CANCER, PROSTATE

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Urology , Oncosurgery , Radiotherapy

ABOUT THE DISEASE

Prostate is a walnut sized gland which is part of the male reproductive system and surrounds part of the urethra. The prostate makes a fluid (semen) that mixes with sperm and other fluids during ejaculation. If this gland becomes enlarged it can obstruct the passage of urine or semen through the urethra.

Prostate cancer is a malignant tumor that usually begins in the outer part of the prostate. In most men, the cancer grows very slowly. Prostate cancer is one of the most common types of cancer in men. A common problem in almost all men as they grow older is an enlarged prostate. This is called benign prostatic hyperplasia, or BPH. It does not raise the risk of prostate cancer.

SYMPTOMS

Prostate cancer, especially in its early stages, often does not have any symptoms. Some of the following symptoms appear as the cancer grows:

• Delayed start or Difficulty starting urination
• Less force to the stream of urine
• Dribbling after finishing urinating
• A need to urinate often, especially at night
• Pain while urinating
• Blood in the urine or semen
• Difficulty starting or maintaining an erection
• Pain with ejaculation
• Pain or stiffness in the lower back, hips, pelvis and upper thighs
• Unintended weight loss and/or loss of appetite

CAUSES

There is no known cause of the disease. Some of the risk factors are –family history, certain races, obesity, high fat diet, high testosterone levels.

DIAGNOSIS

- Digital rectal examination
- PSA (Prostate specific antigen)
The reading might be raised due to some other ailments as well, should therefore be followed up with the following tests:
- transrectal biopsy
- ultrasound
- bone scan
- CT/MRI

TREATMENT METHODS

The treatment plan is based on the Grade and Stage of the cancer as identified during the biopsy:

- Grading : Suggests how aggressive (fast-growing) the cancer is. Gleason scores range from 2 (not aggressive) to 10 (very aggressive).
- Staging : Suggests how advanced the cancer is, or how far it has spread. Stages I or II mean the cancer was caught early and has not spread outside of the prostate. Stages III and IV mean the cancer has spread to nearby tissues or organs, or to other body parts.

Based on these findings the common treatment options include the following:

- Watchful waiting
- Radiation therapy
- Interstitial brachytherapy
- Radical prostatectomy- Open, laproscopic or robotic (prostate cancer surgery)
- Hormone therapy
- Chemotherapy
- Cryotherapy