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Specialist Advice — 7 minutes

Demystifying prostate cancer to improve outcomes

Dr Nicolas Tétreault, Clinical Biochemist, Ph.D., CSPQ, FCACB
Dr Nicolas Tétreault, Clinical Biochemist, Ph.D., CSPQ, FCACB
Scientific and Innovation Director

The prostate is a small gland located under the bladder and in front of the rectum which is associated with the male reproductive system. It is about the size of a walnut in younger men, but increases in size from about the age of 50.

In Canada, prostate cancer is the most common form of cancer in men and the second-leading cause of cancer deaths after lung cancer. [1] During their lifetime, one in nine men will be affected and one in twenty-nine will die from it. [2] Prostate cancer grows slowly and is generally harmless as long as it is confined to the prostate. However, some forms are more aggressive and need to be treated. As with all cancers, the earlier it is detected, the more successfully it will be treated.

Causes of prostate cancer

Little is known about the causes of prostate cancer. It is believed to begin with changes in the chromosomes (DNA) of some prostate cells, causing them to multiply more rapidly until they replace normal cells. Some cancer cells may then break away and invade nearby tissues and possibly spread to distance areas (metastasis). [3]

Risk factors

Age

  • Prostate cancer is very rare in men under 50 years of age.

Race

  • For reasons not yet understood, prostate cancer is more common and often more aggressive in black men.

Family history

  • The risk of developing prostate cancer is higher in people with a family member (i.e., parent, brother or child) who has been diagnosed with the disease. The risk is also higher if there is a history of breast cancer in the family (BRCA1 and BRCA2 genes).

Obesity

  • Obese people appear to have a higher risk of prostate cancer and a more aggressive cancer risk than those who are at a healthy weight.

Symptoms

The symptoms of prostate cancer are not exclusive to the disease and are often observed in the presence of other health problems, particularly prostatitis, a common inflammation of the prostate, or benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate that affects almost all men over the age of 70. [1]

  • Difficulty urinating*
  • Need to urinate often, especially at night (urinary urgency); weak urinary stream; inability to empty the bladder completely; difficulty controlling the bladder (incontinence)
  • Blood in the urine*
  • Blood in the semen
  • Bone pain
  • Involuntary weight loss
  • Erectile dysfunction

*Also present in benign prostatic hyperplasia

Read more : Does an abnormal prostate-specific antigen (PSA) result mean I have prostate cancer?

Complications

Metastasis

  • It can affect nearby organs, such as the bladder, or use the blood and lymphatic vessels to travel to bones (pain and fractures) and other organs.

Incontinence (involuntary loss of urine)

  • Incontinence can result as much from the cancer as its treatment.

Erectile dysfunction

  • It can also result from the cancer and its treatment (e.g., surgery, chemotherapy, hormone therapy or radiation therapy). [3]

Prevention

  • Eat a healthy diet rich in fruit and vegetables.
  • Get some exercise.
  • Maintain a healthy weight.
  • Consult your doctor to assess your individual risk of developing prostate cancer. [3]
  • Get a prostate-specific antigen (PSA) test at the age of 50 (age 45 if you are in a high-risk group). Repeat the test as needed based on the results. [4]

Read more: The impact of obesity on your health

To test or not to test with prostate-specific antigen (PSA)?

The usefulness of PSA as a screening test is far from unanimous. It is important to understand that the debate centres on the use of PSA to screen for prostate cancer in men who are not symptomatic or at risk. Under these conditions, a positive test is attributable three times out of four to a benign prostate condition requiring no intervention. In other words, the PSA test may alert the physician and cause concern when in fact no cancer is present.

Read more : Total, free or bioavailable testosterone: What does it all mean?

For professional support, we’re here for you.

We offer services that can help your doctor diagnose prostate cancer and determine the most appropriate treatment.

  • Total PSA: The level of PSA in the blood indicates an increase in the size of the prostate gland, which may be physiological in origin or associated with inflammation or cancer.
  • Free and total PSA report: Measuring the ratio of free PSA to total PSA is useful in assessing the risk of prostate cancer in patients who have a slightly elevated PSA level.
  • Prostate biopsy: This procedure involves microscopic analysis of suspect samples of tissue from the prostate.
  • Prostate MRI: The MRI is the test of choice for viewing the prostate and detecting any anomalies.

Do you have a medical prescription for these tests? Please book an appointment online or contact Biron Health Group’s customer service at 1-833-590-2712.

  1. Canadian Cancer Society. “What is prostate cancer?” https://www.cancer.ca/en/cancer-information/cancer-type/prostate/prostate-cancer/?region=on (accessed on June 17, 2021).
  2. Brenner, Darren R. et al. “Estimations prévues du cancer au Canada en 2020,” CMAJ (March 2, 2020): Vol. 192, https://cdn.cancer.ca/-/media/files/research/cancer-statistics/2020-statistics/canadian-cancer-statistics/2020-incidence-and-mortality-estimates-for-other-cancers/res-cancerstatistics-canadiancancerstatistics-estimations-prvues-du-cancer-au-canada-en-2020.pdf?rev=b9b9832340fa43a9a538ed60e2f0ea93&hash=98562D8B30CC34421600F2B8E516D43F (accessed on June 17, 2021).
  3. Mayo Clinic. “Prostate Cancer,” https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087 (accessed on June 17, 2021).
  4. Canadian Cancer Society. “Recommendations and Guidelines,” https://www.prostatecancer.ca/Supporting-You/Health-Professionals/Recommendations-and-Guidelines?lang=en-CA (accessed on June 17, 2021).
  5. Collège des médecins du Québec. “Le dépistage du cancer de la prostate,” http://www.cmq.org/publications-pdf/p-3-2013-09-01-fr-depistage-cancer-de-la-prostate.pdf (accessed on June 17, 2021).
Dr Nicolas Tétreault, Clinical Biochemist, Ph.D., CSPQ, FCACB
Dr Nicolas Tétreault, Clinical Biochemist, Ph.D., CSPQ, FCACB
Scientific and Innovation Director