer hasn't spread but isn’t responding to hormone therapy.

• Radium-223 (Xofigo): This treatment targets prostate cancer that has spread to the bones, helping with pain relief and extending survival.

• PARP Inhibitors: Drugs like olaparib and rucaparib are used for men with BRCA1 or BRCA2 gene mutations. They stop cancer cells from repairing themselves, leading to their death.

• Enzalutamide (Xtandi): This drug blocks testosterone from reaching cancer cells and is used when the cancer has spread. It’s also almost as old as Abiraterone, so generic Enzalutamide cost is widely affordable.

• Zoladex (Goserelin): Zoladex is a type of hormone therapy called an LHRH agonist. It reduces testosterone levels to slow or stop cancer growth. This medication is also commonly used with other treatments.

• Cabazitaxel (Jevtana): Cabazitaxel is a chemotherapy drug, usually used when prostate cancer has become resistant to hormone therapy and previous chemotherapy. It works by inhibiting cell division, leading to cancer cell death.

Managing Prostate Cancer Treatment Side Effects

Prostate cancer treatments often cause side effects, but many are manageable:

• Surgery: May lead to urinary incontinence or erectile dysfunction, which can improve with pelvic exercises or medication.

• Radiation therapy: Can cause fatigue, bowel issues (like diarrhea), and urinary problems. These usually subside after treatment.

• Hormone therapy: Can result in hot flashes, weight gain, and bone thinning; regular exercise and a healthy diet can help.

• Chemotherapy: May lead to nausea, hair loss, and fatigue. Medications in general help ease these side effects.

• Immunotherapy: Side effects are generally less common but can include flu-like symptoms, fever, or fatigue. Most side effects are manageable with supportive care.

Always discuss any side effects with your doctor for proper management.

Prevention of Prostate Cancer 

While you can't completely prevent prostate cancer, some lifestyle changes may reduce the risk:

• Healthy diet: Focus on fruits, vegetables, and lean proteins while limiting red and processed meats.

• Exercise: Regular physical activity and maintaining a healthy weight are beneficial.

• Avoid smoking: Smoking (which has a fairly solid link to the cancer) increases the risk of cancer.

While these steps aren’t foolproof, they support overall health and may lower your risk. 

Major Complications During Prostate Cancer Treatment 

Prostate cancer treatments can come with complications:

• Surgery: May result in long-term urinary incontinence or erectile dysfunction. 

• Radiation therapy: Could damage the bladder or bowel. 

• Hormone therapy: Raises the risk of heart issues or bone loss. 

• Chemotherapy: Can weaken the immune system, increasing infection risk and causing fatigue. 

There’s also the risk of the cancer returning or spreading. Besides all that, there’s no serious complications in regards to immunotherapy. Either way, staying in regular contact with your doctor can help manage these challenges effectively. You’ll usually need to simply switch the treatment or take extra medications.

Conclusion

Prostate cancer isn’t easy, but you have options. 

95% of people can still survive for 15 or so years with advanced prostate cancer, where the cancer has spread from the prostate to the bones and other body parts. Although, since this mostly occurs in seniors, other unrelated but fatal health conditions may appear.

By learning about treatments, managing side effects, and making smart lifestyle choices, you can take control of your or your patient’s health and live well.