Prostate carcinoma, or prostate cancer, is a type of cancer that affects the prostate gland in men. It’s one of the most common cancers among men worldwide, especially those over 50.

April 13, 2026

Symptoms:

In its early stages, prostate cancer often doesn’t cause noticeable symptoms. As it progresses, symptoms may include ¹ ² ³:
Urinary Changes: Frequent urination, difficulty starting or stopping urination, weak urine flow, and pain or burning during urination
Erectile Dysfunction: Difficulty achieving or maintaining an erection
Pelvic Pain: Discomfort in the pelvic area, lower back, hips, or upper thighs
Bone Pain: Pain in the bones, especially the hips, back, or ribs
Unexplained Weight Loss and fatigue

Causes and Risk Factors:

The exact cause of prostate cancer is unknown, but risk factors include ¹ ⁴:

Age (especially over 50)
Family history
African American ethnicity
Genetic mutations
Diet and lifestyle factors

PSA(Prostate-SpecificAntigen) Test:

The PSA test measures the level of PSA in the blood. PSA is a protein produced by the prostate gland. Elevated PSA levels can indicate prostate cancer, but also other conditions like prostatitis or BPH (benign prostatic hyperplasia).

Key Points:

Normal Range: Typically <4 ng/mL, but age-specific ranges apply
Elevated PSA: >4 ng/mL, may indicate cancer, prostatitis, or BPH
Borderline: 4-10 ng/mL, may require further testing
High: >10 ng/mL, increased likelihood of cancer

Factors Affecting PSALevels:

Age: Levels rise with age
Prostate Size: Larger prostates produce more PSA
Medications: Finasteride, dutasteride, and some herbs can lower PSA
Ejaculation: Can temporarily increase PSA levels
Prostatitis: Can cause elevated PSA

PSA Test Limitations:

Not Specific: Can be elevated in non-cancerous conditions
Not Sensitive: Some cancers may not produce elevated PSA
Overtreatment: Can lead to unnecessary biopsies and treatment

Next Steps:

If PSA is elevated, further testing may include:

Digital Rectal Exam (DRE): To check for abnormalities
Imaging Tests: MRI, ultrasound, or CT scans
Biopsy: To confirm cancer diagnosis

Digital Rectal Exam(DRE):

A DRE is a physical exam where a healthcare provider inserts a gloved, lubricated finger into the rectum to check the prostate gland.

What to Expect:

Positioning: You’ll typically bend forward or lie on your side
Exam: The provider will feel the prostate for abnormalities, such as nodules or hardness
Discomfort: May feel some pressure or discomfort, but it’s usually brief

DRE Findings:

Normal: Prostate feels smooth and symmetrical
Abnormal: Nodules, hardness, or irregularities may indicate cancer or other conditions

DRE Limitations:

Subjective: Findings depend on the provider’s experience
Not Definitive: A normal DRE doesn’t rule out cancer

Why DRE is Done:

Screening: Part of routine prostate cancer screening for men over 50
Diagnostic: To evaluate symptoms like urinary issues or pain
Monitoring: To track changes in prostate health

Treatment Options:

Treatment depends on the stage and aggressiveness of the cancer, as well as overall health. Options include ⁵ ⁶:

Active Surveillance: Monitoring the cancer with regular check-ups and tests

Surgery: Radical prostatectomy or robotic-assisted surgery Radiation Therapy: External beam radiation or brachytherapy Hormone Therapy: To reduce testosterone levels Chemotherapy: For advanced cancer Immunotherapy: To boost the immune system

Survival Rates:

The 5-year relative survival rate for prostate cancer is almost 100% when detected early. The 10-year survival rate is around 80-85% ⁷⁸.

Dr. V. Manjunath

MBBS, MS – General Surgery, MCh – Urology

Consultant – Urology and Andrology