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Prostate cancer is the most common form of cancer in American men — skin cancer excluded — and causes a significant number of cancer deaths every year. Due to its high prevalence, understanding what causes prostate cancer and what early signs look like is imperative for disease detection and treatment.
According to the American Cancer Society, 1 out of every 8 men will get prostate cancer at some point in their lives — albeit the likelihood of it increases with age, with prostate cancer being most frequently identified in individuals over the age of 65.
The outlook for 2024 is rather bleak with the American Cancer Society projecting roughly 299,010 new prostate cancer cases and approximately 35,250 deaths as a result of the disease.
So, what can you do to stay vigilant of the early signs of prostate cancer? And what does preventative medicine for this disease entail?
What Causes Prostate Cancer?
While many risk factors have been identified, it’s not clear what exactly causes prostate cancer. Luckily, prostate cancer remains within the prostate in most instances — a small gland producing seminal fluid for sperm, however, there are forms of prostate cancer that can metastasize and spread to other parts of the body.
On a cellular level, prostate cancer begins to develop with changes in the cells’ DNA. These changes cause the cells to divide and grow more rapidly than normal cells. The abnormal cells also have a longer life expectancy, which means they are viable even when normal cells would have already died.
Some of the risk factors that can cause prostate cancer or exacerbate disease progression once diagnosed include:
- old age,
- ethnicity,
- family history,
- lifestyle factors (smoking, diet, and exposure to chemicals),
- sexually transmitted diseases (STDs),
- previous inflammation in your prostate,
- vasectomy, and
- obesity.
Age is by far the most important variable that can increase your chances of developing prostate cancer. While it’s rare for men in their 20s and 30s to develop the disease, the cancer risk goes up for men over age 50. The risk is the highest for men over age 65 as more than half of the men with prostate cancer will fall within that age range.
Early Signs of Prostate Cancer
Prostate cancer comes with specific signs and symptoms that can make it easier to spot. However, early signs of prostate cancer are sometimes non-existent as many men remain asymptomatic in the early stages of disease development.
The most common signs of prostate cancer can be divided into three categories:
- Symptoms pertaining to urination
- Sexual symptoms
- Other symptoms (affecting your extremities/back)
The first group can include more frequent urination — especially at night and struggling to start or stop urinating. Further signs of prostate cancer encompass changes in your urine stream, feeling a burning sensation while urinating, or having blood in your urine.
Signs of prostate cancer can also include declining sexual health, erectile dysfunction, and changes in your ejaculation. The latter can vary from having blood in your semen to ejaculating less frequently to feeling pain while ejaculating.
Experiencing additional symptoms to the aforementioned can be indicative of advanced prostate cancer that requires more pressing medical attention. Some of these signs include pain and stiffness in your lower back and hips, or swelling in your lower extremities.
Another concern would be unintentional weight loss and pain in your bones.
Testosterone and Prostate Cancer
The relationship between testosterone and prostate cancer is complex, leading to discussions about whether testosterone replacement therapy (TRT) in individuals with low in-house testosterone production could be a risk factor for prostate cancer.
A review that looked into the connection between testosterone and prostate cancer found no evidence of an increased risk of disease development. The review also noted that recent clinical trials concluded that there’s no higher risk of getting prostate cancer in patients on TRT.
The same rings true for another review that determined that no research to date established that TRT could be an independent risk factor.
A recent large-scale study conducted on 5,246 men underlined these findings by coming to the conclusion that TRT taken by men with low testosterone levels will not amplify their risk of developing prostate cancer.
What Does a Prostate Cancer Screening Look Like?
You might not be thrilled about having to go to your doctor for a prostate cancer screening but guidelines recommend that men age 55 and older should routinely get their prostates checked. Prostate cancer screenings are not common in younger men — that is unless you have a family history of prostate cancer or are symptomatic.
Both your primary care physician and urologist can complete a prostate cancer screening — if you see your PCP first, he will only refer you to a urologist if any abnormalities have been found.
Your doctor will likely order some bloodwork and check your PSA (prostate-specific antigen), a protein produced by prostate cells. The majority of healthy men will have PSA levels below 4 nanograms per milliliter (ng/mL).
While not definite, your PSA is considered indicative of your prostate cancer risk as higher PSA levels can correlate with cancer cells being present in the prostate.
Your doctor may also perform a DRE (digital rectal exam) where he inserts a lubricated finger into your rectum to feel for any lumps or abnormalities on your prostate. However, your doctor won’t be able to feel your entire prostate.
You will also discuss potential symptoms and changes in your health with your physician so he can determine if any symptoms may be an early sign of prostate cancer.
If your PSA or DRE necessitates further testing, your doctor can order a prostate biopsy, which — whilst more invasive — can provide clarity over the potential presence of cancer cells in your prostate.
Rising Prostate Cancer Rates
Remember that prostate cancer is one of the most common forms of cancer in men. Staying vigilant of your sexual well-being and changes in urination is, therefore, quite important.
If you want to read more about prostate cancer, download the pamphlet provided by the Prostate Cancer Foundation for more information.
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