Prostate cancer: A common male cancer that is slow to grow
My uncle was diagnosed as having prostate cancer. He did a routine blood check, which included a screening for the prostate markers in his blood. They were found to be high. They then did further tests, and he was found to have prostate cancer. He is not the only one; a few of my male friends have it too. Even King Charles from the United Kingdom has it. Why is it so common?

Prostate cancer is a common cancer in men.

In the United States, 13 out of every 100 men will develop prostate cancer.

In Malaysia, prostate cancer is the third most common cancer in men, affecting one out of every 117 men.

No one knows exactly what causes prostate cancer.

However, there is higher risk of developing it if:

You are older Most cases are in men over 50 years old. In the past, not many people lived to be past 45, let alone 50 – that’s why it wasn’t as well known. But when they dissected cadavers from medieval times, it was found that many of them also had prostate cancer. It was just that no one knew what it was at that time.

You have a brother or father with prostate cancer This type of family history significantly increases your risk.

It is especially risky if your brother had prostate cancer.

You have a sister or mother who has or had breast cancer This increases the chance of you having prostate cancer if you are a man. This is due to the same genes being implicated in both cancers, including the BRCA1 and BRCA2 genes.

You are obese, i.e. having a body mass index (BMI) of over 30.

You eat a lot of calcium, such as in milk and cheese.

You smoke.

You have had prostatitis, i.e. inflammation of the prostate gland.

You have or had a sexually-transmitted disease (STD).

Some of these risk factors are more important than others, and some are causal.

If you are a man, it is a good thing to keep getting your PSA (prostate specific antigen) levels screened regularly via a blood test once you turn 50.

This is especially important if you have one or more of the above risk factors.

Where is the prostate gland located in the body?

The prostate gland is a small, walnut- shaped gland situated beneath a man’s bladder and in front of the rectum.

Its function is to secrete fluid that will be mixed with semen.

This is to keep the sperm healthy in order to procreate.

Because the prostate is a gland, the type of cancer that develops is most likely to be an adenocarcinoma, which is a cancer of glandular cells.

There are also other, less common prostate cancer types like small cell, transitional cell and neuroendocrine cell.

Are there different stages to prostate cancer?

Yes, there are.

Although prostate cancer is a relatively common cancer, it is also slow to grow.

However, it can still spread throughout the body (i.e. metastasise) and cause death.

My uncle died of prostate cancer that metastasised to his bones.

Prostate cancer is staged using the Gleason score, as well as the usual cancer staging.

The Gleason score looks at how abnormal your cancer cells are – the more abnormal the cells, the worse it is.

Prostate cancer staging is done with the help of MRI (magnetic resonance imaging) and CT (computed tomography) scans to see if the cancer has spread beyond the prostate gland, such as to the nearby lymph nodes or bones (especially the spine).

It can also spread through the blood and to the liver, lungs, brain and other organs.

Men above 50 years of age are recommended to check their PSA levels regularly to pick up BPH or prostate cancer. — 123rf

I heard that as men age, there is a disease that involves enlargement of the prostate gland. How can I tell the difference between that and prostate cancer?

The condition you are talking about is called benign prostate hyperplasia (BPH).

It is a common prostate enlargement that happens to half of all men between the ages 51 and 60, and gradually increases to 80% of all men above 70.

It can be very difficult to differentiate between the two by symptoms alone as they cause the same symptoms.

It is best to screen regularly and let a doctor diagnose it for you.

One way is for the doctor to do a rectal examination on you with his finger.

BPH feels smooth and firm, while prostate cancer may be hard and lumpy.

This examination is coupled with the PSA test.

The rise in PSA in BPH is not as high as in prostate cancer.

The doctor will consider this result along with your risk factors and family history, and decide if you need further tests.

The rest of the tests that will be done will provide more detail.

My friend who has prostate cancer was told to “watch and wait”. Essentially, there was no treatment given to him. Is there such a thing?

Yes. Many doctors opt to monitor the prostate cancer if the cancer is slow to grow and doesn’t spread.

This is called active surveillance.

The patient has to come for screening and a biopsy annually or more frequently, depending on the doctor’s judgement.

If the condition worsens or starts to grow, then treatment will be initiated.

Another method is known as watchful waiting.

It is like the former method, but is mainly for men who are more frail and have prostate cancer that will likely not need to be treated.

Their treatment usually focuses on managing symptoms.

Most of the time, the prostate cancer is so slow-growing that these patients often die in their old age of other causes and not the cancer itself.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Men,Prostate cancer,benign prostate hyperplasia,prostate,men's health,PSA,screening
As such, it just requires monitoring, without treatment, in the early stages.