What is prostate cancer?
Prostate cancer originates in the prostate gland, a walnut-sized organ below the bladder. It primarily affects men over 50 and occurs when abnormal cells within the prostate gland multiply uncontrollably. If left untreated, the cancerous cells can eventually spread beyond the prostate.
How does prostate cancer spread?
Prostate cancer spreads through a process called metastasis. The cancer cells can invade nearby tissues, such as the seminal vesicles, or travel through the lymphatic system or bloodstream to other body parts. Common sites of metastasis include the bones, lymph nodes, liver, and lungs.
Is prostate cancer an aggressive disease?
Prostate cancer can range from slow-growing to aggressive. The behaviour of the disease can vary significantly between individuals. Some prostate cancers grow slowly and may never cause significant harm, while others can be more aggressive and spread quickly.
What are the risk factors for aggressive prostate cancer?
Certain risk factors can increase the likelihood of more aggressive disease progression. These include:
a. Gleason score:
The Gleason score is a grading system used to assess the aggressiveness of prostate cancer cells based on their appearance under a microscope. Higher Gleason scores indicate more aggressive cancer. Approximately 6 out of 10 men diagnosed with prostate cancer have a Gleason score of 6 or 7, meaning intermediate-grade cancer. If you are diagnosed with a Gleason score of 8 or higher, this indicates high-grade cancer with a higher risk of spread.
b. PSA levels:
Prostate-specific antigen (PSA) is a protein produced by the prostate gland.
Elevated PSA levels can indicate the presence of prostate cancer and may suggest a higher risk of aggressive disease.
According to Prostate Cancer UK, men with a PSA level above 20 ng/mL have a significantly higher risk of aggressive prostate cancer.
c. Tumor stage:
The stage of prostate cancer refers to its extent of growth and whether it has spread beyond the prostate gland. Higher-stage cancers may have a greater chance of spreading quickly. Around 1 in 3 men diagnosed with prostate cancer have tumours that have already spread beyond the prostate gland at the time of diagnosis.
What do statistics on prostate cancer spread show?
a. According to Cancer Research UK, approximately 4 out of 10 prostate cancer cases are diagnosed at the local stage, indicating that the cancer has not yet spread to distant sites. This suggests that many patients are detected at an early, potentially curable stage.
b. The 5-year relative survival rate for localised prostate cancer is nearly 100%, emphasizing the favourable prognosis when the disease is detected early. Almost all men diagnosed with localized prostate cancer survive for at least 5 years after diagnosis.
c. However, the 5-year relative survival rate drops to around 30% for advanced or metastatic prostate cancer. This highlights the importance of early detection and timely treatment. It also emphasizes the need for effective treatments for progressive disease to improve survival rates.
Can prostate cancer spread quickly in some cases?
While the majority of prostate cancers are slow-growing, there are instances where the disease can spread rapidly. This can occur in aggressive forms of the disease or when the cancer is detected at an advanced stage.
Importance of early detection and treatment:
Early detection through regular prostate cancer screenings, including digital rectal exams and PSA tests, is vital in identifying the disease's early stages. Timely treatment can significantly improve outcomes and reduce the risk of metastasis.
According to research published in the British Journal of Cancer, men diagnosed with localised prostate cancer who received immediate treatment had a 95% 10-year survival rate compared to 74% for those with delayed treatment.
Reflection from a prostate cancer specialist
The speed at which prostate cancer spreads varies among individuals. While most cases progress slowly, there are instances where the disease can spread quickly, particularly in aggressive forms or advanced stages. Many men seek natural ways how to prevent prostate cancer or slow progression. Many of these lifestyle changes need further studies.
Understanding risk factors such as Gleason score, PSA levels, and tumour stage can help identify individuals at higher risk of aggressive disease. Regular screenings and early detection are crucial for favourable outcomes.
As a consultant urologist, I aim to empower patients with knowledge and raise awareness about prostate cancer, ensuring timely interventions and improved outcomes.
