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How can you be screened for Prostate Cancer?

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Prostate Cancer

How can you be screened for Prostate Cancer?

Dr. Rudra Prasad Acharya
Head– Surgical Oncology & Senior Consultant
Cancer Care / Oncology, Surgical Oncology

1. What is prostate cancer?

Prostate cancer is a malignant tumour in the prostate. It is more common in elderly (> 75 years of age). It is usually not detected in early stage although it is a screenable cancer. Prostate cancer is generally asymptomatic, which means that there are no clear symptoms to indicate it. In most cases, symptoms are caused by benign prostatic enlargement (BPE), or an infection.

The symptoms may include:

  • Urinary symptoms such as urinary frequency or a weak stream of urine
  • Blood in the urine
  • Erection problems
  • Urinary incontinence
  • Loss of bowel control
  • Pain in the hips, back, chest, or legs
  • Weak legs

2. How is prostate cancer diagnosed?

Your doctor will perform a digital rectal exam (DRE) and take a blood test to measure your prostate-specific antigen (PSA) levels. If the results are not normal, you may also undergo a transrectal ultrasound and transrectal biopsy.

3. Should I be Screened?

The goal of prostate screening is to detect prostate cancer as early as possible, ideally at a manageable and even curable stage. Prostate cancer screening is composed of both a digital rectal examination and a serum PSA. Both of these are important in the screening process, and an abnormality in either of these warrants further evaluation.

Roughly 20% of prostate cancers are found by rectal examination; most are detected by an abnormal PSA. Prostate cancer screening should be performed on a yearly basis, except for men with an initially low PSA level who may want to consider screening on an every-other-year basis.

As you continue with screening on a yearly basis, changes in the PSA (beyond what is believed to be a change caused by benign growth of the prostate) or rectal examination will prompt further evaluation. Through the use of prostate cancer screening, the morbidity and mortality associated with prostate cancer will be diminished. More recent studies are showing increased survival as a result of prostate cancer screening.

4. How curable is prostate cancer?

As with all cancers, "cure" rates for prostate cancer describes the percentage of patients likely to remain disease-free for a specific time. In general, the earlier the cancer is detected, the more likely it is for the patient to remain disease-free.

Approximately 90% of all prostate cancers are detected in the local and regional stages, the cure rate for prostate cancer is very high—nearly 100% of men diagnosed at this stage will be disease-free after five years.

5.How is prostate cancer treated?

There are a wide variety of treatment options available for men with prostate cancer, including surgery, radiation therapy, hormone therapy and chemotherapy, any or all of which might be used at different times depending on the stage of disease and the need for treatment.

6.How does treatment affect sexual life?

Cancer treatment can affect your sexuality. You may experience erectile dysfunction after radical prostatectomy. Hormonal therapy can lower your sex drive. Feelings of depression and fatigue can also have a negative effect on your sexual life. It is important that you talk to your partner about your feelings.

7. What are some common side effects of chemotherapy? Will they go away?

The most common side effects of chemotherapy include:

  • nausea and vomiting
  • mouth sores
  • fatigue
  • anaemia
  • dizziness
  • hair loss, and
  • loss of appetite.

Yes, temporary side effects like nausea, vomiting, hair loss, and fatigue usually go away following the completion of treatment.

8. Will I become impotent after the treatment?

When seeking treatment for prostate cancer, several men are concerned about the effects of treatment on erectile function. The incidence of erectile dysfunction associated with radical prostatectomy varies with patient age, erectile function before surgery, nerve-sparing status, and the surgeon’s technical ability to perform a nerve-sparing radical prostatectomy. Erectile function continues to improve for up to 3.5 years after surgery although most men regain their potency within the first 12-18 months.

9.Will my lifestyle be changed significantly with prostate cancer?

No, your lifestyle won’t change if you are suffering with prostate cancer. A lot of what you will be able to do will vary with the stage of your disease and the treatment that you are undergoing. With early-stage prostate cancer, there are usually few limitations; you can golf, travel, and so on. If you are planning to undergo surgical treatment, you will want to take good care of yourself before surgery. It is helpful to make sure that you are eating right, resting, and getting regular exercise.

There will be a recovery period after the surgery, and your doctor will indicate when he or she feels that you can resume full activity. The recovery period varies with the surgical procedure used. Recovery from the laparoscopic approach appears to be quicker than with the traditional open approach, and with interstitial seed therapy, the convalescence is much shorter than with surgery.

10.Can I work during the treatment?

Some people benefit from keeping to a regular work schedule with flexibility if they don't feel well. Some schedule chemotherapy for Fridays so that they have time over the weekend to recover. Others may want to take medical leave from work.