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Prostate cancer is the second most common cancer among men, with 1.4 million patients worldwide in 2020. In Thailand, prostate cancer has the fifth highest incidence among male cancer patients. Understanding the risks, recognizing early symptoms, and getting screened before the cancer progresses is crucial.
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<h2>Causes and Risk Factors for Prostate Cancer</h2>
Prostate cancer can arise from multiple factors, including genetics, environment, and lifestyle. The following causes and risk factors are associated with prostate cancer:
<ul>
<li>Age: Especially in men over 50.</li>
<li>Genetics and Gene Mutations: Having a father, brother, or son with prostate cancer increases risk, as does a family history of ovarian or breast cancer.</li>
<li>Gene Mutations: Particularly mutations in the BRCA1 and BRCA2 genes.</li>
<li>Race: Black men are at higher risk, with a higher incidence found in African populations.</li>
<li>Hormones: Continuous high levels of the male hormone testosterone.</li>
<li>Inflammation: Related to obesity, high blood pressure, high blood sugar or fat levels, smoking, and alcohol consumption, which can cause chronic inflammation in the prostate.</li>
<li>Exposure to Chemicals: Such as pesticides or industrial substances.</li>
</ul>
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While these factors can increase the risk of prostate cancer, not everyone with risk factors will develop the disease.
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<h2>Symptoms of Prostate Cancer by Stage</h2>
Prostate cancer is divided into four stages:
<ul>
<li>Stage 1: The tumor is small and confined within the prostate, usually without symptoms. It may be detected through a prostate-specific antigen (PSA) test or by accident during tests for other conditions.</li>
<li>Stage 2: The tumor grows larger but remains within the prostate. Symptoms may include difficulty urinating, frequent urination (especially at night), and decreased sexual function.</li>
<li>Stage 3: The tumor begins to spread to nearby tissues, such as the seminal vesicles, but not to lymph nodes or distant organs. Symptoms may include inability to hold urine, painful urination or ejaculation, pelvic pain, and visible blood in urine or semen.</li>
<li>Stage 4: The cancer has spread to other organs, such as lymph nodes, bones, lungs, or liver. Symptoms can include bone pain, fatigue, and weight loss. If the cancer spreads to the spinal cord, it can cause pain or difficulty walking.</li>
</ul>
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<h2>Screening Methods for Prostate Cancer</h2>
Prostate cancer screening can be done in several ways, with three main methods being popular:
<ol>
<li>Digital Rectal Exam (DRE): A doctor inserts a gloved, lubricated finger into the rectum to check for lumps or abnormalities. This method is quick and convenient but has limitations in detecting smaller tumors.</li>
<li>PSA Blood Test: Measures the level of prostate-specific antigen produced by the prostate. A level above 4 ng/ml may indicate risk, although elevated levels can also result from other conditions like benign prostatic hyperplasia or infections.</li>
<li>MRI Fusion with Ultrasound Biopsy: A highly effective method that combines MRI and real-time ultrasound to precisely identify and biopsy suspicious areas.</li>
</ol>
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<h2>Who Should Undergo Prostate Biopsy?</h2>
A biopsy is essential for diagnosing prostate cancer and determining surveillance and treatment plans. Considerations for who should be biopsied include:
<ul>
<li>Suspicious findings from a DRE, such as a hard lump or irregular prostate.</li>
<li>PSA levels above 10 ng/ml with no other causes.</li>
<li>PSA levels between 4-10 ng/ml with a significant upward trend.</li>
<li>Abnormal MRI findings with a PIRADS score of 3-4 or higher.</li>
</ul>
Those with additional risk factors, such as a family history of prostate cancer, should also be considered for biopsy, even if PSA levels are normal.
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<h2>Treatment Options for Prostate Cancer</h2>
Prostate cancer treatment depends on the stage of the disease and the patient’s overall health. Treatment options may include:
<ul>
<li>Active Surveillance: Monitoring PSA levels and performing biopsies at intervals.</li>
<li>Surgery: Removing the prostate and surrounding tissue, suitable for early-stage patients.</li>
<li>Radiation Therapy: Includes external beam radiation and brachytherapy (internal radiation).</li>
<li>Hormone Therapy: Reducing or blocking testosterone to inhibit cancer growth, often post-surgery.</li>
<li>Chemotherapy: Used for advanced-stage prostate cancer.</li>
</ul>
Prostate cancer is a treatable disease. Regular health check-ups, especially PSA screenings, can lead to early diagnosis and timely treatment, allowing for appropriate management.

Prostate cancer is the second most common cancer among men, with 1.4 million patients worldwide in 2020. In Thailand, prostate cancer has the fifth highest incidence among male cancer patients.

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Prostate Cancer : Early Detection Can Lead to Treatment

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