When prostate cancer is discovered early, and if it is located only in the prostate area, the treatment will be more likely to succeed. If the cancer spreads to other parts of the body, the treatment can be more difficult.

• RISK FACTORS

  A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the chance to develop cancer, most do not directly or by themselves cause cancer. Some people with several known risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.
  
  The following factors may raise a man’s risk of developing prostate cancer:
  
  - Age : The risk of prostate cancer increases with age, especially after age 50. More than 80% of prostate cancers are diagnosed in men who are 65 or older. Older patients who are diagnosed with prostate cancer can face unique challenges, specifically with regard to cancer treatment.
  
  - Race/ethnicity : Black men have a higher risk of prostate cancer than white men. They are also more likely to develop prostate cancer at an earlier age and to have more aggressive tumors that grow quickly. The exact reasons for these differences are not known and may involve genetic, socioeconomic, or other factors. Family history. Prostate cancer that runs in a family, called familial prostate cancer, occurs about 20% of the time. This type of prostate cancer develops because of a combination of shared genes and shared environmental or lifestyle factors.
  
  - Hereditary prostate cancer : meaning the cancer is inherited from a relative, is rare and accounts for about 5% of all cases. Hereditary prostate cancer occurs when changes in genes, or mutations, are passed down within a family from 1 generation to the next. Hereditary prostate cancer may be suspected if a man’s family history includes any of the following characteristics:
  
  • 3 or more first-degree relatives with prostate cancer
  • Prostate cancer in 3 generations on the same side of the family
  • 2 or more close relatives, such as a father, brother, son, grandfather, uncle, or nephew, on the same side of the family diagnosed with prostate cancer before age 55
  
  If a man has a first-degree relative—meaning a father, brother, or son—with prostate cancer, his risk of developing prostate cancer is 2 to 3 times higher than the average.
  
  - Eating habits : No study has proven that diet and nutrition can directly cause or prevent the development of prostate cancer. However, many studies that look at links between certain eating behaviors and cancer suggest there may be a connection. For example, obesity is associated with many cancers, including prostate cancer, and a healthy diet to avoid weight gain is recommended
  
  Ref : https://www.cancer.net/cancer-types/prostate...

• SYMPTOMS

  There are usually no symptoms during the early stages of prostate cancer. However, if symptoms do appear, they usually involve one or more of the following:
  
  - frequent urges to urinate, including at night
  - difficulty commencing and maintaining urination
  - blood in the urine
  - painful urination and, less commonly, ejaculation
  - difficulty achieving or maintaining an erection may be difficult
  Advanced prostate cancer can involve the following symptoms:
  
  - bone pain, often in the spine, femur, pelvis, or ribs
  - bone fractures
  
  If the cancer spreads to the spine and compresses the spinal cord, there may be:
  
  - leg weakness
  - urinary incontinence
  - fecal incontinence
  
  Ref : https://www.medicalnewstoday.com/articles/150086.php

• DIAGNOSIS

  The prostate cancer screening test is called the prostate specific antigen (PSA) assay. PSA is produced in a normal way by prostate cells and PSA levels can be measured in a blood sample. Men with prostate cancer often have a higher PSA than normal. However, it may increase in non-cancerous conditions, just as it may be low in the presence of prostate cancer. Therefore, it may be necessary to repeat the assay to confirm the results. If multiple exams give high PSA levels, the doctor may request a biopsy. As men get older, the PSA dosage becomes less reliable for diagnosing prostate cancer. Ask your doctor if you should use an PSA dosage.
  
  The doctor can also perform another exam called digital rectal exam, that is to say, he feels the prostate of his gloved finger. If the palpation reveals an abnormality or if the PSA concentrations are high, he will order a needle biopsy, which consists of removing cells from the prostate with 10 to 12 punctures performed with a biopsy gun. The manipulation of the biopsic gun is facilitated by the transrectal ultrasound, which allows to obtain an image of the prostate. The doctor may also order a sample of the lymph nodes to check if the cancer has spread. This removal can cause acute but transient pain. In some cases, the doctor may freeze the area to reduce the pain.
  
  If the results suggest cancer, a specialist, called a urologist, will then evaluate the size, stage and grade of the tumor. These data will guide the choice of cancer treatment.

• TREATMENT AND PREVENTION

  CCompared to most other forms of cancer, prostate tumors evolve slowly, often over a period of 10 years or more, and non-aggressively. They also tend to appear late in life. In older men in particular, small tumors are left untreated. The doctor should then check regularly to make sure that the cancer is not progressing faster than expected. This process is called "active monitoring".
  
  On the other hand, when the cancer invades structures other than the prostate, it is necessary to administer anti-cancer drugs and analgesics.
  
  When the cancer is still confined to the prostate, surgical treatment or radiotherapy is used.
  
  Radiotherapy is often a treatment option. Your doctor may use an external beam of radiation or implants of radioactive seeds inserted inside or near the prostate by surgery (brachytherapy) to destroy the cancer cells. Specialists are looking for new ways to deliver radiation therapy, as well as new treatments in which hormones and radiation are given at the same time (see below for information on hormone therapy). If a surgical operation is recommended, the classic procedure is radical prostatectomy, that is to say the total removal of the prostate. The surgeon makes an incision in the abdomen or between the anus and the scrotum to remove the prostate. This method is the one that has the best chance of curing prostate cancer.
  
  The removal of the prostate can have important consequences, including impotence and incontinence. After the surgery, the possibility of getting an erection depends on the presence or absence of damage to the nerves adjacent to the prostate. It can happen that the nerves are affected by cancer and that they must be excised. Sometimes the doctor decides to leave these nerves in place, but the impotence occurs anyway. You should discuss with your doctor the possibility of an intervention with nervous savings.
  
  When it comes to choosing the best treatment to administer, the doctor and the patient must discuss the risks and benefits of each option together. Both treatment modalities can lead to complications such as bladder irritation, sexual dysfunction and problems with anal incontinence, and the decision should be made based on the extent of the cancer, the health status the patient and his preferences. Sometimes the cancerous tissue is destroyed with a cold probe (cryosurgery) that freezes the tissue. This technique can also lead to impotence. This intervention is fairly recent, and it is not yet known whether long-term efficacy is as favorable as that of radical prostatectomy.
  
  Hormone therapy aims to lower the levels of male hormones (or androgens), especially testosterone, or to prevent these hormones from acting on cancer cells. Prostate cancer cells need androgens to multiply. Hormone therapy also helps to reduce the size of the prostate. This modality does not cure cancer, but it can slow the growth of the tumor and be useful before surgery, especially before cryosurgery. Instead of drug treatment, some men opt for orchiectomy (removal of the testicles) to reduce their testosterone levels.
  
  Hormone therapy and radiotherapy are often given together to patients whose cancer continues to spread or reappears after surgical treatment. Chemotherapy can be used to treat prostate cancer when hormone therapy is no longer effective.
  
  Your doctor will explain the various treatment options based on the size, nature and location of the tumor.

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