Prostate Cancer: Symptoms, Causes, Risk factors, Diagnosis, and Treatment

What is Prostate Cancer?

The prostate is a walnut-sized exocrine gland. The prostate gland is situated below the bladder and in front of the rectum, It is part of a male reproductive system. The prostate gland produces some of the fluid in semen and controls urine in men. Prostate cancer affects the prostate gland and it is one of the most common cancer in men.

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It is crucial for prostate cancer to be diagnosed before it spreads, hence regular testing is essential.

What are the Symptoms of Prostate Cancer?

During the early stages of prostate cancer, there are usually no symptoms. However, if symptoms do appear, they may include:

  • Pain while passing out urine
  • Blood in urine
  • Frequent urges to urinate, including at night
  • Difficulty commencing and maintaining urination
  • Urinary or fecal incontinence
  • Painful urination and, less commonly, ejaculation
  • Bone fractures
  • Difficulty achieving or maintaining an erection may be difficult

Advanced prostate cancer can involve the following symptoms:

  • Bone pain, often in the spine, femur, pelvis, or ribs

If the cancer spreads to the spine and compresses the spinal cord, there may be:

  • leg weakness
  • fecal incontinence

What Causes Prostate cancer?

The prostate produces fluid that nurtures and transports sperm on their journey to fuse with a female egg or ovum. During orgasm, the prostate contracts and forces these fluids out.

The protein excreted by the prostate, prostate-specific antigen (PSA), helps semen maintain its liquid state. The first sign of prostate cancer is an excess of this protein in the blood. Sperm and urine leave the body through the urethra which also passes through the prostate. This makes the prostate also responsible for urine control. It can tighten and restrict the flow of urine through the urethra using thousands of tiny muscle fibers.

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Stages of Prostate Cancer

The advancement of prostate cancer is grouped into the size and extent of the tumor and the scale of the metastasis.

At Stage 0, the tumor has neither spread from the prostate gland nor attacked deeply into it. At Stage 4, the cancer has spread to distant sites and organs.

Prostate cancer usually begins in the glandular cells (adenocarcinoma). Tiny changes occur in the shape and size of the prostate gland cells, known as prostatic intraepithelial neoplasia (PIN). This happens slowly and does not show any visible symptoms until further into the progression.

Risk factors

The exact cause of prostate cancer is yet vague, but there are many possible risk factors.

Age: It is uncommon for prostate cancer to affect men under the age of 45 years, but more common after the age of 50 years.

Geography: For unknown reasons, prostate cancer occurs most frequently in North America, northwestern Europe, on the Caribbean islands, and in Australia.

Genetic factors: Certain genetic and ethnic groups have an increased risk of prostate cancer.

Diet: According to studies, a diet high in red meat or high-fat dairy products may increase a person’s risks of developing prostate cancer.

Medication: Some research has suggested that non-steroidal anti-inflammatory drug (NSAID) use may lower the risk of prostate cancer. Others have linked NSAID use with a higher risk of death from the disease.

Obesity: Some studies have found that obesity increases the risk of death in prostate cancer.

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A doctor will ask questions about medical history. If the patient has symptoms, or if a routine blood test shows abnormally high PSA levels, further examinations may be requested.

Tests may include:

  • a digital rectal examination (DRE): This involves a doctor manually checking for any irregularities of the prostate with their finger
  • a biomarker test checking the blood, urine, or body tissues of a person with cancer for chemicals unique to individuals with cancer

If these tests show abnormal results, further tests will include:

  • a PCA3 test: This test examines the urine for the PCA3 gene only found in prostate cancer cells
  • a transrectal ultrasoundscan: This provides imaging of the affected region using a probe that discharges sounds
  • a biopsy: This involves the removal of small pieces of tissue from several areas of the prostate for investigation under a microscope

To track any spread, or metastasis, doctors may use a bone, CT scan, or MRI scan.

Treating Prostate Cancer

Treatment is different for early and advanced prostate cancers.

Early stage prostate cancer

If prostate cancer is small and localized, the following treatments may be given:

Watchful waiting or monitoring: PSA blood levels are regularly checked, but there is no instantaneous action. The risk of side-effects sometimes outweighs the need for immediate treatment for this slow-developing cancer.

Radical prostatectomy: The prostate is surgically removed. For normal surgery, the patient may stay of up to 10 days in the hospital after the procedure, with a recovery time of up to 3 months. However, for robotic keyhole surgery which is more expensive, recovery time and hospitalization is shorter.

Brachytherapy: Radioactive seeds are implanted into the prostate to deliver targeted radiation treatment.

Conformal radiation therapy: Radiation beams are shaped so that the region where they overlap is as close to the same shape as the organ or region that requires treatment. This minimizes healthy tissue exposure to radiation.

Treatment recommendations depend on individual cases. The patient should discuss all available options with their urologist or oncologist.

Advanced prostate cancer

The advanced cancer stage is more aggressive and will have spread further throughout the body. Treatments may include:

Chemotherapy: This is to destroy the cancer cells around the body.

Androgen deprivation therapy (ADT): This hormone treatment reduces the effect of androgen. Androgens are male hormones that can stimulate cancer growth. ADT can slow down and even stop cancer growth by reducing androgen levels.


The prostate is directly involved with sexual reproduction, so removing it will affect semen production and fertility. Radiation therapy affects the prostate tissue and often reduces the ability to impregnate a woman. The sperm can be damaged and the semen insufficient for transporting sperm.

Non-surgical options can also affect a man’s fertility. So, options for preserving these functions can include donating to a sperm bank before surgery, or having sperm extracted directly from the testicles for artificial insemination into an egg.


Disclaimer: The content provided on is purely informative and educational in nature and should not be interpreted as medical advice. Please use the content only in consultation with an appropriate certified medical doctor or healthcare professional.

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