What Is Prostate Cancer?

Prostate cancer is one of the most common cancers among men worldwide, especially in men over the age of 50. The prostate is a small, walnut-shaped gland located just below the bladder. Its main role is to produce fluid that nourishes and transports sperm. When cells in the prostate grow abnormally and out of control, they can form a tumor. Some prostate cancers grow very slowly and may not cause problems for years, while others can be aggressive and spread quickly to other parts of the body, such as bones and lymph nodes. Early detection of prostate cancer is extremely important. Cancers found at an early stage, before they spread, are often easier to treat and have very high survival rates.

What Are the Types of Prostate Cancer?

Most prostate cancers are adenocarcinomas, but there are less common types as well.

• Adenocarcinoma of the prostate: The most common type, making up more than 95% of cases. It begins in the gland cells that produce prostate fluid.
• Small cell carcinoma: A rare, aggressive form of prostate cancer.
• Neuroendocrine tumors: Very uncommon, but often fast-growing.
• Squamous cell carcinoma: Rare, develops in flat cells covering the prostate.
• Transitional cell carcinoma: Usually starts in the bladder but can involve the prostate.

What Are the Causes of Prostate Cancer?

The exact cause of prostate cancer is not fully understood, but researchers believe it happens due to a combination of genetic changes, aging, and environmental factors. These changes cause prostate cells to grow uncontrollably and form tumors.

Possible contributing factors include:

• DNA mutations in prostate cells.
• Hormone changes, particularly high levels of testosterone and dihydrotestosterone (DHT).
• Chronic inflammation in the prostate.

What Are the Risk Factors for Prostate Cancer?

Not every man with risk factors will develop prostate cancer, but certain factors increase the chances:

• Age: Risk increases significantly after age 50.
• Family history: Having a father, brother, or son with prostate cancer doubles the risk.
• Genetics: Inherited mutations such as BRCA1, BRCA2, or Lynch syndrome raise the risk.
• Race and ethnicity: African American men are at higher risk and tend to have more aggressive disease.
• Diet and lifestyle: A high-fat diet, obesity, and lack of exercise may contribute.
• Exposure to chemicals: Certain occupations involving pesticides or industrial chemicals may raise risk.
• Medical history: Conditions like prostatitis (inflammation of the prostate) may increase susceptibility.

What Are the Symptoms of Prostate Cancer?

In its early stages, prostate cancer often causes no symptoms. That’s why regular screening is important.

When symptoms appear, they may include:

• Frequent urination, especially at night
• Difficulty starting or stopping urination
• Weak or interrupted urine flow
• Blood in urine or semen
• Pain or discomfort in the pelvic area
• Erectile dysfunction

Advanced prostate cancer symptoms may include:

• Bone pain (hips, spine, ribs)
• Unexplained weight loss
• Swelling in the legs
• Fatigue
• Loss of bladder or bowel control if cancer spreads to the spine

How Is Prostate Cancer Diagnosed?

Doctors use several tests to detect and confirm prostate cancer:

• Prostate-specific antigen (PSA) blood test: Measures PSA levels; higher levels may indicate cancer, though other conditions can also raise PSA.
• Digital rectal exam (DRE): The doctor feels the prostate for abnormalities.
• Imaging tests: MRI, CT, or bone scans help assess whether cancer has spread.
• Prostate biopsy: A needle is used to remove tissue samples from the prostate for lab analysis. This is the only way to confirm cancer.

Staging of Prostate Cancer

Staging and grading help doctors decide the best treatment plan.

Gleason Score: A grading system that describes how aggressive the cancer cells look under a microscope. Scores range from 6 (low grade) to 10 (high grade).

TNM Staging System:

• T (tumor size)
• N (spread to nearby lymph nodes)
• M (spread to distant organs)

Stages of prostate cancer:

• Stage I: Cancer is small and only in the prostate.
• Stage II: Cancer is larger but still within the prostate.
• Stage III: Cancer has spread beyond the prostate to nearby tissues.
• Stage IV: Cancer has spread to lymph nodes, bones, or distant organs.

What Are the Treatment Options for Prostate Cancer?

Treatment depends on the stage, overall health, and patient preferences.

• Surgery: Radical prostatectomy is the removal of the entire prostate gland and some surrounding tissue. It is usually done through minimally invasive robotic-assisted surgery.
• Radiation Therapy: External beam radiation therapy (EBRT) uses high-energy rays to target cancer cells. Brachytherapy uses tiny radioactive seeds placed inside the prostate.
• Hormone Therapy: Lowers male hormone (androgen) levels to slow cancer growth. May involve medications or surgical removal of testicles (orchiectomy).
• Chemotherapy: Uses drugs to kill cancer cells, especially in advanced or resistant cases.
• Targeted Therapy: Drugs that specifically attack cancer cell changes, such as PARP inhibitors for BRCA mutations.
• Immunotherapy: Boosts the body’s immune system to fight cancer. An example is sipuleucel-T for advanced prostate cancer.

Proton Therapy: When Is It Applicable?

of radiation therapy that uses protons instead of X-rays. It is more precise and may reduce damage to surrounding healthy tissue. In the treatment of prostate cancer, the increased precision of proton therapy can lead to fewer side effects. Available at select centres like Apollo Proton Cancer Centre, it is often used for localized prostate cancer.

What Is the Prognosis for Prostate Cancer?

Prostate cancer survival rates are very favorable, especially when detected early.

• Localized and regional stages: Nearly 100% 5-year survival rate.
• Distant (metastatic) stage: Around 30% 5-year survival rate.

Prognosis depends on:

• Stage at diagnosis
• Gleason score
• PSA level
• Patient’s age and overall health
• Response to treatment

Screening and Prevention for Prostate Cancer

Screening can help detect prostate cancer before symptoms develop.

• PSA test: Recommended for men aged 50 and above (45 for high-risk groups such as African Americans or those with family history).
• Digital Rectal Exam: Often combined with PSA for better detection.

Discussing risks and benefits of screening with a doctor is important, as not all detected cancers require treatment.

For International Patients

People from around the world come to Apollo Hospitals for the treatment of prostate cancer. Our international patient services team will guide you all the way from seeking the first virtual connect all the way to treatment in India and then returning home post treatment.

Services include:

• Medical opinions and scheduling: Pre-arrival medical review of reports and imaging.
• Travel and logistics: Assistance with visa invitation letters, airport transfers, and nearby accommodation options. Dedicated international patient coordinators to guide through each step.
• Language and cultural support: Interpreter services in multiple languages. Clear, simple explanations at every stage with written care plans.
• Financial coordination: Transparent treatment estimates and packages when possible. Support with international payment methods and insurance coordination.
• Continuity of care: Shared records, imaging, and treatment summaries for home doctors. Telemedicine follow-ups for convenience after returning home.

About Apollo Proton Cancer Centre

Apollo Proton Cancer Centre (APCC) is the first proton therapy centre in India. APCC has a fully integrated treatment suite that offers the most advanced treatment in surgical, radiation and medical oncology procedures. True to the Apollo Pillars of Expertise and Excellence, the Centre brings together a powerful team of clinicians renowned globally for cancer care.

At Apollo Proton Cancer Centre (APCC), we combine advanced technology with globally renowned clinical expertise to deliver superior outcomes and improved quality of life to our patients.