Prostate cancer is a type of cancer that develops in the prostate gland. Males have a little gland called the prostate that resembles a walnut that secretes seminal fluid, which feeds and carries sperm. The prostate is found just right at the base of the penis at the neck of the urinary bladder.

One of the most typical forms of cancer is prostate cancer. Most forms of prostate cancers multiply at a slow rate and just localizes within the gland such that they are not destructive. Some cancers of the prostate develops slowly such that they do not cause any trouble and only needs monitoring for any changes that may require treatment.

What are symptoms of prostate cancer

In some cases prostate cancer do not cause any symptoms especially when the cancer is not aggressively growing and spreading. However advanced stage can cause the following symptoms:

  • Difficult passing urine (pain and need to push with force only little urine comes out)
  • Blood in semen (the ejaculatory fluid may contain blood)
  • Urinating blood
  • Unexpectedly weight loss.
  • Erection problems may occur.
  • Urine dribbling (urine flow is dribble not strongly flowing and may come out in drops sometimes) or urinary retention
  • Painful bones when the cancer spreads.

What are the aggressive prostate cancer symptoms?

For the stage 4 prostate cancer symptoms are more severe and it's said to be an aggressive type. The urine emptying becomes more difficult and the spread of cancer to other parts of the body commonly bones can cause severe pains of the bones, weight loss to an extreme extent. In most cases the treatment at aggressive stage has poor outcome.
Note that most of the aggressive prostate cancer symptoms started as the above mild ones but due to failed or delayed treatment they progress to severe stage.

What causes prostate cancer

What specifically causes prostate cancer is unknown.

According to medical professionals, prostate cells change in their DNA and this is how prostate cancer starts. The instructions directing a cell's behavior are encoded in its DNA. The modifications instruct the cells to grow and divide more quickly than typical cells do. The aberrant cells have higher survival ability such that it would be other cell types dying not them.

The accumulation of aberrant cells creates tumor and they can metastasize to other surrounding tissue. Over time, certain aberrant cells may separate and disperse (metastasize) to different bodily regions.

Who is at higher Risk for prostate cancer?

The factors that can increase your risk of developing prostate cancer as a man include the following:

Family history: You may be at a higher risk if a blood relative—a parent, sibling, or child—has been identified as having prostate cancer. Additionally, if you have a significant family history of breast cancer or if you carry the BRCA1 or BRCA2 gene, your risk of developing prostate cancer may be increased.

Your age : 40 years and above for most Africans and 50 + years for other races are at higher risk of developing cancer.

Race: Prostate cancer risk increases with race, blacks being at higher risk of having it than other races. The reason for race differences in this type of cancer has no concrete explanation yet. In addition prostate cancer in blacks tends to be more aggressive

Being obese: Compared to persons who are regarded to be of a healthy weight, those who are obese may have an increased chance of prostate cancer, while studies have produced conflicting findings. Obese individuals have a higher risk of the cancer being more aggressive and coming back after the initial course of therapy.

symptoms of aggressive prostate cancer
Image Credit: UNC School Of Medicine

What are complications of prostate cancer.

Prostate cancer complications occurs especially when the cancer is aggressive and has spreads to other parts.

Here are complications:

Spreading (metastasizing) cancer. The bladder is one of the adjacent organs where prostate cancer can spread. It can also reach your bones or other organs through your circulation or lymphatic system. Broken bones are a possibility if prostate cancer spreads to the bones. Prostate cancer may still respond to treatment and may be controlled if it has spread to other parts of the body, but it is unlikely to be cured.

Incontinence. Urinary incontinence may result from prostate cancer or its treatment. Treatment for incontinence is based on the type, severity, and chance that it will get better over time. Medication, catheters, and surgery are all possible forms of treatment.

Erection issues. Prostate cancer and its therapies, such as hormone therapy, surgery, or radiation, can also cause erectile dysfunction. Erectile dysfunction can be treated with medications, vacuum devices that help with erections, and surgery.

How is screening for prostate cancer done

It is debatable whether or not to test healthy men without symptoms for prostate cancer. Medical groups dispute somewhat about whether testing is advantageous compared to possible hazards. Most medical organizations advise men in their 40s or over to speak with their doctors about the advantages and disadvantages of prostate cancer screening. Reviewing your risk factors and your screening requests should be part of the conversation. If you are Black, have a history of prostate cancer in your family, or have other risk factors, you could think about starting the conversations earlier. Some prostate screening exams include:

The Digital Rectal Examination (DRE). In a DRE, your doctor examines your prostate, which is close to the rectum, by inserting a gloved, lubricated finger into your rectum. You could require more testing if your doctor notices any irregularities in the texture, shape, or size of the gland.

The Prostate-specific Antigen (PSA) test. Your blood is collected from a vein in your arm and tested for PSA, a chemical that your prostate gland naturally produces. It's usually normal to have a little concentration of PSA in your blood as long as it's within an acceptable range. However, If a higher-than-average level is found, though, this might be an indication of malignancy (prostate cancer), inflammation, enlargement, or just a prostate infection.

How do Doctors investigate prostate cancer

Your doctor may suggest additional tests to find out if you have prostate cancer if a prostate cancer anomaly is found during prostate cancer screening, such as:

The Ultrasound scan. A transrectal ultrasonography involves inserting a tiny probe into your rectum that is roughly the size and shape of a cigar. In real time, the probe takes an image of your prostate gland using some sound waves.

The Magnetic resonance imaging (MRI) .In some circumstances, your doctor could advise an MRI scan of the prostate to produce a more thorough image. MRI scans may be used by your doctor to help in the design of a procedure to get samples of prostate tissue.

Prostate tissue biopsy. Your doctor might advise having a prostate biopsy (process to take a sample of cells from your prostate) to check for the presence of cancerous cells. A little needle is frequently introduced into the prostate during a prostate biopsy in order to collect tissue. To ascertain whether cancer cells are present, a laboratory histological analysis of the tissue sample is usually performed.

What test determines the cancer aggressiveness?

Finding out the grade (aggressiveness) of the cancer cells is the next step after a biopsy confirms the presence of cancer. To assess how much your cancer cells differ from healthy cells, a specialist examines a sample of your cancer cells in a lab. A cancer having higher grades is more likely to spread faster and aggressive at the same time.

The following methods are used to assess the cancer's aggression:

The Gleason score. A Gleason score is the most popular scale for determining the grade of prostate cancer cells. Although the lower end of the range isn't utilized as frequently, Gleason scoring incorporates two scores and can range from 2 (nonaggressive disease) to 10 (highly aggressive cancer).

Most prostate biopsy samples are evaluated using Gleason scores between 6 and 10. Prostate cancer with a low grade is indicated by a score of 6. Prostate cancer with a medium grade is indicated by a score of 7. Scores from 8 to 10 simply shows you have a high grade cancer.

The Genomic test. Your prostate cancer cells are examined using genomic testing to identify any gene mutations. You may learn more about your prognosis from this sort of test. The tests aren't commonly employed, though, because it's unclear who may profit the most from this knowledge. Genomic testing are not often required for men with prostate cancer, but they may give doctors extra information in some circumstances.

How is the cancer spreading determined?

Your doctor will try to ascertain the extent (stage) of the cancer after diagnosing you with prostate cancer. One or more of the imaging tests listed below may be suggested by your doctor if they have reason to believe your cancer has spread outside of your prostate:

  • Computerized tomography (CT) scan
  • Scan of the bone
  • Positron emission tomography (PET) scan
  • Ultrasound scan
  • Magnetic resonance imaging (MRI)
Not everybody needs to take every test. Which tests are most appropriate for your particular circumstance will be decided with the advice of your doctor.

Your cancer is given a stage by your doctor using the results of these tests. Roman numerals ranging from I to IV are used to denote the various stages of prostate cancer. The cancer is only found in the prostate, according to the first stages. By stage IV, the cancer may have spread to other parts of the body and has developed outside the prostate.

What is the treatment of prostate cancer?

Your prostate cancer treatment options rely on a number of variables, including how quickly the cancer is developing, if it has spread, your general health, as well as the potential advantages or disadvantages of the proposed course of action.

Treatment is determined by some factors and not all cancers may need treatment immediately.
It's possible that low-grade prostate cancer can wait to be treated. Some people might never require treatment. Instead, medical professionals occasionally advise active surveillance.

In order to track the development of your cancer, regular follow-up blood tests, rectal exams, and prostate biopsies may be done. If testing reveal that your disease is spreading, you may choose a prostate cancer treatment like radiation or surgery.

For cancer that isn't causing symptoms, is anticipated to grow extremely slowly, and is contained to a limited area of the prostate, active surveillance may be an option. If a patient has another major medical condition or is too old for cancer treatment, or both, active monitoring may potentially be an option.

Surgical removal of the prostate gland

Radical prostatectomy is the surgical procedure used to remove the prostate gland, some surrounding tissue, and a few lymph nodes.

The cancer that is localized to the gland maybe removed surgically. When combined with other treatments, it is occasionally used to treat advanced prostate cancer.

Surgeons may employ a method that includes the following to gain access to the prostate:

Making a number of tiny abdominal incisions. During a robot-assisted laparoscopic prostatectomy, medical equipment is attached to a machine (robot) and introduced through a number of tiny abdominal incisions. The surgeon directs the robot to move the instruments while seated at a console and using hand controls. Using this method, the majority of prostate cancer surgeries are performed.

Make a single, lengthy abdominal incision. In order to reach and remove the prostate gland during retropubic surgery, the doctor creates a single, lengthy incision in your lower abdomen. Although far less often, this strategy can be required in specific circumstances.
Talk with your surgeon about the best surgical procedure for your particular circumstance.


High-powered energy is used in radiation therapy to eliminate cancer cells. Treatments for prostate cancer utilizing radiation therapy may include:

Radiation (external beam radiation) that enters your body from the outside. In external beam radiation therapy, you lie on a table as a machine rotates around your body, aiming powerful energy beams onto your prostate cancer, such as X-rays or protons. For a few weeks, you normally receive external beam radiation treatments five days a week. A shorter radiation therapy regimen using greater radiation doses administered over fewer days is provided by some medical facilities.

A treatment option for prostate-specific cancer is external beam radiation. If there is a chance that the cancer can spread or recur, it can also be administered after surgery to eliminate any cancer cells that might have survived. Radiation therapy can help reduce the growth of prostate cancer and ease symptoms, such as discomfort, if it has spread to other parts of the body like the bones.

Internal radiation therapy (brachytherapy). Placing radioactive sources inside your prostate tissue is known as brachytherapy. Most frequently, radioactive seeds the size of rice that are injected into your prostate tissue contain the radiation. The radiation from the seeds is spread out over a lengthy time at a low dose. One option for treating cancer that has not progressed past the prostate is brachytherapy.
Doctors may advise using both kinds of radiation therapy in certain circumstances.

Ablation therapy (Prostate Freezing or Heating)

Freezing the prostate tissue. Using an extremely cold gas to completely freeze the prostate tissue is known as cryoablation or cryotherapy for prostate cancer. The process is repeated after allowing the tissue to defrost. The cancer cells are killed, along with some nearby healthy tissue, during the freezing and thawing cycles.

Freezing the prostate tissue. The prostate tissue is heated and eventually dies during a high-intensity focused ultrasound (HIFU) procedure.

When surgery is not an option, these treatments could be taken into account for treating very tiny prostate tumors. If other therapies, such as radiation therapy, have failed to be effective, they may also be used to treat advanced prostate malignancies.

Cryotherapy and high-intensity focused ultrasound (HIFU) are being investigated as possible treatments for prostate-specific cancer. With a technique known as "focal therapy," the prostate's area with the most aggressive cancer cells is found, and just that region is treated. Focused therapy lowers the possibility of adverse consequences, according to studies. However, it's unclear if it provides the same survival advantages as prostate-wide treatment.

Hormonal therapy

The male hormone testosterone is produced by your body, thus hormone therapy works to stop it. A hormone Testosterone is essential for the growth of prostate cancer cells. The removal of testosterone from the body may cause cancer cells to die or develop more slowly.

Options for hormone treatment include:

Medications that inhibit the production of testosterone by your body. Certain drugs, referred to as LHRH (luteinizing hormone-releasing hormone) or GnRH (gonadotropin-releasing hormone) agonists and antagonists, stop your body's cells from getting the signal to produce testosterone. Your testicles quit making testosterone as a result.

Drugs that prevent testosterone from entering cancerous cells. These drugs, also referred to as anti-androgens, are typically used along with LHRH agonists. This is due to the possibility that LHRH agonists may temporarily raise testosterone levels before they fall.

Orchiectomy. A procedure to remove the testicles. Your body's testosterone levels fall immediately and considerably after testicular removal. Surgery to remove the testicles is permanent and irrevocable, in contrast to available pharmaceutical solutions.
In order to reduce the cancer and slow its progress, hormone therapy is frequently used to treat advanced prostate cancer.

When treating prostate cancer that hasn't gone elsewhere, hormone therapy is occasionally administered before radiation therapy. It aids in cancer cell reduction and boosts radiation therapy efficiency.


Chemotherapy employs medications to destroy rapidly proliferating cells, particularly cancer cells. Chemotherapy can be given orally, through a vein in your arm, or both.

Prostate cancer that has spread to other parts of the body may be treated with chemotherapy. Cancers that don't respond to hormone treatment may potentially be treated with chemotherapy.


Immunotherapy fights cancer by activating your immune system. Because cancer cells create proteins that assist them conceal themselves from immune system cells, your body's immune system, which fights disease, may not attack your cancer. Immunotherapy works by obstructing that procedure.

Immunotherapy for prostate cancer can include:

creating cancer-fighting cells in your body. The Sipuleucel-T (Provenge) treatment genetically modifies a portion of your own immune cells in a lab to combat prostate cancer before injecting the modified cells back into your body through a vein. For treating advanced prostate cancer that does not respond to hormone therapy, this is an alternative.

assisting the immune system's detection of cancerous cells. Advanced prostate tumors that no longer respond to hormone therapy can be treated with immunotherapy medicines, which aid immune system cells in recognizing and attacking cancer cells.

Targeted Drug therapy

Specifically identified aberrations in cancer cells are the focus of targeted pharmacological therapies. Targeted medication therapies can kill cancer cells by stopping these anomalies.

If hormone therapy fails to cure advanced or recurrent prostate cancer, targeted therapy medications may be suggested.

Certain genetic alterations in cancer cells are only present in patients who can benefit from targeted therapy. In a lab, your cancer cells may be examined to see if these medications could be beneficial.