👨‍⚕️ Who’s at Risk?

• Age: Risk increases after age 50, with most cases in men over 65.

• Race & Family History: Black men have higher incidence and mortality rates. A family history also increases risk.

• Other Factors: Genetic mutations, obesity, smoking, and diet may also play roles.

🧪 How Is It Diagnosed?

🔎 Screening Tests

• PSA Blood Test: Measures prostate-specific antigen; elevated levels may prompt further evaluation.

• Digital Rectal Exam (DRE): Doctor feels for lumps or irregularities.

🖼️ Imaging

• Transrectal ultrasound (TRUS) or MRI-guided biopsy to visualize and guide sampling.

• PSMA PET scan for detecting spread beyond the prostate.

🧾 Biopsy

• Tissue samples from prostate via needle (transrectal or perineal) confirm cancer presence.

📊 Grading and Staging

• Gleason score/Grade Group (6–10): Indicates aggressiveness based on tissue patterns.

• Cancer stage (I–IV): Depends on tumour size, PSA, and whether it has spread.

🧬 Treatment Options

Treatment decisions consider cancer stage, Gleason score, PSA, age, health, and patient preference.

1. Active Surveillance (“Watchful Waiting”)

• Best for low-grade (e.g., Gleason 6) and early-stage cancers.

• Regular monitoring via PSA, DRE, imaging, and repeat biopsies.

2. Surgery (Prostatectomy)

• Radical prostatectomy: Removes the entire gland.

• Approaches include open, laparoscopic, or robot-assisted methods.

⚠️ Side effects may include urinary incontinence and erectile dysfunction.

3. Radiation Therapy

• External Beam Radiation Therapy (EBRT): Uses IMRT or proton therapy.

• Brachytherapy: Implanting radioactive seeds (LDR or HDR) directly in the prostate.

• May be combined with hormone therapy in certain risk groups.

4. Hormone Therapy (Androgen Deprivation Therapy, ADT)

• Reduces testosterone to slow cancer growth.

• Used for metastatic or locally advanced cancer and alongside radiation.

5. Chemotherapy & Advanced Treatments

• Docetaxel for castration-resistant metastatic prostate cancer.

• Focal therapies (like HIFU).

📊 Prognosis & Survival Rates

• Localized/regional cancer (stages I–III): ~99% 5-year relative survival

• Distant (metastatic) cancer: ~37–40% 5-year survival

Long-Term Outlook

• 5 years: ~98% survival overall

• 10 years: ~98%

• 15 years: ~95%

• About 20–30% may experience biochemical recurrence (PSA rise) within 5 years post-treatment.

✅ Key Takeaways

• Most prostate cancers are detected early via PSA screening or DRE before symptoms appear.

• Treatment is highly effective; many men with localized disease live symptom-free for years.

• Shared decision-making is critical: Discuss benefits, side effects, and preferences with your healthcare team.

• Regular follow-up is essential to monitor PSA levels and detect recurrence early.

🗣️ Tips for Patients and Caregivers

• Stay informed: Understand your diagnostic tests and results.

• Ask questions: Especially about side effects and long-term impacts.

• Explore support: Consider counseling or peer groups to navigate emotional and mental challenges.

• Maintain health: Balanced diet, exercise, and managing other health conditions support overall well-being.

📅 When to Call Your Doctor

• PSA levels rise after treatment.

• New urinary, sexual, bone pain, or other symptoms arise.

• Treatment side effects become intolerable.