Hyderabad: Urinary changes in men should not automatically be dismissed as a normal part of ageing. Some of the symptoms like frequent urination, difficulty starting urination and a weak urinary stream can sometimes be linked to prostate-related conditions, including prostate cancer, said Dr Y.M. Prashanth, Consultant Urologist, Uro-Oncologist, Andrologist, Kidney Transplant and Robotic Surgeon at KIMS Hospitals, Secunderabad.
Prostate cancer is relatively uncommon among men below 50, but the risk rises with advancing age. Men with a close family history of the disease, especially a father or brother diagnosed with prostate cancer, may face a higher risk. Certain genetic alterations, including changes in BRCA2, can also increase the likelihood of developing the disease.
Apart from some of the common symptoms, blood in the urine or semen and pain or burning while urinating may also require evaluation. In advanced cases, some men may experience persistent pain in the lower back, spine or bones.
However, Dr Prashanth pointed out that early-stage prostate cancer may not produce any symptoms. Therefore, the presence or absence of urinary symptoms alone cannot be used to diagnose or rule out prostate cancer.
Prostate-specific antigen (PSA) is a protein produced by prostate cells. A blood test measuring PSA levels can help doctors identify possible abnormalities involving the prostate.
However, an elevated PSA level does not necessarily indicate cancer. PSA levels can also rise due to non-cancerous conditions such as benign prostate enlargement, inflammation or infection.
Doctors may therefore recommend additional evaluation depending on the individual case. This can include a repeat PSA test, digital rectal examination (DRE), prostate MRI or, when appropriate, a biopsy.
PSA testing is not required at exactly the same age or frequency for every man. Men at average risk who are considering early-detection testing may discuss PSA testing with their doctor from around the age of 50.
The decision on whether to undergo PSA testing and how frequently it should be repeated should be made in consultation with a urologist, taking into account factors such as age, family history, overall health, previous PSA levels and estimated life expectancy.
Dr Prashanth said a diagnosis of prostate cancer does not necessarily mean that a patient will immediately require surgery. Treatment depends on several factors, including the stage and grade of the cancer, whether it has spread to other parts of the body, and the patient’s age and overall health.
For some men with early-stage, low-risk prostate cancer, regular monitoring without immediate definitive treatment may be an appropriate approach.
Depending on the nature and extent of the disease, treatment options can include surgery, radiation therapy, hormone therapy and other advanced approaches. TULSA-PRO, a technology-based treatment, is also being used in selected cases and may provide another option for eligible patients.
Regular physical activity, maintaining a healthy weight, eating a balanced diet and avoiding smoking can contribute to overall health. However, lifestyle changes alone cannot completely prevent prostate cancer.
“Changes in urination should not be ignored by assuming that they are simply a result of ageing. Men above 50, particularly those with a family history of prostate cancer, should discuss their individual risk with a doctor. Detecting the disease at an early stage can improve treatment options and outcomes. It is also important to remember that a PSA test by itself is not a definitive diagnosis of prostate cancer,” Dr Prashanth said.
