1. What is Prostate Cancer?
Prostate cancer is the most common type in males after skin cancer. Prostate is a walnut sized gland only found in male and is placed below the urinary bladder. It produces some of the fluids that are part of semen. Prostate cancer usually grows slowly and may not have significant effect on body. This is the reason most people don’t know if they have the cancer.

2. Common Symptoms of Prostate Cancer
There are no obvious symptoms during the early stages. But later, the following symptoms are common-
There may be difficulty in starting and stopping urination.
Frequent urination, especially at night.
There may be blood in urine or semen.
Weak or interrupted urinary stream.
There may be pain or burning sensation during urination or ejaculation.
In some advanced cases, there may be deep pain in the lower back, hips, or upper thighs.

3. Is It Enlarged Prostate or Prostate Cancer?
With age, the prostate can grow larger and sometimes press on the bladder and cause symptoms similar to prostate cancer. This problem is called benign prostatic hyperplasia (BPH). It is not a cancer and can be treated if the problem increases. There’s another disease that may cause urinary symptoms known as prostatitis. This infection or inflammation may result in fever and can be treated with medication.

4. Risk Factors Beyond Your Control
Old age is the main risk factor for prostate cancer. Men older than 50 years are the most prone to this cancer. As per the studies, most men, older than 75 years have some sort form of prostate cancer. Family history is also a major risk factor behind the prostate cancer. Moreover, African-American men are at the high risk and have the highest rate of prostate cancer across the world.

5. Risk Factors Within Your Control
Like any other disorder or disease, diet plays a crucial role in the development of prostate cancer. The growth of prostate cancer is more common in the countries with high consumption of meat and dairy-products. Animal fat especially the fat from red meat may boost the hormone level in men and fuel the growth of cancerous cells. Low consumption of fruits and vegetables may also support the development of prostate cancer.

6. Common Myths About Prostate Cancer
There are several misconceptions about the development of the prostate cancer. Some of such myths are-
Too much sex may cause prostate cancer.
A vasectomy may result in prostate cancer.
Musturbation may cause prostate cancer.
Enlarged prostate (BPH) doesn’t mean that a person has a higher risk of developing prostate cancer.
The effect of alcohol consumption, STDs, or prostatitis on the growth of prostate cancer is not yet clear and is under research.

7. Is It Possible to Find Prostate Cancer Early?
There are screening tests available to find prostate cancer at early stage. Although the tests may find cancers that are growing very slowly, but the medical treatment would offer no benefits. The American Cancer Society advices men to take screening tests, beginning at:
Age of 50 for men with average risk.
Age of 45 for men at high risk. It includes African- Americans, and men with family members diagnosed before the age of 65.
Age of 40 for men with more than one first-degree relative diagnosed at an early age.

8. Prostate Cancer Screening: DRE and PSA
A doctor performs Digital Rectum Exam (DRE), an initial test to feel for the bumps or hard spots on the prostate. A blood test follows it to measure prostate-specific antigen (PSA), a protein that is produced by prostate cells. Higher levels may indicate a higher chance of cancer. However, you may have a high level and still be cancer-free. There is also a possibility that a person with normal PSA has prostate cancer.

9. Understanding PSA Test Results
The normal level of PSA is considered to be less than 4 nanograms per milliliter (ng/mL) of blood. PSA above 10 indicates a higher risk of cancer. However, there are several exceptions:
A man can have cancer even if he has PSA less than 4.
An inflamed prostate (prostatitis) or enlarged (BPH) can increase PSA levels, yet there can be no evidence of cancer in further tests.
Some BPH drugs can lower the PSA levels, regardless of the presence of prostate cancer. It is called a false positive.
If things are not clear with either PSA or DRE tests, further tests will be ordered.

10. What is Prostate Cancer Biopsy
Once a problem is detected by a physical exam or PSA test, a biopsy may be recommended. A needle is inserted through the skin between the rectum and scrotum or directly through the rectum wall. By taking multiple small tissue samples and examining under microscope, it becomes easy to detect cancer and identify whether it is a slow-growing or aggressive type. Biopsy is the best way to analyze the prostate cancer and make treatment strategies.

11. Biopsy and Gleason Score
An abnormal tissue is graded on the scale of 1 to 5. And the sum of two Gleason grades provide the Gleason score. This score determines the chances of cancer spreading and affecting other cells. It ranges from 2, being the least aggressive, to 10 as the most aggressive cancer. Gleason score will also determine the type of treatment.

12. Prostate Cancer Imaging
In some cases, additional tests may be required to check if the cancer has spread to tissues beyond prostate. These tests include ultrasound, CT scan, and MRI. To determine whether the cancer has spread to the bones, a radionuclide bone scan is performed; a low-level radioactive material is injected and traced.

13. Different Stages of Prostate Cancer
Staging is used to explain the extent of the prostate cancer and how far it has spread (metastasized). It helps in determining the right treatment.
Stage I: Size of the cancer is small and within the prostate.
Stage II: Cancer is more advanced but still confined within the prostate.
Stage III: Cancer has spread to the outer parts and to the nearby seminal vesicle.
Stage IV: Cancer has spread to lymph nodes, nearby organs & tissues, or other organs such as bones and lungs.

14. Survival Rate
Prostate cancer usually grows slowly and can be found at an early stage. Overall, the 5-year relative survival rate is 100% for men with cancer confined to the prostate and nearby tissues. But the rate drops to 28% if it spread to distant areas. However, these numbers are based on men diagnosed at least 5 years ago. Things can be better for men who are diagnosed and treated today.

15. Watchful Waiting as Treatment Option
Watch and wait is an option for low-risk prostate cancer which is determined by the biopsy, PSA test, and the Gleason score. Periodic tests are ordered but other treatment with the risk of sexual or urinary problems may not be necessary. For some older men with serious health conditions may not be treated. However, more aggressive treatment is usually recommended for younger men with aggressive cancer.

16. Treatment: Radiation Therapy
External beam of radiation is used to kill the cancerous cells. It can be used after prostate cancer surgery or as a first treatment. It can help in relieving bone pain that is induced from the spread of cancer. In brachytherapy, tiny radioactive pellets about the size of rice grain are inserted into the prostate. Both methods can cause erectile dysfunction and have other side effects such as fatigue, urinary problems, and diarrhea.
There is another form of radiation therapy, proton therapy that some centers provide for prostate cancer treatment.

17. Prostate Cancer Surgery
Removing the prostate, or radical prostatectomy, is used to remove the cancer when it is still confined to the prostate. With new techniques that use smaller incision, avoiding damage to the nearby nerves is possible. Prostatectomy may not be the best option if lymph nodes are also cancerous. Surgery may also impair urinary and sexual function, but both can improve over time.

18. Hormone Therapy
Hormone therapy can shrink or slow the growth of cancer if it is used with another therapy. Drugs or hormone block and stops the testosterone and androgen production. However, there may be some side effects such as hot flushes, growth of breast tissue, weight gain, and impotence.

19. Chemotherapy for Prostate Cancer
Chemotherapy kills cancer cells not just in the prostate but throughout body. Therefore, it is used to treat more advanced cancer and cancer that isn’t affected by hormone therapy. It is usually intravenous and is given is cycles lasting 3-6 months. Because chemotherapy kills other fast-growing cells in the body, it may cause hair loss and mouth sour with other side effects such as nausea, vomiting, and fatigue.

20. Cryotherapy
Cryotherapy kills the cancerous cells within the prostate by freezing them. It is relatively less used because there is not much information about its long-term effectiveness. It is less invasive than surgery and requires shorter recovery time. As many as 80% of men become impotent by the nerve damage caused by freezing. There can be temporary pain and burning sensation in the bladder and bowel.

21. Prostate Cancer Vaccine
This vaccine is designed to treat prostate cancer by prompting body’s immune system to attack cancerous cells. The body remove immune cells from the blood, activate them to fight cancer, and infuse them back into the blood. This cycle occurs three times a month. It’s used for advanced prostate cancer that no longer respond to hormone therapy. There may be mild side effects such as fatigue, nausea, and fever.

22. Hope for Advanced Cancer
A doctor will continuously monitor the PSA levels and may perform other tests after prostate cancer treatment. In case it recurs or spreads to other parts of the body, additional treatment may be suggested. Lifestyle choices also affect the health e.g., as per a study, prostate cancer survivors who exercised regularly had a low risk of dying.

23. How to Cope with Erectile Dysfunction
Erectile dysfunction is the most common side effect of prostate cancer treatments. Generally, it improves within two years of surgery. Younger men have a better chance of improvement than men with 70 years of age and more. Other treatments and medication such as ED medication, injection therapy, and vacuum devices may help.

24. Cancer-Conscious Diet
A cancer-conscious diet may be the best way for survivors to strengthen their health and lower the risks of prostate cancer.
• Consumption of five or more fruits and veggies in a day.
• Considering whole grain instead of white flour or white rise.
• Limiting high-fat meat.
• Limiting or eliminating processed meat such as hot dogs, and bacon.
• Limiting alcohol to 1-2 drinks per day
Folate rich food such as spinach, orange juice, lentils may help in preventing prostate cancer. Studies found mixed results on lycopene, an antioxidant found in tomatoes.

25. Beware of Supplements
It is important to be aware of the supplements that are marketed to prevent prostate cancer. Some natural herbal substances can interfere with PSA levels. A 10-year study showed that men who took folic acid supplements had the increased risk of cancer. Moreover, a 5-year study of selenium and vitamin E didn’t show any decrease in the risk of prostate cancer either. It is crucial to tell your doctor if you are taking any vitamin or supplements.