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types of cancer

Prostate Cancer

Overview

Prostate Cancer is one of the leading cancers in India. Men aged between 35 to 60 years are more likely to get affected by it. Diagnosis and treatment at early stages can lead to better outcomes. The prostate gland is a small, walnut-shaped gland near the urinary bladder in men which produces seminal fluid, nourishes and transports the sperm. Located in front of the rectum and just below the bladder where the urine is stored, the prostate also surrounds the urethra (the canal through which urine passes out of the body). Those older than 60 years are at a higher risk of this disease and would require treatment at the earliest.

Symptoms

Some of the symptoms experienced are:

  • Frequent urination especially at night
  • Difficulty in urination
  • Weak or interrupted flow of urine
  • Painful or burning urination
  • Difficulty in having an erection
  • Painful ejaculation
  • Blood in urine or semen
  • Frequent pain or stiffness in the lower back, hip or upper thigh

    • Causes

    The exact cause of prostate cancer is under investigation. However, increasing age and high testosterone are known risk factors.

    Diagnosis

    Since the above mentioned symptoms can potentially indicate the presence of other diseases or disorders, men who experience any of these symptoms should undergo a thorough check-up to determine the underlying cause. Some of the tests that can be done are:

  • A blood test for a protein known as Prostate Specific Antigen (PSA)
  • An ultrasound examination through the rectum is suggested, usually after the doctor has examined the prostate through the rectum (Digital Rectal Examination – DRE)

    • Treatment

    The prostate cancer treatment options depend on several factors, such as:

  • How fast the cancer is growing
  • The stage of cancer
  • The overall health
  • The pros and cons of the treatment.
  • Immediate treatment may not be necessary:
    • For men diagnosed with a very early stage of prostate cancer, treatment may not be necessary right away. Some men may never need treatment. Instead, doctors sometimes recommend active surveillance. In active surveillance, regular follow-up blood tests, rectal exams and biopsies may be performed to monitor the progression of your cancer. If tests show that cancer is progressing, then the doctor recommends surgery or radiation. Active surveillance carries a risk that the cancer may grow and spread between check-ups, making it less likely to be cured. The treatment methods may vary case-by-case. Some of them are: Radiation therapy: Radiation therapy uses high-powered energy to kill cancer cells. When it comes to Prostate cancer, radiation therapy treatment can be delivered in two ways: External beam radiation: During external beam radiation therapy (treatment without surgery), the patient lies on a table while a machine moves around the body directing high-powered energy beams to the cancer. The patient undergoes this treatment five days a week for several weeks. In this process, the patient gets exposed to x-rays or protons to deliver the radiation. Brachytherapy: It involves placing many rice-sized radioactive seeds in the prostate tissue. The radioactive seeds deliver a low dose of radiation over a long period of time. The doctor implants the radioactive seeds in the prostate gland using a needle guided by ultrasound images. The implanted seeds eventually stop giving off radiation and don’t need to be removed. Hormone therapy: It is a treatment to stop the body from producing the male hormone testosterone known as ‘testosterone suppression treatment’. Prostate cancer cells rely on testosterone to help them grow. Cutting off the supply of hormones may cause cancer cells to die or to grow more slowly. Hormone therapy options include:
  • Medications that stop the body from producing testosterone
  • Medications that block testosterone from reaching cancer cells
  • Surgery for the removal of testicles (orchiectomy) as part of prostate cancer treatment.
    • The objective here is to slow down the growth of tumours during the treatment. In men with early-stage prostate cancer, hormone therapy may be used to shrink tumours before radiation therapy. Sometimes hormone therapy is used after surgery or radiation therapy to slow the growth of any cancer cells left behind. Operation to remove the prostate cancer during treatment: Surgery for prostate cancer involves removing the prostate gland, some surrounding tissue and a few lymph nodes known as Radical Prostatectomy. This includes:
  • Using a robot to assist with surgery
  • Making an incision in your abdomen
  • Making an incision between your anus and scrotum
  • Laparoscopic prostatectomy (a minimally invasive surgery with multiple incisions)
    • Da Vinci Surgery for Prostate treatment: Robotic surgery, or robot-assisted surgery, allows doctors to perform many types of complex procedures with more precision, flexibility and control compared to conventional techniques. Robotic surgery is usually associated with minimally invasive surgery. It is also used in certain traditional open surgical procedures. The average time for surgery is 2 hours. Advantages: Minimal blood loss, pain, scarring and complications are some of the advantages of robotic surgery apart from shorter hospital stay and faster recovery. Freezing prostate tissue: Cryosurgery or cryoablation involves freezing tissue to kill cancer cells. During cryosurgery, small needles are inserted in the prostate using ultrasound images as guidance. A very cold gas is placed in the needles, which causes the surrounding tissue to freeze. A second gas is then placed in the needles to reheat the tissue. The cycles of freezing and thawing kill the cancer cells and the surrounding healthy tissue. Chemotherapy: Chemo uses drugs to kill rapidly growing cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form or both. It is considered as a treatment option especially when the cancer has become Metastatic (spread to distant areas of their bodies). Chemotherapy may also be an option for cancers that don’t respond to hormone therapy. Multiple new chemotherapy drugs have recently been approved for treatment of progressive or metastatic prostate cancer. Immunotherapy: A form of immunotherapy has been developed to treat advanced and recurrent prostate cancer. This treatment takes some of the patient’s own immune cells, genetically engineers them to fight prostate cancer, and then injects the cells back into the patient’s body through a vein. Some men do respond to this therapy with some improvement in their cancer, but the treatment is very expensive and requires multiple visits.

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