Prostate Cancer: Diagnosis and Treatment Options

Prostate cancer is the most commonly diagnosed cancer in western men, and incidence is rising rapidly in most countries, including low-risk populations. Despite the high morbidity, the etiology of prostate cancer remains largely unknown. Advancing age, race, and a family history of prostate cancer are the only established risk factors. Many putative risk factors, including androgens, diet, physical activity, sexual factors, inflammation, and obesity, have been implicated, but their roles in prostate cancer etiology remain unclear. It is estimated that as much as 42% of the risk of prostate cancer may be accounted for by genetic influences, including individual and combined effects of rare, highly penetrant genes, more common weakly penetrant genes, and gene (Hsing, Tsao, & Devesa, 2000).

What is the prostate?

The prostate is a small gland in males that sits below the bladder near the rectum, it is responsible for producing the fluid that enriches sperm. The prostate needs the male hormone testosterone to grow, it is for this reason that doctors generally prescribe androgen blocking treatment in the hope of reducing the growth of the prostate.

What is prostate cancer and what are the symptoms?

Prostate cancer is when cells within the prostate multiply and grow uncontrollably. Common symptoms include sexual dysfunction, urinary problems including a weak flow or a flow that stops and starts, pain or burning when urinating, blood in the urine or semen and pain in the back, hips or pelvis.

How do you diagnose prostate cancer?

Generally a doctor will screen patients with a digital rectal examination and check their prostate specific androgen (PSA) levels. Studies have shown that using these methods together is more effective in diagnosing the cancer.

What is prostate specific androgen (PSA)?

PSA is produced for the ejaculate, where it liquefies semen in the seminal coagulum and allows sperm to swim freely. It is also believed to be instrumental in dissolving cervical mucus, allowing the entry of sperm into the uterus. PSA is present in small quantities in the serum of men with healthy prostates, but is often elevated in the presence of prostate cancer or other prostate disorders

Treatment Methods

Androgen-deprivation therapy (ADT) has established therapeutic benefit for men with prostate cancer; however, ADT is associated with considerable adverse effects widely recognised throughout the literature. Negative changes in body composition (decreased lean mass, increased fat mass including abdominal adiposity), alterations in insulin, lipids and C-reactive protein (CRP), as well as reductions in bone mineral density (BMD) have been reported, contributing to an increased risk of cardiovascular, metabolic and bone diseases. Furthermore, men undergoing ADT experience significant declines in sexual health, reduced functional capacity and increased psychological distress, culminating in significant declines in health-related quality of life (HRQL). Effective management strategies for ADT toxicities are clearly required to minimise treatment-related morbidity.

Clinical trials have established the efficacy of appropriate exercise in ameliorating many of the adverse effects of ADT, leading to exercise being recognised as a management strategy for men undergoing ADT. Exercise programmes combining resistance and aerobic components performed at moderate–high intensity have resulted in improvements in body composition, chronic disease risk factors, functional capacity, sexual health, fatigue and HRQL.

Bibliography

Hsing, A., Tsao, L., & Devesa, S. (2000). International trends and patterns of prostate cancer incidence and mortality. International Journal Of Cancer, 85(1), 60-67. http://dx.doi.org/10.1002/(sici)1097-0215(20000101)85:1<60::aid-ijc11>3.0.co;2-b[/vc_column_text][vc_empty_space height=”10″]

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