Prostate Cancer: Types, Screening Tests & Early Detection Methods

The 3rd most common cancer in India after lung cancer and mouth/oral cancer is prostate cancer. It has been on the rise since 1990 and it is estimated that there were 899,100 new cases and 258,100 deaths from prostate cancer in 2008, globally. So it is important to make yourself aware of the disease and the available treatment options when you or your loved ones get diagnosed.

In this blog, we discuss the types of prostate cancer, including adenocarcinoma, small cell carcinoma, and neuroendocrine tumors, along with screening methods like the PSA test and digital rectal exam (DRE) for early detection and better management.

What is Prostate Cancer?

Prostate cancer is a disease in which abnormal cells grow uncontrollably in the prostate gland, a part of the male reproductive system.

Prostate Cancer affects the man's prostate which is a walnut-size gland present in the male reproductive system. Located below the bladder, opposite to the rectum, it encircles the upper part of the urethra (the tube that clears urine from the bladder). The prostate helps a great deal in bladder control. It also produces the seminal fluid which is known to nourish and transport sperm.

Types of Prostate Cancer

Prostate cancer varies in type and severity. Below, we outline the different types of prostate cancer to help understand their characteristics and impact.

1. Adenocarcinoma (Most Common Type)

• Originates in the glandular cells of the prostate.
• Accounts for about 90% of prostate cancer cases.

2. Carcinoma

• Develops from the prostate gland itself.
• Less common compared to adenocarcinoma.

3. Low-Grade Prostate Cancer

• Defined by a Gleason score of 8 or less.
• Generally grows more slowly.

4. High-Grade Prostate Cancer

• Defined by a Gleason score of 9 or 10.
• More aggressive and likely to spread.

5. Metastatic Prostate Cancer

• Cancer that has spread beyond the prostate to other parts of the body.
• More advanced and requires aggressive treatment.

6. Transitional Cell Carcinoma

• Originates in the urethral lining cells.

7. Squamous Cell Carcinoma

• Arises from flat cells covering the prostate.
• More aggressive and less common.

8. Small Cell Prostate Cancer

• A type of neuroendocrine carcinoma.
• Grows rapidly and is more aggressive.

9. Neuroendocrine Tumors

• Includes large-cell neuroendocrine carcinoma.

10. Sarcoma

• A rare prostate cancer originating in soft tissues.

11. Lymphoma

• Another rare form that affects the lymphatic system.

Stages of Prostate Cancer

• Localized: Confined to the prostate.
• Locally Advanced: Spread to nearby tissues.
• Metastatic: Spread to distant organs.

Prostate Cancer Grading (Gleason Score)

• 6 – Low-grade, slow-growing.
• 7 – Medium-grade, moderate growth.
• 8-10 – High-grade, aggressive.

Growth Patterns in Prostate Cancer

• Slow-Growing: May not require treatment.
• Aggressive: Spreads quickly, needing immediate intervention.

Castrate-Resistant Prostate Cancer (CRPC)

• Also called hormone-refractory prostate cancer.
• Continues to grow despite low testosterone levels.

Prostate Cancer Screening

Early detection is key to managing prostate cancer effectively. Below, we discuss the essential screening tests used to detect prostate cancer at an early stage.

Why is Screening Important?

• Prostate cancer is the most common cancer in men, accounting for 27% of all male cancers.
• While many cases are slow-growing, some can spread and become life-threatening.
• Early detection significantly improves treatment outcomes.

Common Screening Tests

• PSA (Prostate-Specific Antigen) Test: Measures PSA levels in the blood to detect abnormalities.
• Digital Rectal Exam (DRE): A physical examination to check for prostate irregularities.

Screening Guidelines (As per American Cancer Society - ACS)

• Ages 40-49: PSA test annually.
• Ages 50+: Regular PSA screening.

How to Interpret PSA Test Results

• A high PSA level may indicate prostate cancer but does not confirm it.
• Further testing, such as a biopsy or MRI, may be required for diagnosis.

Symptoms That May Indicate the Need for Screening

• Frequent urination, especially at night.
• Difficulty urinating or weak urine flow.
• A persistent feeling of fullness after eating.
• Unexplained weight loss or fatigue.

Next Steps After a Positive PSA Test

• Consult a urologist or consult an oncologist for further evaluation.
• Additional diagnostic tests (biopsy, imaging).
• Treatment options, including prostatectomy surgery, radiation therapy, or active surveillance, based on cancer progression.

Preventive Measures

• Regular check-ups.
• Early screenings from age 50 (or earlier for high-risk individuals).
• Maintaining a healthy diet and active lifestyle to lower risk.

Conclusion

Prostate cancer is a common yet treatable condition when detected early. Understanding the different types of prostate cancer helps in choosing the right treatment approach, while regular screening plays a crucial role in early diagnosis. By staying informed and proactive with PSA tests and medical check-ups, men can significantly improve their chances of effective treatment and a better quality of life.

Frequently Asked Questions

1. When should one begin the testing process for the detection of Prostate Cancer?

Three of the most prominent medical groups, namely - The American Cancer Society (ACS), the National Comprehensive Cancer Network (NCCN), and the American Urological Association have always been engaged in discussing the value and risks of routine testing. They have also urged the physicians to discuss the same with their male patients while keeping in mind their medical records/history. It is advised that men above the age of 50 must go for screening at least once a year.

2. Which specialist, urologist, or oncologist should one see for the treatment of Prostate Cancer?

There are four main types of doctors who are involved in the treatment of prostate cancer:

• Urologists: Urologists are the surgeons who are involved in the treatment of ailments pertaining to the urinary system and male reproductive system (which also include the prostate).
• Radiation oncologists: The doctors who treat cancer with Radiation Therapy are known as radiation oncologists.
• Medical oncologists: The doctors treating cancer with the aid of medicines and do therapies such as chemotherapy/ hormone therapy are called medical oncologists.
• Surgical oncologists: The surgeons who remove tumors along with the surrounding tissue when an operation takes place. They also perform certain types of biopsies. It is not necessarily true that only one kind of doctor is enough to treat you.

You may need a combination of these doctors depending on the severity of your ailment. If your cancer is detected early, you will receive more benefits.

3. What could be the potential side effects of Prostate Cancer treatment?

There is no denying the fact that whichever prostate cancer treatment you are going through, you ought to face some possible risks or side effects. Such as:

• Incontinence
• Urinary issues
• Sexual dysfunction
• Hot flashes
• Hair loss
• Nausea
• Fatigue.

Some of them can be permanent while others are temporary. BLK-Max Hospitals is the leading Best Cancer Treatment Hospital in Delhi, India.

4. What are the causes of prostate cancer?

The specific reasons or causes of prostate cancer are not known yet. However, there are several risk factors pertaining to prostate cancer including:

• Age (higher risk after 50)
• Genetics
• Unhealthy lifestyle

5. What are the symptoms of prostate cancer?

In the earlier stages, prostate cancer symptoms are generally not observed. But when cancer reaches its later stages, symptoms like

• Urinary difficulties
• Pain during ejaculation
• Blood in urine or semen

Learn more about - 5 Symptoms Every Man Should Know About Prostate Cancer

6. How is prostate cancer diagnosed?

Firstly, a digital rectal examination of the prostate is done. Diagnosis may include:

• Digital Rectal Exam (DRE)
• PSA test (most reliable)
• Ultrasonography to detect prostate enlargement