Why Prostate Cancers Are Detected Late

MOVEMBER SERIES OF NEWSLETTER

As we delve into the critical issue of late detection in prostate cancer, our goal is to illuminate a path to earlier diagnosis and better outcomes.

The Global Impact Prostate cancer accounts for a significant health burden, with over 1.2 million men diagnosed each year and an estimated 350,000 fatalities globally. These numbers reflect a stark reality: too many are diagnosed late, diminishing the chance for successful treatment.

Understanding the Age Factor Typically, prostate cancer is diagnosed in men over 65. This trend highlights age as a key factor, with the risk of developing prostate cancer rising as men age.

"Prostate cancer is the second most common cancer amongst men globally"

Benign Prostatic Hyperplasia (BPH), commonly known as an enlarged prostate, is a non-cancerous growth of the prostate gland and is a frequent condition as men age. Symptoms of BPH can significantly affect quality of life and include

• Urinary Frequency, when you find yourself needing to go to the bathroom to pee more often than usual. It's like your bladder is a small water tank that seems to fill up quickly, making you take many trips to the restroom
• Urgency, sudden, strong need to urinate that can come out of nowhere, making you feel like you need to find a bathroom right away, almost like an emergency bell going off telling you to hurry.
• Weakened Stream, when the urine flow is slow and not as forceful as it once was, kind of like a garden hose that doesn't have as much pressure and takes longer to get the job done.
• Difficulty Starting Urination, when you're ready to pee, but it takes a while to get started. It's like trying to squeeze the last bit of toothpaste out of a nearly empty tube; it takes some effort before anything comes out.
• Dribbling At The End Of Urination, when you think you're finished, but then there's a little more that slowly drips out. It's like when you try to pour out a bottle of soda and you think it's done, but there are a few more drops that come out slowly, making it a bit messy.
• Nocturia, when you find yourself waking up in the middle of the night because you need to go to the bathroom to pee.

Cancer Early Symptoms: A Masked Culprit The early symptoms of prostate cancer, unfortunately presents with difficulty in urination, urgency, reduced flow, reduced force and nocturia, are often indistinguishable from those of benign prostatic hyperplasia (BPH). This similarity often mask the presence of cancer, leading to misinterpretation, non-urgency to screen and delayed diagnosis.

Symptoms in the Shadows Tragically, prostate cancer is often silent until it's advanced, with symptoms appearing predominantly when the disease is at a late stage or has spread beyond the prostate. These symptoms are manifestation of cancer affecting other areas and typically raise concern when men suffer these below:

• Back Pain, or Pelvic Pain, often the cancer has spread to the spine, femur, pelvis, or ribs;
• Blood In The Urine or Semen, which can be a sign that the cancer has grown into nearby tissues;
• Numbness or Weakness In The Legs or Feet, or even loss of bladder or bowel control, can happen if the cancer compresses the spinal cord;
• Swelling In The Legs or Pelvic Area, due to lymph node involvement or from the cancer obstructing blood flow.

The Path to Detection Early detection hinges on two critical assessments: the Prostate-Specific Antigen (PSA) blood test and the Digital Rectal Exam (DRE). These are not without their controversies, but they remain vital tools. A higher index of suspicion is essential, particularly for those of advanced age or with a family history of the disease.

Decoding PSA Levels The detection of prostate cancer frequently involves measuring Prostate-Specific Antigen (PSA) levels in the blood. Normal PSA levels typically fall below 4 ng/mL, but higher levels can suggest prostate cancer, BPH, or other prostate conditions. Consequently, an elevated PSA warrants further investigation but isn't an outright confirmation of cancer.

Our Collective Responsibility Given these nuances, we implore all men, especially those over 40, to undergo regular screening. Elevated PSA levels may prompt further testing, such as a biopsy, to ascertain the cause. We advise not to wait for symptoms to escalate and instead adopt a proactive approach to health checks. "Worrisome" symptoms usually only occur when the disease is at an advanced stage.

In closing, let us echo this message: Vigilance in screening can lead to early detection, and early detection can save lives.

-Dr Aly