Prostate Cancer

Prostate Cancer

Signs and symptoms of prostate cancer

In early stages prostate cancer can remain quite asymptomatic and may be detected during routine health checks. Prostate cancer can coexist or mimic the other common condition affecting the prostate which is Benign Prostatic Hyperplasia (BPH).

The symptoms would include

• Increased frequency of passing urine
• Difficulty in passing urine
• Sense of incomplete urination
• Blood in urine

Prostate cancer can remain asymptomatic and directly presently with symptoms of spread to bone like pain and fractures.

Clinical examination and investigations :

The most important clinical examination for prostate cancer is a digital rectal examination. The doctor uses a gloved finger and lubricant through the rectum to examine the prostate. 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 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 bone.

Trans rectal ultrasound and biopsy:

To see the prostate clearly the ultrasound probe is passed through the rectum. Biopsies are done at the same time under image guidance. Bone scan and MRI are some of the other investigations which are performed.

Treatment of prostatic cancer :

This will depend on various factors like stage of the disease, general condition of the patient , comorbidities, aggressiveness of the cancer and 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 is just an innocent bystander which trouble the patient. So in elderly patients with less aggressive cancer not doing anything till it troubles him is also an option.
• Radical Prostatectomy - This is considered as one of the good option for younger patients with early-stage 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 now a days.
• Radiation therapy is usually given by two methods - external beam radiation and brachytherapy. In 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 cancer which can be effectively treated even in advanced stage. The main treatment here would be what we call hormone therapy

The Spread of prostate cancer and its development is highly dependent on the male hormone androgens. The growth of the tumour reduces when androgens are blocked automatically. The main source of androgens in males is the testes. Removing both the testicles effectively controls prostatic cancer.

Injections are used to control the androgens which suppress the testes from producing androgens. It is known as luteinizing hormone-releasing hormone agonists.

In those patients which have the disease is progressing despite hormone blockage or has stopped responding chemotherapy is an option.

Prostate cancer is 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 40 have blood test for PSA at least once in a year.