Prostate Cancer

June 9, 2022 /
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While Men’s Health Month and Men’s Health Week are celebrated in Canada every June, there’s also Prostate Cancer Awareness Month that is celebrated every September in effort to raise perception on the importance of screening for prostate cancer itself, as well as the need for more education on the subject.

First, we’ll look at this year’s estimated statistics:

• An estimated 24,600 men (20% of all new cancer cases in men in 2022) will be diagnosed with prostate cancer.
• An estimated 4,600 men (10% of all cancer deaths in men in 2022) will die from prostate cancer.
• On average, 67 men will be diagnosed with prostate cancer every day.
• On average, 13 men will die from prostate cancer every day.
• Prostate cancer is the most common cancer among Canadian men.
• Prostate cancer is the 3rd leading cause of death for Canadian men.

The prostate is a walnut-sized gland that is located just below the bladder and in front of the rectum, and it is part of a male’s urinary and reproductive system. The prostate is responsible for making prostatic fluid that mixes with sperm and different fluids to make semen. When a male develops prostate cancer, it begins in the cells of the prostate, but can metastasize to other areas of the body. As mentioned, prostate cancer is quite common, but many men may not even realize they have it as it does not typically present with any signs or symptoms in its early stages, which is why screening is so important – not just for this, but for many other types of cancers and health conditions.

If you are over the age of 50, it’s recommended that you speak with your family physician about whether or not you would make a good candidate for early testing for prostate cancer. There are two types of tests that are typically performed as part of the screening process for prostate cancer; a test known as a digital rectal examination (DRE) and a test known as a prostate-specific antigen test (PSA).

DRE test vs. PSA test
The digital rectal examination (DRE) test is the most common way for a physician to test a patient for prostate cancer, in which they will feel around the peripheral zone (the area closest to the rectum) for any lumps or abnormal changes to the prostate – including the shape, size, and consistency. If the prostate is normal and cancer-free, it should feel smooth and rubbery.

The prostate-specific antigen (PSA) test is a type of blood test that measures the amount of prostate-specific antigen in the patient’s blood. This test can help a physician detect problems with the prostate that they may not have been able to detect during a DRE. That being said, it’s not always a definitive test for detecting prostate cancer. You can have high PSA levels from issues aside from prostate cancer, including prostatitis, as well as another condition known as benign prostatic hyperplasia. While these two conditions can be deemed serious, they are typically non-life threatening.

Prostatitis vs. Benign Prostatic Hyperplasia
Prostatitis is an extremely painful condition that causes inflammation of the prostate and can sometimes be caused by not just inflammation itself, but also by infection. There are four types of prostatitis that an individual can be diagnosed with: acute bacterial prostatitis, chronic bacterial prostatitis, non-bacterial prostatitis, and prostatodynia. You have a much higher risk of developing prostatitis if you have an infection, have undergone surgical procedures (such as a biopsy of the prostate) or have a catheter, or have unprotected sex and expose the prostate to sexually transmitted diseases/infections. Other risk factors include having a history of urinary tract infections, bladder obstruction, or inflammation-causing trauma resulting in nerve damage to the pelvic area. Signs and symptoms of prostatitis include everything from blood in the urine or semen, pain/burning during urination, trouble passing urine, painful of difficult ejaculation, pain in the genitals, lower abdomen, groin or lower back, pain or a sensation of pressure in the rectum, as well as sexual problems, and even fever, chills and body aches. Prostatitis can be diagnosed through a DRE, though your physician may also order a series of other tests, including blood tests (the PSA test, as mentioned, as well as a complete blood count), and urinalysis. Treatment can include antibiotics (if a bacterial infection is present) as well as muscle relaxers (to decrease bladder contractions), and alpha-blockers.

Benign Prostatic Hyperplasia occurs when the prostate becomes enlarged due to an overgrowth of cells in the prostate’s transition zone, which is located just around the urethra. It is non-life threatening, non-cancerous, and unlike prostate cancer it cannot metastasize. Almost all men will experience prostate enlargement by the age of 70. In addition to aging, other risk factors of BPH include abdominal obesity and lack of physical activity. BPH can come without symptoms, or it can come with symptoms including difficult passing urine or urinary frequency, urinary incontinence, inability to fully empty the bladder (which can potentially lead to UTI’s and/or bladder stones), as well as blood in the urine. BPH can be diagnosed through a series of tests including the aforementioned DRE, blood tests, urinalysis, as well as a general physical exam. You may also require imaging tests (such as an x-ray or ultrasound), a cystoscopy, or even a biopsy in the event that your doctor cannot make a diagnosis. In many cases, patients with BPH will be asked to wait and see if their symptoms worsen or decrease, while treatment can also include drug therapy (such as alpha-blockers, muscle relaxers, and 5-alpha-reductase inhibitors) in addition to making certain lifestyle changes.