Prostate Cancer in the Philippines

Prostate cancer is a significant health concern for men worldwide, impacting their lives and well-being. Among their group, it’s the second most common cancer next to skin cancer—which is why it’s important to understand this disease.

In this article, we talk about what prostate cancer is, its symptoms, causes, stages, and the treatment options available. By having a deeper knowledge of the disease, you're taking the first step in raising awareness and learning how to approach it.

What is Prostate Cancer?

Prostate cancer begins in a man’s prostate, a small walnut-sized gland located below the bladder, in front of the rectum, wrapping around the urethra. This gland is crucial to their reproductive health, producing the fluid for semen that helps transport sperm during ejaculation.

Generally, if there’s an abnormal cell growth within the prostate it creates a malignant tumor. Over time, these cancerous cells can spread to the surrounding lymph nodes, other organs, and even to the bones.

The Types of Prostate Cancer

Prostate cancer can present in different forms, but the most common type is adenocarcinoma. This cancer develops from the cells that line the tubes of the prostate, growing slowly as time passes. Most prostate cancer patients suffer from this type, differing only in the abnormality grade of the cells and their size.

Rarely, other variants of prostate tumors can occur. A few other types are:

1. Small Cell Carcinoma

   :

   These cells are a less common but more aggressive form of prostate cancer. Small cell carcinomas start in the round cells of the neuroendocrine system, growing and spreading rapidly around the prostate gland.

2. Prostate Sarcomas:

   These are rare tumors that develop outside the prostate glands, in the connective soft tissue. It’s mainly seen forming in the muscles and nerves of the prostate.

3. Neuroendocrine Tumors:

   This subset of prostate cancer typically occurs in advanced cases and is generally more aggressive than the other types. They originate in nerve and gland cells that create and release hormones into the bloodstream.

Understanding the specific type of prostate cancer is crucial to predict the disease's behavior. Through a series of biopsies and diagnostic tests, healthcare providers can help you diagnose the specific type of prostate cancer you or your loved ones have and determine the appropriate treatment plan.

How Common is Prostrate Cancer in the Philippines?

For Filipinos, the disease ranked third on the list of most common cancers among men following colorectum and lung cancers. Data from the Global Cancer Observatory revealed that 8,242 Filipinos were diagnosed with prostate cancer in 2020 and the 5-year prevalence of the disease affected 26,942 people.

While these numbers can feel overwhelming and scary, it’s not hopeless. By knowing the causes, symptoms, and treatments for prostate cancer, you are empowering yourself with knowledge on how to prevent or go about the disease.

The Risk Factors of Prostate Cancer

There is no one cause of prostate cancer. It gradually appears throughout the years––which is why it’s most common in adults. A few of the recognized and possible risk factors for prostate cancer are:

• Increasing Age: Prostate cancer is more common in older men, with the risk increasing significantly after the age of 50.
• Family History: Familial cancer makes up an estimated 20% of prostate cancer patients. Those with family members who suffer or previously suffered from this disease have a higher risk of getting it due to shared genes or environmental factors.
• Lifestyle: Unhealthy habits like smoking, obesity, and a diet high in red meat and fat may increase the risk of getting prostate cancer.

Although your daily routines and habits are the only controllable factors that can prevent the risk of prostate cancer, they can drastically improve your health. After all, the consensus is that healthier practices lead to better health outcomes.

What are the Symptoms of Prostate Cancer?

Prostate cancer often progresses slowly, and its early stages may not exhibit any noticeable symptoms. However, as the cancer advances and the tumor grows, it can manifest a variety of symptoms such as:

• Frequent pain or stiffness in the lower back, hips, or upper thighs
• Difficulty starting urination and holding back urine
• A need to urinate frequently at night
• A Weak or interrupted flow of urine
• Blood in the urine or semen
• Inability to have an erection
• Painful ejaculation

In case symptoms worsen, there can be more discomfort and pain throughout the body. A few advanced signs of prostate cancer are:

• Lower extremity edema or swelling
• Loss of weight and appetite, fatigue, nausea, or vomiting
• Paralysis

Recognizing the symptoms of prostate cancer is important for early detection and effective treatment. If you or someone you know experiences any of these warning signs, it's crucial to seek prompt medical evaluation and consultation.

Diagnosing Prostate Cancer

Effective treatment and management of prostate cancer begins with diagnosis. As this disease often begins silently with no noticeable symptoms in its early stages, it’s important to rely on diagnostic assessments to accurately and timely test for the disease. The common cancer screening exams for prostate cancer are:

1. Digital Rectal Exam (DRE)

   Digital Rectal Exam is usually done by inserting a gloved, lubricated finger into the rectum. Doing so helps the doctor determine if the prostate is enlarged, hard, or smooth.

2. Prostate–Specific Antigen (PSA) Test

   Prostate-Specific Antigen is a substance produced by the prostate cells and is measurable through a blood test. If your PSA level is above normal, you are at risk of developing prostate cancer.

3. Transrectal Ultrasound (TRUS) Guided Biopsy

   Transrectal Ultrasound (TRUS) is used to detect abnormal prostate growth by guiding a needle to get tissue from the abnormal prostate. The acquired tissue is then examined under the microscope to determine the presence of cancer.

According to the Philippine Urological Association, annual screening with DRE and PSA is recommended for men, especially for those presenting the risk factors associated with prostate cancer. Remember, early intervention can significantly improve the prognosis and quality of life for you or your loved ones facing this condition.

The Stages of Prostate Cancer

Prostate cancer is categorized into different stages to determine the extent of its spread. The stages include:

• T1: At this stage, the tumor is confined to the prostate. They are small enough that they cannot be felt during a DRE or detected during ultrasound. In case you want to be thorough in detecting the disease, you can consult with your doctor regarding a test that can detect the cancer.
• T2: This stage of the cancer is an advanced localized level wherein the cancer is still confined to the prostate, but it is large enough to be detected during a DRE.
• T3 and T4: At these stages, the cancer cells have expanded beyond the prostate into surrounding tissues.

Knowing the stages of prostate cancer is not only vital for diagnosis but also for making informed decisions about treatment and care. Each stage provides a unique perspective on the extent and aggressiveness of the disease, guiding healthcare professionals in developing personalized treatment plans for you.

Prostate Cancer Treatment

Once your doctors have accurately diagnosed your cancer stage and assessed your overall health, age, and personal preferences, they can recommend treatment programs tailored to your needs. Here at The Medical City, the healthcare plans of our Augusto P. Sarmiento Cancer Institute include:

Early Prostate Cancer

For the early stages of prostate cancer, there are three treatment protocols available for patients:

1. Radiation Therapy

   Radiotherapy is typically used to eliminate or shrink cancer cells. For prostate cancer, two types of radiation therapy are available:

   • External Beam Radiation: The damaged cancer cells are subjected to high-energy rays to stop them from growing and dividing.
   • Brachytherapy: The radiation source comes from small pellets implanted into the prostate for more concentrated delivery of energy

2. Cryotherapy

   This medical treatment uses a method of localized freezing temperatures up to negative 40°C to kill the cancer cells while sparing the surrounding normal structures. This type of therapy deadens any irritated nerves and serves as a pain treatment for the disease.

3. Radical Prostatectomy

   Getting this treatment entails surgical removal of the entire cancerous prostate gland. It’s the most time-honored method of treating prostate cancer as it can remove the cancer cells altogether. This procedure can typically be performed by the traditional open, laparoscopic, and robotic-assisted approach.

Advanced Prostate Cancer

For severe cases of the disease, there are usually two treatment plans healthcare professionals recommend:

1. Hormonal Therapy: Prostate cancer needs testosterone stimulation for its growth. With this strategy, the source of hormones to the cancerous prostate gland is blocked off, effectively slowing down its growth. And while this doesn’t entirely cure the cancer, it can decrease its progression rate.
2. Chemotherapy: This form of treatment is usually utilized as a last resort in cases of resistance to hormonal therapy. Chemotherapy uses chemicals targeted to eliminate cells that are dividing and growing quickly, which is a characteristic of many cancer cells.

Prostate cancer is a complex disease with a highly personalized treatment that hinges on a precise diagnosis. Each medical plan has its merits and considerations, and your healthcare team will work closely with you to determine the most suitable approach. Awareness, early detection, and understanding the risk factors of prostate cancer are essential for prevention and successful treatment. By knowing more about the disease, the better equipped you are to address it.