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Difficulty in starting (hesitancy), maintaining, or stopping the urine stream

A weak or interrupted urine stream

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The prostate is a small walnut shaped gland in the pelvis of men. It is located next to the bladder and can be examined by getting a digital rectal examination.

Prostate cancer is a form of cancer that develops in the prostate gland. It is the second-leading cause of cancer deaths for men in the U.S. About 1 in 9 men will be diagnosed with prostate cancer in their lifetime. In 2019, nearly 191,000 men were diagnosed of prostate cancer in American.

Growths in the prostate can be benign (not cancer) or malignant (cancer).

BENIGN GROWTHS (like benign prostatic hyperplasia (BPH):

•Are rarely a threat to life

•Don’t invade the tissues around them

•Don’t spread to other parts of the body

•Can be removed and can grow back very
slowly (but usually don’t grow back)

Malignant growths (prostate cancer):

•May sometimes be a threat to life

•Can spread to nearby organs and tissues (such as the bladder or rectum)

•Can spread (metastasize) to other parts of the body (like lymph nodes or bone)

•Often can be removed but sometimes grow back

Prostate cancer cells can spread by breaking away from a prostate tumor. They can travel through blood vessels or lymph nodes to reach other parts of the body. After spreading, cancer cells may attach to other tissues and grow to form new tumors, causing damage where they land.

When prostate cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if prostate cancer spreads to the bones, the cancer cells in the bones are actually prostate cancer cells. The disease is metastatic prostate cancer , not bone cancer. For that reason, it’s treated as prostate cancer in bone.
To understand prostate cancer, it helps to know how the prostate normally works.

The Prostate

The prostate and seminal vesicles are part of the male reproductive system. The prostate is about the size of a walnut and weighs about one ounce. The seminal vesicles are two much smaller paired glands. These glands are attached to each side of the prostate. Some have said that the seminal vesicles look like rabbit ears attached to the prostate. The prostate is below the bladder and in front of the rectum. The prostate surrounds the urethra. The urethra is a tube that carries urine from the bladder out through the penis. This is why men with an enlarged prostate have difficulty urinating. It can disrupt the flow of urine from the bladder.

The main job of the prostate and seminal vesicles is to make fluid to bathe semen. During ejaculation, sperm is made in the testicles, and then moves to the urethra. At the same time, fluid from the prostate and the seminal vesicles also moves into the urethra. This mixture of semen and fluid from the prostate and seminal vesicles forms the ejaculate that passes through the urethra and out of the penis.

When prostate cancer occurs, it starts in the prostate gland and occasionally spreads to the seminal vesicles.


A patient with early prostate cancer is usually asymptomatic. However, prostate
cancer symptoms associated with enlargement of the prostate due to prostate cancer, which may occur with early and late-stage/advanced-stage disease, include the following:

Frequent urination, during the day and/or at night

Difficulty in starting (hesitancy), maintaining, or stopping the urine stream

A weak or interrupted urine stream

Straining to urinate

Inability to urinate (urinary retention)

Loss of control of urination

Difficulty urinating when standing, requiring sitting during urination

Pain with urination or ejaculation

Blood in the urine or in the semen

Abnormal rectal examination

Many symptoms of early prostate cancer can also be attributed to benign (noncancerous) conditions of the prostate, including
benign prostatic hypertrophy (BPH ), or
infection in the prostate gland or
urinary system.

Signs and symptoms of advanced prostate cancer (late-stage prostate cancer) that has already spread from the prostate gland to elsewhere in the body (called metastatic prostate cancer) include:

a new dull, then progressively severe,
pain in the bones, especially the low back;

unexplained weight loss


increasing shortness of breath while doing activities previously well-tolerated

low-impact fracture of bone(s) without a lot of trauma (or broken bone [s] from minor trauma); and

swelling of the legs related to obstruction of the lymph tissue by prostate cancer.

It is always best to find and diagnose prostate cancer at an early stage and hopefully still confined to its site of origin. At that point, treatments can cure it. When prostate cancer is widespread or metastatic, it can be treated, but it cannot be cured.


The exact causes of prostate cancer are not known. Several risk factors for developing prostate cancer have been identified, but which of these risk factors cause a prostate cell to become cancerous is not fully known.

For cancer to develop, changes must occur in the chemicals that make up the DNA, which makes up the genes in the cell. The genes control how the cell works, for example, how quickly the cell grows, divides into new cells, and dies, as well as correcting any mistakes that occur in the DNA of the cell to keep the cell working normally.

• Cancer occurs when certain genes that either control the growth or death of the cell are affected, which results in abnormal cell growth and/or death.

• Genes are inherited (passed on from parents to their children) and thus some changes in the genes (gene mutations) that increase the risk of developing cancer may be inherited.

For prostate cancer, approximately 5%-10% of prostate cancers are due to inherited gene changes. Several inherited genes have been identified that increase the risk of prostate cancer, including:

• BRCA 1, and BRCA 2,
• DNA mismatch genes,
• HPC1, and
• HoxB13.

Research carried out by kite – Jarai and colleagues have identified that men who carry a hereditary mutation in homeobox 13 (HoxB13) have a higher than average risk of developing prostate cancer. In a systematic review and meta-analysis the investigators noted that in these men with the HoxB13 mutation, the risk of prostate cancer is also affected by a family history of prostate cancer and the year of their birth.

Gene changes may also be acquired (develop during the course of your life). These changes are not passed on to children. Such changes may occur when a cell normally undergoes growth and division. It is thought that at times during normal cell growth, risk factors may affect the DNA of the cells.


Certain risk factors may predispose a person to prostate cancer. These include the following:

Age: Sixty percent of cases of prostate cancer arise in men over 65 years of age. The disease is rare in men under 40.
Race or ethnicity: African-American men and Jamaican men of African ancestry are diagnosed with prostate cancer more often than are men of other races and ethnicities. Asian and Hispanic men are less likely to develop prostate cancer than are non-Hispanic white males.

Family history: Prostate cancer can run in families. A man whose father or brother (first-degree relative) has or had prostate cancer is twice as likely to develop the disease. The younger the family member is when he is diagnosed with prostate cancer, the higher the risk is for male relatives to develop prostate cancer. The risk of developing prostate cancer also increases with the number of relatives affected.

Nationality: Prostate cancer is more common in North America, Europe (especially northwestern countries in Europe), the Caribbean, and Australia. It is less common in Asia, Africa, and South and Central America. Multiple factors, such as diet and lifestyle, may account for this.

Smoking: Studies show prostate cancer risk may double for heavy smokers. Smoking is also linked to a higher risk of dying from prostate cancer. However, within 10 years of quitting, your risk for prostate cancer goes down to that of a non-smoker the same age.

Genetic factors: Mutations in a portion of the DNA called the BRCA2 gene can increase a man’s risk of getting prostate cancer, as well as other cancers. This same mutation in female family members may increase their risk of developing breast or ovarian cancer . However, very few cases of prostate cancer can be directly attributed to presently identifiable genetic changes. Other inherited genes associated with an increased risk of prostate cancer include RNASEL, BRCA 1, DNA mismatch genes, HPC1, and HoxB13.

Other factors: High-fat diets (fatty foods) and diets high in red meats and fatty foods and low in fruits and vegetables appear to be associated with a higher risk of developing prostate cancer. Obesity is also linked to a higher risk of the disease. Increased calcium intake and dairy foods may increase the risk of prostate cancer.
Smoking , a history of sexually transmitted diseases , a history of prostatitis (inflammation of the prostate), and a history of vasectomy have not been proven to play a role in causing prostate cancer. The role of fish oil in the risk of prostate cancer remains under investigation.


Some cancers grow so slowly that treatment may not be needed at all. Others grow fast and are life-threatening so treatment is usually necessary. Deciding what treatment one should get can be complex.

Prostate Cancer treatment plan will depend on:
•The stage and grade of the cancer (Gleason score and TNM stage)

•Your risk category (whether the cancer is low, intermediate or high risk)

•Your age and health

•Your preferences with respect to side effects, long-term effects and treatment goals.

Results from other diagnostic tests will help the team if medical experts to understand if the cancer can spread or recur (return) after treatment.

Before one can decide what to do, you should consider how immediate and long-term side effects from treatment will affect your life, and what you’re willing to tolerate.
If you have time before you start treatment, consider your range of options. Get a second opinion from different prostate cancer experts. You may need to see another urologist, oncologist or radiation oncologist. Consider the expertise of your doctor before you begin. With more experienced surgeons, the risk of permanent side effects (like incontinence) is lower. Also, it helps to talk with other survivors and learn from their experiences.

In addition, try and get or stay healthy. Eating a well-balanced diet, maintaining a healthy weight, exercising and not smoking are all important factors when fighting prostate cancer.

Moreover, don’t ignore your emotions. Think about how you’re coping with this diagnosis. Many men who have prostate cancer feel worried, stressed and angry. You and those that care about you may need to consider professional counseling.

Treatment choices for prostate cancer include:
•Active Surveillance
•Watchful Waiting

•Radiation Therapy
•Focal Therapy


•Hormonal Therapy


Complications of prostate cancer and its treatments include:

•Cancer that spreads (metastasizes): Prostate cancer can spread to nearby organs, such as your bladder, or travel through your bloodstream or lymphatic system to your bones or other organs. Prostate cancer that spreads to the bones can cause pain and broken bones. Once prostate cancer has spread to other areas of the body, it may still respond to treatment and may be controlled, but it’s unlikely to be cured.

•Incontinence: Both prostate cancer and its treatment can cause urinary incontinence. Treatment for incontinence depends on the type you have, how severe it is and the likelihood it will improve over time. Treatment options may include medications, catheters and surgery.

•Erectile dysfunction: Erectile dysfunction can result from prostate cancer or its treatment, including surgery, radiation or hormone treatments. Medications, vacuum devices that assist in achieving erection and surgery are available to treat erectile dysfunction.


You can reduce your risk of prostate cancer if you:

•Choose a healthy diet full of fruits and vegetables. Avoid high-fat foods and instead focus on choosing a variety of fruits, vegetables and whole grains. Fruits and vegetables contain many vitamins and nutrients that can contribute to your health.
Whether you can prevent prostate cancer through diet has yet to be conclusively proved. But eating a healthy diet with a variety of fruits and vegetables can improve your overall health.

•Choose healthy foods over supplements. No studies have shown that supplements play a role in reducing your risk of prostate cancer. Instead, choose foods that are rich in vitamins and minerals so that you can maintain healthy levels of vitamins in your body.

•Exercise most days of the week. Exercise improves your overall health, helps you maintain your weight and improves your mood. There is some evidence that men who don’t exercise have higher PSA levels, while men who exercise may have a lower risk of prostate cancer. Try to exercise most days of the week. If you’re new to exercise, start slow and work your way up to more exercise time each day.

•Maintain a healthy weight: If your current weight is healthy, work to maintain it by exercising most days of the week. If you need to lose weight, add more exercise and reduce the number of calories you eat each day. Ask your doctor for help creating a plan for healthy weight loss.

•Talk to your doctor about increased risk of prostate cancer. Men with a high risk of prostate cancer may consider medications or other treatments to reduce their risk. Some studies suggest that taking 5-alpha reductase inhibitors, including finasteride (Propecia, Proscar) and dutasteride (Avodart), may reduce the overall risk of developing prostate cancer. These drugs are used to control prostate gland enlargement and hair loss in men.
However, some evidence indicates that men taking these medications may have an increased risk of getting a more serious form of prostate cancer (high-grade prostate cancer). If you’re concerned about your risk of developing prostate cancer, talk with your doctor.

African Report Files -ARFs Blog is Anchored By:


Dominic J. Essien :

Dominic J. Essien ( MPH) is
a public Health expert in Nigeria
Whatsapp:  +234 809 343 4126

contact him for more health tips and conselling .

Uyo, Akwa Ibom State ,Nigeria

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