Prostate is a small gland, present just beneath the urinary bladder in males and is responsible for production of the fluid portion of semen. Cancer in this small gland is one of the most common cancers in the United States of America. The detection of this cancer is increasing in India. The main risk factor for prostate cancer is age. Therefore, the older a person, the more are the chances of developing this type of cancer.
Signs And Symptoms
In early stages of prostate cancer can remain quite asymptomatic and may be detected during a routine health check. It can coexist or mimic the other common conditions affecting the prostate which is benign prostatic hyperplasia (BPH). The symptoms would include the following.
- Increased frequency of passing urine
- Difficulty ¡n passing urine
- Sense of incomplete urination
- Blood ¡n urine
Clinical Examinations And Investigations
The most important clinical examination for prostate cancer is digital rectal examination. The doctor examines the prostate through the rectum using a gloved finger and lubricant. A hard nodule is felt in most cases of prostate cancer.
Serum PSA (prostate specific antigen) this tumour marker is found to be increased in the blood of patients with prostatic cancer. It can also be elevated in other conditions like prostatitis and BPH. Very high levels indicate spread to other organs especially to the bones. Trans Rectal Ultrasound And Biopsy To see the prostate clearly, an ultrasound probe is passed through the rectum. Biopsies can be taken at the same time under image guidance. MRI and bone scan are some of the other investigations which are performed.
The treatment for prostate cancer depends on various factors like the stage of the disease, general condition of the patient, comorbidities, aggressiveness of the cancer and what the patient wishes.
Treatment Options For Early Prostate Cancer
- Wait And Watch – Many people with prostate cancer do not die of the disease. In many cases, the cancer may be just an innocent bystander unlikely to trouble the patient. So, in elderly patients with a less aggressive cancer not doing anything till it troubles is also an option.
- Radical Prostatectomy – This is considered a good option for younger patients in the early stage of the cancer. The surgery effectively clears the disease and can also preserve the potency of the patient in most cases. The operation is done laparoscopically and by using robotic arms in higher centres nowadays.
- Radiation Therapy – It is usually given by two methods, external beam radiation and brachytherapy. For brachytherapy, wires are placed within the prostate so that high doses of radiation can be given to that area. Radiation has control rates similar to surgery but has higher chances of causing impotence.
- Treatment Options For Metastatic Prostate Cancer
- Prostate is one of the types of cancer which can be effectively treated even in the advanced stages. And the main treatment would be hormone therapy.
- The development and spread of prostate cancer is highly dependent on the male hormone androgens. If androgens are blocked, automatically the growth of the tumour reduces.
- The main source of androgens ¡n males is the testes. Removing both the testicles effectively controls prostatic cancer.
- The androgens can also be controlled with injections which supress the testes from producing androgens. These are called luteinizing hormone releasing hormone agonists.
- In those patients where the disease progresses despite hormone blockage or has stopped responding, chemotherapy is an option.
Prostate cancer ¡s one of the cancers which can be detected early with PSA screening and can be effectively treated with the above mentioned treatment armamentarium. It is highly recommended that all males who have crossed the age of 40 have blood test for PSA at least once a year.