Prostate Cancer Program

Symptoms, Causes & Risk Factors

Symptoms of Prostate Cancer

Prostate cancer has no symptoms in the early stages, signs of disease only appear later. Patients often feel a need to urinate frequently at night, have difficulty urinating, notice a weak or interrupted flow of urine, or have painful and burning urination. Other symptoms may include painful ejaculation, blood in urine or semen, and frequent pain or stiffness in the lower back, hips, or extremities.

The cause of prostate cancer is unknown, but doctors do know that it is more common in African American men and men with a family history of the disease. The male sex hormone testosterone also contributes to its growth.

Causes & Risk Factors of Prostate Cancer

Prostate cancer is one of the most common cancers in men. The following are some of the risk factors for prostate cancer:

• Age: The greatest risk factor for prostate cancer is age, with more than 75% of all prostate cancers being diagnosed in men older than 65 years.
• Family history: Men whose relatives have had prostate, breast or colon cancer are at higher risk. Therefore, screening for prostate cancer should be started at age 40 in men with a family history of the disease.
• Diet: High dietary fat may be a contributing factor. The disease is much more common in countries in which meat and dairy products are dietary staples.
• Male hormones: High levels of male hormones called androgens may increase the risk of prostate cancer for some men.
• Sedentary lifestyle: Regular exercise and maintaining a healthy weight may reduce the risk of prostate cancer.

Prevention & Screening

Doctors don’t know why many men develop prostate cancer as they get older. While prostate cancer can’t be prevented, if you have any of the risk factors associated with the disease, taking the following steps to improve your lifestyle may minimize your risk:

• Attend regular prostate screenings
• Quit smoking
• Maintain a healthy body weight
• Eat a healthy, well-balanced diet
• Take regular exercise.

For men over 40, routine visits to a urologist should be a part of your health routine, to ensure the health of your bladder, prostate, and sexual health, and to help detect early signs of things like prostate cancer.

Diagnosis & Treatment

Diagnosis of Prostate Cancer

The most effective method to detect prostate cancer is through screening, which involves a digital rectal exam and measuring the amount of prostate-specific antigen (PSA) in the blood.

PSA is a protein secreted by the prostate into the bloodstream. Elevated levels of this antigen may indicate the presence of prostate cancer.

If cancer is suspected, your doctor may request an imaging study, including MRI and PET Scan. Our radiologists have specific expertise in advanced prostate cancer diagnostic and imaging modalities. Additionally, a test called an IsoPSA (a test that an help identify if PSA proteins were made by cancer cells) can sometimes be used to assist our doctors to determine the need for a biopsy.

A prostate biopsy may also be performed. By removing a tissue sample from the tumor and examining it, doctors can confirm or determine if the disease has spread to other organs. Cleveland Clinic Abu Dhabi is one of only a handful of centers in the region to offer MRI fusion guided biopsy for prostate cancer. Combining a specialized MRI scan with images from an ultrasound, doctors can accurately target the area for biopsy, supporting more accurate diagnosis.

Fortunately, most prostate cancers have not spread at the time they are diagnosed, and the cancer is most frequently confined to the prostate gland.

Treatment of Prostate Cancer

Prostate cancer treatment will depend on the patient’s needs, taking into account the type of cancer, the age of the individual, the degree to which the cancer has spread and the general health of the patient.

• Observation or surveillance: For men with low-risk cancer.
• Laparoscopic radical prostatectomy: A minimally invasive procedure that removes the prostate gland. Unlike conventional surgery, a laparoscopic prostatectomy requires only five button-hole incisions, through which a surgeon uses a laparoscope (tiny camera) and surgical instruments to remove the prostate.
• Robotic radical prostatectomy: Surgeons use robotic arms to guide the laparoscope through small incisions and remove the cancerous prostate and affected tissue.
• Open radical prostatectomy: A procedure to remove the whole prostate with a cut in the lower abdomen.
• High-intensity focused ultrasound (HIFU): An advanced, minimally invasive procedure that involves using high-intensity, highly focused ultrasound waves. The sound waves are directed at the tumor and interact with targeted tissues and modify or destroy them. The focused beams of sound waves cause the temperature of the targeted tissue to increase, which destroys it.
• Radiation therapy: Targeting cancer cells with radiation so their DNA is damaged, and they are destroyed. Different forms of radiation therapy can be used to treat prostate cancer:
  • Interstitial brachytherapy (seed implantation): A form of radiation therapy in which radioactive pellets or “seeds” are implanted into the prostate, and the pellets radiate the prostate and surrounding tissue over time.
  • Intensity-modulated radiotherapy and volumetric modulated arc therapy: An advanced form of radiotherapy which has shortened the duration of prostate cancer treatment by several weeks. With computer guidance, high doses of radiotherapy can be delivered precisely to the tumor, reducing the risk to normal tissue.
  • Stereotactic body radiation therapy: A novel modality of radiotherapy that will complete the treatment within a week..
• Hormone therapy. Hormone therapy is a prostate cancer treatment that changes the body’s hormone balance to stop certain cancers growing. Hormone therapy can use drugs that alter the way in which hormones work or via surgery which removes the hormone-producing organs (like the testes).
• Chemotherapy: The use of anticancer drugs, sometimes in combination, to either kill or stop the growth of cancer cells.
• Immunotherapy: Using medication to enhance the body’s immune response to destroy cancer cells.
• Targeted therapy: Targeting certain mutations in cancer cells using medication.