Prostate Cancer

Prostate Cancer


Prostate cancer is one of the leading cancers among men in India and is also called as prostatic carcinoma. It occurrence among the population has been see on the increase in the last decade and it is expected to double by 2020. Prostate cancer forms in the cells of the prostate.


Overview

Though several types of cells are found in prostate, almost all prostate cancers develop from glandular cells (adenocarcinomas). Prostate cancer is usually a very slow growing cancer and most patients do not have significant symptoms until the cancer reaches an advanced stage. Most men with prostate cancer die of other unrelated causes, and many never know that they have the disease. But once prostate cancer begins to grow quickly or spreads outside the prostate, it is dangerous.


Risk Factors

Both exposure (environmental or occupational) to particular agents & an individual’s susceptibility to these agents are thought to contribute to one’s risk of developing prostate cancer

Risk Factors
Age: Risk of prostate cancer increases with age.
Family history: Prostate cancer seems to run in families which suggest a genetic or inherited factor involved in its causation. A family history of prostate cancer increases your risk of getting it
Obesity
Diet - a diet of excessive calcium through dietary foods or supplements is known to increase risk to prostate cancer

Symptoms

The following are the common symptoms of prostate cancer

Symptoms
Difficulty in urination
Urgency to pass urine
Passing urine more often than usual, especially at night
Decreased force in the urine stream
Not having a feeling of emptied bladder
Discomfort in the pelvic area
Bone pains
Loss of bladder or bowel control due to cancer growth pressing the spinal cord
Weakness or numbness in the legs or feet
Impotency

These symptoms can be caused by cancerous as well as non-cancerous prostatic conditions. However, if you feel any of such symptoms consult your doctor.


Diagnosis

Prostate cancer can often be found early by:
Screening Tests
Digital rectal exam (DRE)
Testing the amount of prostate-specific antigen (PSA) in a man’s blood sample

If the results of the screening tests are abnormal , further tests can be performed to check for cancer.

Staging of the disease

Staging Description
Stage I
  • The PSA level is lower than 10
  • Tumor is found in one-half or less of one lobe of the prostate
Stage II
  • The PSA level is more than 10 but lower than 20
  • Tumor is found in one-half or less of one lobe of the prostate
Stage III
  • The PSA level can be any level
  • Tumor has spread beyond the outer layer of the prostate and may have spread to the seminal vesicles.
Stage IV
  • The PSA level can be any level
  • Tumor has spread beyond the seminal vesicles to nearby tissue or organs, such as the rectum, bladder, lymph nodes, bones or pelvic wall

Confirmatory Tests

Confirmatory Tests Description
Transrectal ultrasound (TRUS) A small lubricated probe is placed in the rectum to provide images of prostate on a computer screen. It is also used to measure the size of prostate and to obtain guided biopsy of the prostate , if needed
Prostate Biospy A small tissue sample is taken for testing in the lab and confirm presence of cancerous cells
Imaging Tests Imaging tests like MRI, PET/CT and Bone Scans are used to look for spread of spread of prostate cancer

Treatment Options

As with other cancers, the actual decision to treat is driven by a combination of clinical and psychological factors, including:

  • The need for therapy
  • Your level of risk
  • Your personal circumstance
  • desire for a certain therapy based on risks and benefits
Stage of Disease Common Treatment Approach
Stage I and II (Treating Localized or Locally Advanced Prostate Cancer)
  • Active Surveillance
  • Surgery/Prostatectomy
  • Radiation Therapy
Stage III and IV (Treating metastatic or Advanced Prostate Cancer)
  • Hormone therapy
  • chemotherapy
  • Radiation Therapy
  • Immunotherapy

Common Side Effects of Treatment

Treatment Approach Side Effects
Surgery (Radical Prostatovesiculectomy)
  • Accidental or involuntary loss of urine from the bladder (Incontinence)
  • Rectal bleeding
  • DVT(Deep Vein Thrombosis) - A blood clot in a deep vein, usually in the legs.
  • Impotence
  • Pulmonary embolism and wound infection
Radiation
  • Bladder symptoms including cystitis, hematuria, incontinence
  • Rectal symptoms including pain, tenesmus (continual or recurrent inclination to evacuate the bowels), and diarrhea
  • Impotence
Hormone Deprivation Therapy and Anti-Androgens
  • Hot flashes, sweats
  • Osteoporosis
  • Rarely, hyperglycemia, hyperinsulinemia and insulin resistance, and dyslipidemia.
  • Impotence

Further Reading and Research

There are many resources on the net for reading further about cancer

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