Prostate cancer is formed when healthy cells in the prostate grow out of control and form a tumour. It can be benign or cancerous. It is one of the most common cancers found in men. This type of cancer is somewhat different as compared to other types of cancer and do not spread quickly to other parts of the body.

It grows slowly and remains confined to the prostate gland initially causing less harm. If detected early have better chances of successful treatment.

Symptoms Of Prostate Cancer

A patient shows no signs and symptoms in the initial stages but causes symptoms in later stages, such as :

• Frequent urination
• Blood in urine
• Blood in semen
• Trouble in urination
• Erectile Dysfunction
• Pain and burning during urination
• Urge for urination at night

Causes & Risk Factors

The reasons and causes of prostate cancer are still not clear. Medical experts say prostate cancer begins if some cells in the prostate become abnormal. They grow more rapidly than normal cells do and form tumours. Some abnormal cells break and spread to other parts of the body.

• Family history
• Age, as you age chances of prostate cancer increases
• Obesity – Men who are obese and having prostate cancer are more likely to have other advanced diseases and are more difficult to operate on.

Complications Of Prostate Cancer

• Spreading of cancer to other body parts/organs and difficult to be cured with treatment.
• Incontinence : Prostate cancer treatment can cause urinary incontinence and the same can be cured either by medications, catheterization or surgery.
• ED Surgical treatment or Radiotherapy for prostate cancer may result in ED ( Erectile Dysfunction). The same can be further treated with medications, vaccum devices and penile implant surgery if required.

Diagnosis Of Prostate Cancer

Prostate Screening Tests, Which Include

• DRE ( Digital Rectal Examination)
• SPSA test ( blood test).

Prostate Screening Tests, Which Include

If SPSA / DRE detects an abnormality, a Urologist may recommend:

• TRUS (Transrectal Ultrasound) : It helps to further evaluate the prostate by inserting the probe in the rectum and pictures are taken of the entire prostate gland.
• Prostate Biopsy : A urologist may recommend a prostate biopsy if initial tests reveal prostate cancer. A biopsy is done with a needle inserted into the prostate to collect multiple tissues and then sent to a laboratory for checking cancer cells.
• MRI Fusion : MRI Fusion is done along with a biopsy to diagnose prostate cancer.

Stages of Prostate Cancer

Once it’s diagnosed that patient has prostate cancer, a Urologist works to determine the stage of cancer: Following tests are done to determine the spread of cancer :

• USG
• Bone scan
• MRI
• PET scan
• CT scan

Stages range from I to IV, the lowest one indicate that the cancer is confined to the prostate only, whereas the last stage reveals that it has spread to other organs of the body beyond the prostate gland.

Stage wise Treatment Of Prostate Cancer

STAGE (I & II)

At this stage, prostate cancer grows at a slower pace and takes years to cause symp0tioms or other health issues. As discussed earlier active surveillance and waiting is recommended. For men with high Gleason scoring, radical prostatectomy and radiation therapy is recommended. Uro-Oncologist is the ideal person to suggest on a treatment plan after evaluating the patient. 

STAGE III

At this stage, external-beam-radiation therapy and testosterone suppression therapy is recommended. A combination of treatments is given for better results. Normally, 24 months of testosterone suppression therapy is needed to control the disease.

STAGE IV

Advanced Prostate Cancer, also known as metastatic cancer, spreads to other parts of the body. In the case where it is already metastatic, we need to consult experts who have rich experience in treating the same.

Testosterone therapy followed by other drugs, cryosurgery or radical prostatectomy, HIFU (Focal therapy) is ideal choices of treatment for Stage IV prostate cancer.

Treatment of Prostate Cancer

1st line of treatment recommended by a Urologist is active surveillance for those who are being diagnosed with low-risk cancer.

Surgery

To treat prostate cancer a Urologist or Uro-Oncologist should be involved. The type of surgery depends on the stage, nature of the disease and overall condition of the patient.

Radical Prostatectomy

In this procedure, entire prostate and seminal vesicles are removed. Lymph nodes may also be removed, however, there are several complications ( viz, urinary incontinence, ED etc. )

Robotic-Assisted Lap Prostatectomy

This is a minimally invasive procedure with quick recovery. Small keyhole incisions are made in the patients abdomen to remove the prostate gland. However, the side effects are almost similar to those of radical or open prostatectomy.

Bilateral Orchidectomy

In this procedure, both the testicles are removed surgically. This surgery is performed for treating testicular cancer and sometimes to treat advanced prostate cancer.

HIFU (High-Intensity Focused Ultrasound)

HIFU is a heat-based focal therapy. During HIFU, a USG probe is inserted in the rectum and sound waves are directed on the cancerous part of the gland. The main advantage of HIFU is that it destroys cancer cells while limiting damage to the entire prostate gland. The procedure is already US FDA approved in the year 2015 and is the best option for prostate cancer treatment. Diyos Hospital have experts that perform HIFU regularly.