Prostate Health

7/6/2025

Prostate Cancer in Sri Lankan Men: What You Need to Know

What is Prostate Cancer?

Prostate cancer is a disease where abnormal cells grow uncontrollably in the prostate gland, a small organ in men located below the bladder that helps produce fluid for semen. It is one of the most common cancers affecting men worldwide and also in Sri Lanka. The exact cause of prostate cancer is not fully known, but the risk increases with age.

Why is Prostate Cancer Important in Sri Lanka?

In Sri Lanka, prostate cancer is the fifth most common cancer among men, accounting for about 6.5% of all new cancer cases in males as of recent data (source1, source2). The number of prostate cancer cases has been rising steadily over the past years. (source) Unfortunately, many men in Sri Lanka are diagnosed at an advanced stage, which makes treatment more difficult and outcomes less favorable. This highlights the urgent need for awareness, early detection, and effective treatment strategies.

Who is at Risk?

Several factors can increase the risk of developing prostate cancer:

  • Age: Risk rises significantly after 50 years.

  • Family history: Men with close relatives who had prostate cancer have a higher risk.

  • Ethnicity: Globally, prostate cancer is more common in Black men; Sri Lankan men have a lower incidence compared to Western countries but tend to present with more aggressive disease.(source)

  • Genetics: Certain inherited gene changes can increase risk.

  • Diet and lifestyle: High-fat diets, obesity, smoking, and alcohol consumption may contribute, although more research is needed in the Sri Lankan context.

Symptoms of Prostate Cancer

Early prostate cancer often has no symptoms, which is why screening is important. When symptoms do appear, they may include:

  • Difficulty starting or stopping urination

  • Frequent urination, especially at night

  • Weak urine flow

  • Blood in urine or semen

  • Painful urination or ejaculation

  • Pain in the back, hips, or pelvis

Advanced prostate cancer may cause more severe symptoms depending on where it has spread.(source)

How is Prostate Cancer Diagnosed?

Doctors use several methods to diagnose prostate cancer:

  • Medical history and symptom review

  • Digital rectal exam (DRE): A doctor feels the prostate through the rectum to check for abnormalities.

  • Prostate-specific antigen (PSA) blood test: Measures PSA protein levels, which may be higher in prostate cancer.

  • Imaging tests: Ultrasound, MRI, or CT scans to visualize the prostate and surrounding tissues.

  • Biopsy: Taking a small tissue sample from the prostate to confirm cancer under a microscope.(source)

In Sri Lanka, PSA screening is not yet widespread, contributing to late diagnoses.(source)

Stages of Prostate Cancer

Prostate cancer is categorized by how far it has spread:

  • Stage I : Cancer confined to the prostate gland
  • Stage II : Cancer still within the prostate but larger or higher PSA levels
  • Stage III : Cancer spread to nearby tissues
  • Stage IV : Cancer spread to distant parts of the body

Knowing the stage helps doctors decide the best treatment.

Treatment Options

Treatment depends on the cancer stage, patient health, and preferences.

Early Stage Treatments

  • Watchful waiting or active surveillance: Monitoring PSA levels and prostate health without immediate treatment, suitable for slow-growing cancers.

  • Surgery (Radical prostatectomy): Removing the prostate gland and sometimes nearby tissues.

  • Radiation therapy: Using targeted radiation to kill cancer cells, either from outside the body or by implanting radioactive seeds near the prostate.

  • Hormone therapy: Reduces male hormones (androgens) that fuel cancer growth, sometimes combined with radiation.

Advanced Stage Treatments

  • Hormonal blockade: Lowering testosterone levels through medication or surgery to slow cancer growth.

  • Chemotherapy: Drugs to kill cancer cells that have spread.

  • Targeted therapy and immunotherapy: Newer treatments that attack specific cancer cells or boost the immune system.

Prostate Cancer and Fertility

Prostate cancer and its treatments can affect fertility by reducing semen production or damaging sperm. Men who wish to have children after treatment should discuss fertility preservation options with their doctors before starting treatment.(source)

What Can Sri Lankan Men Do?

  • Be aware: Understand the risk factors and symptoms of prostate cancer.

  • Get screened: Men over 50, or earlier if there is a family history, should discuss PSA testing and DRE with their doctor.

  • Seek early medical advice: Don’t ignore urinary symptoms or pelvic pain.

  • Support awareness programs: Community education can help reduce late-stage diagnoses.

  • Adopt healthy lifestyle habits: Balanced diet, regular exercise, avoiding smoking and excessive alcohol may reduce risk.

The Way Forward for Sri Lanka

Research shows a rising trend in prostate cancer cases in Sri Lanka, with many men presenting late. The National Cancer Control Programme is working to improve cancer detection and treatment.(source) Introducing routine PSA screening and public awareness campaigns, similar to those in Western countries, could save lives by catching prostate cancer early.

This article is for educational purposes and encourages Sri Lankan men to take proactive steps in prostate health. Always consult healthcare professionals for personalized advice and treatment.