Like other forms, cancer of the prostate occurs when there are sufficient genetic mutations to a clone of cells within the prostate that allow them to proliferate uncontrollably. By definition, cancers are invasive to the surrounding tissue and have the potential to spread to other sites of the body through the bloodstream. It’s the secondary tumours, or metastases, that are created when this happens that make untreated prostate cancer lethal.
The good news, is that as long as a prostate cancer is detected early enough, it can be cured 90% of the time. Treatment may require surgical resection of the tumour, radiation therapy, and/or chemotherapy. No doubt it would be a very difficult treatment to undergo, but fortunately the cure rate is very high.
Clearly then, one of the biggest concerns with prostate cancer is its detection. The longer a cancer goes unchecked, the more opportunity it has to metastasize to another location and eventually progress beyond rescue. In contrast, the earlier it is detected the better the chances are for being cured.
Once over the age of 50, men are routinely screened for prostate cancer. There are two tests in general use: the infamous Digital Rectal Exam (DRE), and a blood assay for Prostate Specific Antigen (PSA). PSA is a protein enzyme produced by the prostate whose levels usually rise due to prostate cancer. An increase in PSA can be detected from a blood sample, and is fairly sensitive in screening for the presence of prostate cancer. One caveat, is that you generally want a baseline PSA amount to compare to. In other words, to detect whether levels of PSA have increased, you first need to know what the normal levels are, and these may vary from person to person.
One final note, is that there is some controversy over screening for prostate cancer. Certainly it can be proven that many more men have been diagnosed and treated for prostate cancer since the establishment of routine screening programs. But did treatment actually make a clinical difference for these men? Prostate cancer is slow-growing, and the screening tests are sensitive enough to detect it before any symptoms are felt by the patient. Would these men, who then received aggressive treatment, ever have shown symptoms? It is possible that they could have lived out the rest of their life, never affected by the cancer. We cannot know for sure.
