Prostate Cancer: What it is, Causes, Symptoms, Treatment & More

What is Prostate Cancer?

The prostate is a small, walnut-sized gland that forms part of the male reproductive system. It is located below the bladder and in front of the rectum, surrounding the upper part of the urethra, the tube that carries urine and semen out of the body.

Prostate cancer happens when abnormal cells in the prostate gland start to grow out of control. The prostate helps make semen as part of the male reproductive system. Most prostate cancers grow slowly and stay within the gland at first, but some types can be aggressive and spread to other parts of the body.

How Common is Prostate Cancer in India?

Prostate cancer is a common cancer among men in India and ranks in the top ten cancers nationwide. According to GLOBOCAN estimates, India reported approximately 19,095 new cases of prostate cancer, 12,231 related deaths, and 63,818 men living with the disease within five years of diagnosis.

Prostate cancer is found more often in urban areas. It is the second most common cancer among men in cities such as Delhi, Kolkata, Pune, and Thiruvananthapuram, and the third most common in Mumbai and Bengaluru. The overall five-year survival rate for prostate cancer is about 64%, although outcomes are significantly better when the disease is detected at an early stage.

What are the Symptoms of Prostate Cancer?

Many men with early-stage prostate cancer do not experience noticeable signs. However, as the disease progresses, it can lead to the following symptoms:

• Blood in the Urine: The presence of blood in the urine, which may cause it to appear pink, red, or brown.

• Pain or Burning During Urination: Feeling discomfort, pain, or a burning sensation while passing urine.

• Frequent Urination: Urinating more often than usual, particularly during the night.

• Urgent Need to Urinate: Experiencing a sudden and difficult-to-control urge to urinate.

• Pain in the Lower Back, Hips, Pelvis, or Chest: Persistent pain or discomfort in these areas, which may indicate that the cancer has spread beyond the prostate.

• Weak or Interrupted Urine Stream: A urine stream that is slow, weak, or frequently stops and starts during urination.

• Painful Ejaculation: Painful ejaculation is when you have strong pain or discomfort during or after you ejaculate.

What Causes Prostate Cancer?

The exact cause of prostate cancer is not fully understood, but several factors may increase risks, such as

• Increasing Age: The risk of this condition rises significantly with age, particularly after the age of 50.

• Inherited Genetic Mutations: Certain inherited gene changes, such as mutations in the BRCA1 and BRCA2 genes, may increase the likelihood.

• Ethnicity: Some ethnic groups have a higher risk of getting this disease. For example, men of African ancestry tend to have higher incidence rates and may develop more aggressive forms of the disease.

• Hormonal Changes: Male hormones, particularly testosterone and its derivatives, can influence the growth and development of prostate cancer cells.

• Family History: Having a father, brother, or other close relative with this disease can increase your risk of developing the condition.

• Obesity: Being overweight or obese may increase the risk of developing advanced or severe stages of this cancer.

• Unhealthy Diet: A diet high in saturated fats, processed foods, and red meat may contribute to an increased risk.

• Chronic Prostate Inflammation: Long-term inflammation of the prostate gland may contribute to cellular changes that increase cancer risk.

What are the Complications of Prostate Cancer?

If left untreated, prostate cancer can lead to serious complications, including:

• Urinary Incontinence: Prostate cancer or its treatment may weaken bladder control, leading to accidental leakage of urine.

• Erectile Dysfunction: Damage to nerves and blood vessels caused by the cancer or its treatment can make it difficult to achieve or maintain an erection.

• Urinary Obstruction: The growing tumour may block the flow of urine, making urination difficult or painful.

• Chronic Pelvic Pain: Some people experience persistent pain or discomfort in the pelvic region due to tumour growth or cancer spread.

• Spread of Cancer to Bones: Advanced prostate cancer can spread to the bones, particularly the spine, hips, and ribs, causing pain and other complications.

• Fractures Due to Bone Metastasis: Cancer that has spread to the bones can weaken them, increasing the risk of fractures even from minor injuries.

• Spinal Cord Compression: If this disease spreads to the spine, it may put pressure on the spinal cord, causing pain, numbness, or difficulty walking.

• Kidney Problems: Urinary blockage caused by this condition can interfere with normal kidney function and may lead to kidney damage over time.

When Should I See My Healthcare Provider?

You should consult a healthcare provider if you experience any of the following warning signs of prostate cancer:

• Have ongoing pain in the bones, especially in the back, hips, or pelvis.

• Have difficulty urinating or notice a weak or interrupted urine stream.

• Need to urinate frequently, especially during the night.

• Notice blood in your urine or semen.

• Experience persistent pain or discomfort in the pelvic region.

• Develop erectile dysfunction, particularly when accompanied by urinary problems.

• Experience unexplained weight loss.

• Have a strong family history of prostate cancer and would like to discuss screening options.

How is Prostate Cancer Diagnosed?

Doctors use a combination of screening tests, imaging studies, and biopsy to diagnose this condition. Various methods to diagnose this condition are as follows:

How is Prostate Cancer Managed?

Treatment of this cancer depends on the stage, grade, age, overall health, and patient condition. It can be managed, in various ways, such as

• Hormone Therapy: Hormone therapy reduces or blocks testosterone, a hormone that can stimulate the growth of prostate cancer cells. It is commonly used for advanced or recurrent prostate cancer.

• Chemotherapy: Chemotherapy uses anti-cancer drugs to kill cancer cells throughout the body and is typically recommended when the cancer has spread beyond the prostate.

• Targeted Therapy and Immunotherapy: These newer treatments help attack cancer cells more precisely. Targeted therapy focuses on specific genetic changes in cancer cells, while immunotherapy helps the body's immune system recognise and destroy cancer cells.

• Surgery: Surgery, known as a radical prostatectomy, involves removing the prostate gland and is often recommended when the cancer is confined to the prostate.

• Radiation Therapy: Radiation therapy uses high-energy rays to destroy cancer cells and may be used as a primary treatment or alongside other therapies.

• Active Surveillance: For slow-growing, low-risk prostate cancer, doctors may closely monitor the condition through regular PSA tests, scans, and biopsies without starting immediate treatment.

What is the Prognosis for Prostate Cancer?

The outlook for prostate cancer is usually better if it is found early. Many prostate cancers that are still in the gland can be treated successfully, and survival rates are high. Results depend on things like the stage of cancer, Gleason score, PSA level, age, and how well treatment works. Advanced prostate cancer may require long-term treatment and monitoring. However, newer therapies have significantly improved survival rates and quality of life for many patients.

Can Prostate Cancer Be Cured?

Many cases of prostate cancer can be cured with surgery, radiation therapy, or other suitable treatments. Even if the cancer has spread beyond the prostate, treatment can often slow its growth, ease symptoms, and help people live longer. The chances of a cure are best when the cancer is found early.

How Can I Prevent Prostate Cancer?

While prostate cancer cannot always be prevented, these steps may help lower your risk:

• Keep a healthy body weight by staying active and making thoughtful food choices.

• Try to be physically active for at least 30 minutes on most days.

• Eat a balanced diet with plenty of fruits, vegetables, whole grains, and fibre.

• Try to limit processed and high-fat foods to support your health and lower your cancer risk.

• Avoid smoking and try to stay away from second-hand smoke whenever you can.

• Limit alcohol consumption and maintain an overall healthy lifestyle to support long-term health.

• Go for regular health check-ups to catch any potential health issues early.

• If you have a family history of prostate cancer, talk to your doctor about screening options.

Does Health Insurance Cover Prostate Cancer?

Yes, prostate cancer is covered under cancer-specific health insurance plans as well as many comprehensive health insurance policies. Cancer-specific plans are designed to provide financial protection against cancer-related expenses and may offer benefits such as lump-sum payouts on diagnosis, coverage for hospitalisation, surgery, chemotherapy, radiation therapy, targeted therapy, medications, and follow-up treatment, depending on the policy terms.

Coverage is usually available if the cancer is diagnosed after the policy is purchased and any applicable waiting periods have been completed. Since benefits, exclusions, and waiting periods vary among insurers, it is important to review the policy details carefully before buying a plan.

How Much Health Insurance Coverage is Needed for Prostate Cancer Treatment?

The treatment cost for prostate cancer ranges between ₹2,00,000 and ₹9,00,000, depending on the treatment stage, hospital chosen, surgery, radiation therapy, hormone therapy, chemotherapy, and targeted treatments required.

A health insurance plan with a sum insured of up to ₹10 lakh may be sufficient for early-stage detection treatment. However, individuals requiring advanced therapies, robotic surgery, long-term hormone therapy, or treatment for metastatic disease may benefit from a cover of ₹15-20 lakh or higher for better financial protection.