Prostate cancer is the leading malignancy in men over the age of 50. It is due to the abnormal proliferation of prostatic tissue cells. It is often a slow-growing cancer and remains localized at first. Later, it may extend as it spreads to nearby tissues and organs and then metastasizes to other more distant organs (lymph nodes, bones, lungs, etc.) via the bloodstream and the lymphatic system. Preventing such a development by early screening is a major public health issue, all the more so because as life expectancy increases, so does the frequency of this cancer.
Prostate cancer occurs when abnormal cells, fuelled by male hormones such as testosterone, grow uncontrollably to form tumors.
Causes of Prostate Cancer
The cause of prostate cancer isn't fully understood at present. But there are certain factors that make prostate cancer more likely, which are listed below.
The risk of prostate cancer increases steadily with age and it is rare in men under 50.
Your risk is higher if you have close relatives (a father, uncle or brother) who have had prostate cancer.
If several women in your family have had breast cancer (especially if they were diagnosed at less than 40 years of age) an inherited faulty gene may be present. The gene may also increase the risk of the men in that family getting prostate cancer.
If you are African-Caribbean or African-American you are at highest risk whereas if you are Asian, you are at lower risk.
A high fat diet may increase your risk.
Symptoms of Prostate Cancer
Prostate cancer often has no symptoms, particularly in the early stages.
Some men may never have any symptoms or problems from the disease. Some types of prostate cancer can be slow-growing and may not become a serious threat to your health. Whereas others are a faster-growing and aggressive form and can be more harmful.
You are more likely to get symptoms if and when your cancer grows in the prostate gland and narrows the urethra.
Symptoms then include : -
problems urinating such as difficulty in starting to pass urine, a weak, sometimes intermittent flow of urine, dribbling of urine before and after urinating, a frequent or urgent need to pass urine or a need to get up several times in the night to urinate.
a feeling that your bladder is not completely empty.
pain when you orgasm.
rarely, blood in the urine.
These symptoms are similar to those produced by a common non-cancerous disease where the prostate becomes enlarged (benign prostatic hyperplasia)
Enlarged prostate (BPH)
If prostate cancer spreads to other parts of your body, other symptoms can develop. The most common site for prostate cancer to spread to is one or more bones, especially the lower back, pelvis and hips. These bones can become painful and tender.
Diagnosis of Prostate Cancer
Your doctor will ask you about your symptoms and will examine you for Prostate Cancer. He or she may do some of the following tests or refer you to a hospital specialist (urologist) for them.
A digital rectal examination (DRE) is an examination of your prostate. Your doctor will insert a lubricated, gloved finger into your rectum and feel your prostate through the wall of your rectum. If there is prostate cancer it may feel harder than usual, or knobbly.
A PSA blood test will test the amount of prostate-specific antigen (PSA) in a sample of your blood. PSA is a chemical which is made by both normal and cancerous prostate cells. If you have an abnormally high level of PSA, prostate cancer is a possibility. However, a high PSA score does not always indicate cancer and can be caused by other prostate diseases.
In a prostate biopsy, your doctor will surgically remove a small piece of tissue using a needle. The sample will be sent to a laboratory for examination to find out if it is a tumour and how fast it is growing.
CT (computerized axial tomography), MRI (magnetic resonance imaging) and bone scans can help your doctor see how far the cancer has spread (if at all). A bone scan involves injecting a small amount of radioactive liquid into your vein. This can show if the cancer has spread to the bone.
Treatment of Prostate Cancer in India.
Your treatment for prostate cancer will depend on a number of factors such as your age and whether the cancer has spread and if so, how far. There are a number of treatments which are described below.
Active monitoring of Prostate Cancer : -
Sometimes, particularly for slow-growing tumors, no treatment is the best course of action. This is often called active monitoring or watchful waiting. Your condition will be monitored closely with routine check-ups. You can start treatment at any time and will be advised to do so if tests show the cancer is growing.
Surgery of Prostate Cancer in India : -
Surgery is a common treatment for prostate cancer. It is most suitable for otherwise healthy men (usually, those under 70) whose cancer has not spread beyond the prostate.
The most common technique is a radical prostatectomy. This is a major operation, which removes the whole of the prostate, seminal vesicles and nearby lymph nodes.
Radiotherapy for Prostate Cancer in India : -
Newer techniques that are used for treating prostate cancer with radiotherapy include conformal radiotherapy (CRT) or high-resolution intensity modulated radiotherapy (IMRT). Conformal radiotherapy shapes the radiation beams to match the shape of the prostate. This reduces the radiation received by the healthy surrounding cells in nearby organs such as the bladder and rectum.
This lowers the side-effects and may allow higher doses to be given which could be more effective. IMRT allows the radiotherapist to vary the dose of radiotherapy given to the tumour and surrounding tissue.
Read More.
Brachytherapy for Prostate Cancer in India : -
Brachytherapy involves implanting radioactive seeds into, or next to, the tumour in your prostate. Radiation can be released slowly over time. The seeds lose their radioactivity over about a year. Brachytherapy is more effective if the tumour is small and you have early prostate cancer.
Read More.
Hormone therapy for Prostate Cancer in India : -
Hormone therapy blocks the action of male sex hormones that help cancer grow. This can slow the growth and spread of prostate tumors but will not kill the cancer cells.
New treatments for Prostate Cancer in India : -
There are new treatments being developed such as cryotherapy. This is surgery to freeze the prostate with liquid gas and kill cancer cells.
High intensity focused ultrasound (HIFU) is a treatment given using a machine that gives off high frequency sound waves. Some cancer cells die when this is focused directly onto them.
New surgical developments include keyhole surgery (a laparoscopic prostatectomy) where the prostate is removed through smaller incisions.
Green Light Laser therapy is also offered for prostate treatment.
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