There is a shadow disease that often lurks unnoticed, growing quietly within a man’s body which is hidden behind the mundane routine of daily life, masked by age, dismissed as ‘just part of getting older.’ That disease is prostate cancer, and its greatest danger lies not in loud alarms or obvious pain, but in its uncanny ability to remain silent until it demands attention.
Prostate cancer arises when cells in the Prostate Gland, a small, walnut-sized gland below the bladder and in front of the rectum, responsible for seminal fluid production, begin to grow abnormally and multiply without control. In many cases, the tumor remains confined inside the prostate for years, showing no outward signs or causing no symptoms. Only occasionally, or when the disease advances, do warning signs emerge and by then the risk factors become much higher. Because early prostate cancer often gives no hint, the only way to unmask it before danger grows is through awareness, regular medical check-ups, and informed discussions about risk.
The hidden symptoms
In its early stages, prostate cancer often causes no symptoms at all. The body seems fine, the day-to-day lives go on. It is only when the tumour grows large enough or begins to spread that men may start noticing clues but by that time, the cancer may be more advanced. Since many of these symptoms overlap with benign conditions (such as benign prostate enlargement or infections), they are often ignored or misattributed, which makes vigilance and awareness all the more essential.
Some of the possible signs, which should never be ignored, include:
Blood in the urine or semen — even a single episode of pink or cola-coloured urine can be a red flag.
Pain or burning during urination.
If the cancer spreads beyond the prostate, a stage often referred to as metastatic or advanced prostate cancer, additional symptoms may appear like aching or pain in the lower back, hips, or pelvis; bone pain or fractures if the cancer reaches bones; unexpected weight loss; fatigue; and other systemic symptoms.
Who Is at risk?
Prostate cancer is common globally, and its risk grows significantly with age. While it is rare in men under 40, most diagnoses occur in those aged 60 and above, with the average age around the late 60s. Beyond age, other risk factors include: a family history of prostate and certain genetic mutations. Since the disease often shows no symptoms early on, relying on “feeling healthy” is risky. Screening, especially for men above a certain age or those with risk factors, results better outcomes with fewer complications.
From detection to defence
Prostate cancer is diagnosed through a combination of a physical exam, blood tests, imaging, a prostate biopsy and digital rectal exam (DRE). The journey to detecting prostate cancer often begins with a simple blood test measuring the level of Prostate-Specific Antigen (PSA), a protein produced by the prostate. Elevated PSA levels may indicate the presence of a tumour. If PSA or other risk indicators raise concern, further investigations follow: a physical exam (often a digital rectal exam), imaging studies (MRI, CT, or specialised scans), and sometimes a biopsy, extracting a small sample of prostate tissue to examine under a microscope and confirm the presence of cancerous cells.
When cancer is confirmed, treatments vary depending on how advanced the disease is, how aggressive it appears, and the overall health of the patient. Many men with early-stage prostate cancer may be offered active surveillance, careful monitoring with periodic tests, especially if the tumour is slow-growing and not causing symptoms.
If intervention is needed, treatments may include surgery (for example, removal of the prostate), radiation therapy, hormone therapy (to reduce prostate-stimulating hormones), or more intensive methods like chemotherapy, targeted therapies, or radiopharmaceuticals when the cancer has spread beyond the prostate. Experts also emphasise lifestyle and a balanced diet, healthy body weight, and regular physical activity as supportive measures.
The writer is a Senior Consultant-Uro Oncology & Transplant Surgery at Aster Medcity, Kochi.