Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The prostate is a small organ about the size of a walnut. It lies below the bladder (where urine is stored) and surrounds the urethra (the tube that carries urine from the bladder). The prostate makes a milky fluid that helps to nourish sperm as part of the semen (ejaculatory fluid).
Older men often have an enlarged prostate, which is a noncancerous condition called benign prostatic hypertrophy (BPH) that causes urinary symptoms. Cancer occurs when normal cells undergo a transformation in which they grow and multiply without normal controls formingmalignant (cancerous) tumor (growth) that consists of cells from the prostate gland. Generally, the tumor usually grows slowly and remains confined to the gland for many years. Some aggressive types of prostate cancer grow and spread more rapidly than others and can cause a significant shortening of life expectancy in men affected by them.
All prostate cancers arise from the secretary glandular cells in the prostate. Cancer arising from a glandular cell is known as adenocarcinoma. Therefore, almost all prostatic cancers are prostatic adenocarcinomas
As the cancer advances, the cancer cells may metastasize (spread) from the prostate to other parts of the body, particularly the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, problems during sexual intercourse, or erectile dysfunction.
Prostate cancer tends to develop in men over the age of fifty and although it is one of the most prevalent types of cancer in men but in most cases prostate cancer is slow growing, symptom-free. About 2/3 of cases are slow growing, the other third more aggressive and fast developing. Thus usually symptoms and signs are more often associated with advanced prostate cancer.

The specific causes of prostate cancer remain unknown, but hormonal, genetic, environmental, and dietary factors are thought to play roles. BPH BenignProstatic Hyperplasia has no relation with prostatic cancer. The following risk factors have been linked with development of this condition:

• Age: There is a strong correlation between increasing age and developing prostate cancer. More than 80% of prostate cancers are diagnosed in men older than 65 years of age.
• Genetic factors: Men, who have a history of prostate cancer in their family, especially if it was a first-degree relative such as a father or brother, are at an increased risk. This risk may be two to three times greater than the risk for men without a family history of the disease.
• Infection: Recent evidence has suggested the role of sexually transmitted infections as one of the causative factors for prostate cancer. People who have had sexually transmitted infections are reported as having 1.4 times greater chance of developing the disease as compared to the general population.
• Diet: A diet high in fat has been associated with an increased risk of prostate cancer.
• Chemical agents: Exposure to chemicals such as cadmium has been implicated in the development of prostate cancer.

There is no proven link between frequency of sexual activity and prostate cancer risk.

In the early stages, prostate cancer often causes no symptoms for many years. As a matter of fact, these cancers frequently are first detected by an abnormality on a blood test (the PSA,) or as a hard nodule (lump) in the prostate gland.
Symptoms usually appear when the tumor causes some degree of urinary blockage at the bladder neck or the urethra.

• A weak stream of urine;
• Difficulty starting urination;
• Dribbling of urine, especially after urinating;
• A sense of not fully emptying the bladder;
• Leaking of urine;
• More frequent urination and a strong and sudden desire to urinate, especially at night; and
• Haematuria: Blood in the urine.
• Dysuria: Painful urination.
• As the disease advances it can cause Impotence and painful ejaculation

These symptoms alone on themselves prove nothing as BPH (Benign prostatic Hyperplasia), which is much more common condition can also produce the same symptoms. Thus a complete evaluation of the patient presenting with these symptoms is required to confirm the diagnosis.
In case Metastasis (process of invading and spreading to other organs) of prostatic cancer occurs it causes additional symptoms along with the above mentioned symptoms such as:

• Fatigue
• Malaise
• Weight Loss
• Prostatic cancer usually metastasizes first to the lower spine or the pelvic bones (the bones connecting the lower spine to the hips), thereby causing back or pelvic pain.
• If the cancer spreads to liver and lungs it can cause abdominal pain, jaundice, chest pain and coughing.

A proper medical interview and physical examination are essential in the diagnostic workup of any man in whom prostate cancer is suspected. Prostate cancer usually is suspected initially because of an abnormality of one or both of the two screening tests that are used to detect prostate cancer. These screening tests are

• A digital rectal examination
• Blood test called the prostate specific antigen (PSA).

Imaging studies: These reveal the size and location of the tumor in the prostate as well as the extent of spread of the disease.

• CT scan or MRI of abdomen and pelvis: This is the best way to detect the extent of the primary cancer as well as distant metastases.
• Chest x-ray film: This is a simple test that shows whether cancer has spread to the lungs.
• Ultrasound of kidneys, bladder, and prostate

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