Prostate cancer: 11 common questions answered

“Prostate cancer is not as common in India as it is in the western world. If we look at the globocan data by 2018, in India approximately 25,000 to 26,000 people were diagnosed with prostate cancer annually. It is about the 15th of 16th commonest cancer in India,”  says Dr Ashay Karpe, Medical Oncologist, Specialist blood and bone cancers, Sunrise Oncology Center

Prostate cancer is something that most men suffer in silence, because to them it is considered a ‘private problem’.  

But keeping quiet can only make matters worse. So here are some of the most common questions about prostate cancer – answered.

What are the signs and symptoms of prostate cancer?

Different people have different symptoms of prostate cancer. While some people don’t have any symptoms at all , some common indicators include:

  • Difficulty starting to pass urine
  • Weak or interrupted flow of urine.
  • Frequent urination, especially at night.
  • Difficulty emptying the bladder completely.
  • Pain or burning during passing urine.
  • Blood in the urine or semen.
  • Pain in the back, hips, or pelvis that does not subside.
  • Painful ejaculation

How is prostate cancer diagnosed?

If your Urologist suspects the presence of prostate cancer he may suggest a prostate biopsy to be performed. This is where a small tissue sample is taken from the prostate. The sample is then analysed for the presence of cancer cells. The possibilities of the cancer spreading is done using a Gleason score.

Further staging is done via other tests.

In some cases your doctor may also suggest a transrectal ultrasound, where a ultrasound probe, as thick as a finger is inserted into the rectum to detect prostate abnormalities using high-energy sound waves.

What foods can kill/help beat prostate cancer?

There is no proven way to prevent prostate cancer, but you can reduce your chances of suffering from the disease by exercising and eating healthy foods.

A healthy diet includes:

  • High fat foods have been linked to men developing prostate cancer. Therefore eating low fat foods like meats, nuts and healthy oils
  • Increase the amount of fruits and vegetables you eat in a day.  Eating fruits that are rich in vitamins and minerals can help you feel full and reduce the amount of high fat food you eat. \
  • There have been studies that have shown that men who ate dairy products such as milk, cheese and yogurt each day, had the high risk of prostate cancer.

Who is most likely to get prostate cancer?

As per the CDC, all men are at risk of prostate cancer. That being said, the most common risk factor is age. The older you get, the greater the risk of developing prostate cancer. Indians who get diagnosed with prostate cancer is ranges from 5.0-9.1 per 100,000/year. 85% of Indians also get diagnosed at later stage.

Is prostate cancer genetic, should I get screened?

According to Dr Ashay Karpe, “Usually screening is not recommended. But if a person’s close relative has had prostate cancer or someone in their close family has died before the age of 50 from prostate cancer, that person can be considered at high risk for prostate cancer. Usually we recommend a man suffering from any urinary issues should meet their urologist at the earliest. A patient may choose to get a PSA screening after 60 years of age.”

A small percentage of prostate cancers are found to cluster in families. These cancers are linked to inherited gene mutations and tend to develop earlier than non-inherited or sporadic cancers.

If you believe  you may have a family history of prostate cancer, you can talk to your doctor about screening tests like PSA (Prostate Specific Antigen) and DRE (Digital rectal examination)

How is prostate cancer treated?

No, surgery is not always necessary. While this is an invasive procedure, it is the apt choice for some men.

Dr Ashay Karpe says, “When prostate cancer is localized, there are two treatment modalities – radical prostatectomy where the prostate gland is removed surgically. For patients who do not or cannot undergo surgery there are treatment methods like radiation, newer technologies like proton therapy and even hormone therapy.”

“If the prostate cancer has spread to other parts of the body, then, essentially this cancer comes under hormonal influence and the mainstay of the prostate cancer is then a combination of hormonal treatment and use of certain drugs that prevent osteoporosis (which is a side effect of the drugs used to treat prostate cancer),” adds Dr Ashay Karpe.

What are the treatment options?

Your doctor decides the treatment protocol for you based on the stage and grade of your cancer. By and large the treatment modalities include:

  • Active surveillance or watchful waiting – this is usually done when the cancer is in stage I and II.

But if your Gleason score is high or you are in the latter stages of prostate cancer, your doctor may recommend the following:

  • A radical prostatectomy or
  • Radiation therapy (external-beam or brachytherapy), and
  • Testosterone suppression treatment.

Can prostate cancer kill you?

The five year survival rate for prostate cancer in India is close to about 64 percent. That being said, if the cancer is detected early, it can be treated successfully. In India, unfortunately, approximately 15 lakh men are detected with prostate cancer, out of which 85 percent are in the fourth stage of the cancer. This makes the cancer extremely difficult to treat.

If I have prostate cancer, will I lose my ability to have sex?

Dr. Mark Pomerantz, an oncologist with Harvard-affiliated Dana-Farber Cancer Institute, said in a statement to Harvard Health, “Prostate cancer strikes a personal part of a man’s body, and for most, it is a glaring sign of aging and a reminder they are not as young as before.” In short, you will not lose the ability to have sex, but the treatment options that prostate cancer presents have shown to affect one’s sexual function in one way or another, either your libido or desire. 

Can I have children after being diagnosed with prostate cancer?

Unfortunately, it is not possible for you to father a child after treatment for prostate cancer since the treatment modalities affect your ability to have an erection, ejaculate and produce sperm.

In the case of a radical prostatectomy, the prostate and adjoining seminal vesicles are removed, which prevents the production of semen – the fluid that carries sperm to the penis to be ejaculated.

What is the rate of relapse?

The rate of recurrence greatly depends on the type and aggressiveness of the cancer. Statistically, about 20 to 30 percent of men will relapse after the five year mark following initial therapy.


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