Prostate cancer is one of the most common types of cancer affecting millions of men across the world.
Dr. Alok Gupta, Consultant - Medical Oncology, Max Institute of Cancer Care-Lajpat Nagar, explains below some of the frequently asked questions that can help people learn about prostate cancer and help them lead a healthy life:
1. What is prostate gland?
Situated between the urinary bladder and penis, the prostate is a walnut-sized gland which forms a part of the male reproductive system. This gland not only produces some of the fluid in semen but also plays a vital role in controlling urine in men.
2. What is prostate cancer?
It is a type of cancer that occurs in prostate gland when the normal cells change into abnormal cells, and their growth goes out of control. Men who are older than 50 years are more prone to prostate cancer.
3. What are the symptoms of prostate cancer?
In most of the cases, prostate cancer does not cause any symptoms in the early stages. However, if they do occur, the common ones include:
- Frequent urination
- Interrupted flow of urine
- Blood in urine
- Bone pain arising from the spread of prostate cancer to bones
- Pain or burning sensation while urinating
Though these signs are connected to prostate cancer, they are not necessary in all the cases. Hence, it is vital to consult a doctor when someone experiences such symptoms to know the exact reason behind them.
4. Is there a test for prostate cancer?
There are various tests and diagnostic process which are used to check the presence of prostate cancer. Doctors usually perform a blood test known as PSA test and a rectal exam to check for prostate cancer. During a rectal exam, the doctor inserts a finger into the anus and up into the rectum to feel for abnormal areas on the prostate.
After these exams, if the doctors suspect that you might have prostate cancer, you will be recommended some other tests, Some of them are as follows:
· Imaging Tests such as Ultrasound and MRI scan
These tests are performed to create images of internal organs through which the doctors are able to identify the abnormal growths in the prostate gland.
· Biopsy
This test is used to make a definite diagnosis of cancer. The doctors take a small sample of tissue from the prostate which is then diagnosed under a microscope to check for the cancerous cells.
5. What is Prostate Specific Antigen (PSA)?
This is a glycoprotein produced by the cells of the prostate gland. Any disorder in the prostate leads to an elevated production of PSA. Some of those disorders include prostatic inflammation or infection, benign prostatic hyperplasia (BPH), perineal trauma and prostate cancer. The raised level of PSA is measured with a blood test. A PSA test is often used to identify the early stages of prostate cancer.
6. What is cancer staging?
It is a process to determine how much cancer has affected the body and if it has spread to other parts as well. Cancer staging is done through various scans including MRI scan, PSMA-PET or CT scan and bone scan.
7. How is prostate cancer treated?
Once the doctors identify the stage of prostate cancer, they opt for the best treatment that can match with the situation. Some of the main treatments for prostate cancer are:
· Active surveillance – This is not a treatment but a set of routine checkups that are performed when men are diagnosed with low risk of prostate cancer. When the doctors identify that the cancers cells have started growing quickly, they begin the active treatment.
· Surgery – It is the removal of a cancerous tumour and the surrounding tissues to treat cancer. There are mainly two types of surgeries: Radical prostatectomy and Robotic or laparoscopic prostatectomy.
· Radiation therapy – This therapy uses high-energy rays to destroy cancer cells. The therapy can be performed by either a machine that moves around the patient’s body or by putting a source of radiation directly into the prostate gland (Brachytherapy).
· Hormone therapy – Also known as androgen deprivation therapy (ADT), this treatment option is used to reduce the level of male hormones (androgen) as they make prostate cancer grow. Hormonal therapy can be performed by a surgery where testicles are removed or by taking several medicines prescribed by the doctors. This treatment is used for men with an advanced stage of cancer.
· Chemotherapy – This therapy is performed to kill the cancer cells which cannot be treated by hormone therapy. Chemotherapy targets the cells throughout the body that grow quickly; thus, it can have some side-effects on the body. In some severe cases, chemotherapy and hormone therapy are given at the same time.
In some cases where the patients, especially older men, may choose not to receive any treatment mentioned above. They just opt for treating the symptoms when they occur. This is known as “watchful waiting” and is mostly preferred by old men who have a short life expectancy and want to avoid repeated tests and biopsies.
8. How do I choose which treatment to have?
There are various factors that are considered before opting for a particular treatment. Your doctor will help you in making that decision. The best treatment depends on:
· The stage of your cancer
· Your age
· Whether you have other health problems
· How you feel about the treatment options.
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9. What happens after treatment?
You need to go for follow-up test after the treatment as there are chances that your cancer might come back. Some of the follow-up tests that are performed post-treatment are PSA tests, exams, biopsies, or imaging tests.
10. What happens if the prostate cancer comes back or spreads?
If in an unfortunate case cancer comes back or spreads, you will have to go for the treatments again.
