Prostate gland is a almond shaped gland situated at the urinary bladder opening. Prostate gland is involved in secretion of prostatic fluid part of seminal fluid of semen. The urethra passes through the center of prostate gland. The cancerous growth of cells of prostate leads to formation of prostate cancer.
Adenocarcinoma is the most common type of prostate cancer. It arises from the prostatic gland cells. The other type of prostate cancers are; small cell carcinoma, neuroendocrine tumours, transitional cell carcinomas and sarcomas.
Adenocarcinoma of prostate are often of two types: slow growing/low risk disease and fast growing/ high risk disease based upon the microscopic features.
Following are the major risk factors of Prostate Cancer like:
Early Prostate cancer is often asymptomatic. Most of the early symptoms of prostate cancer are similar to BPH/ enlarged prostate like increased frequency of urination, urgency to pass urine, weak stream of urine, dribbling, sense of incomplete emptying and straining to pass urine.
In late stages prostate cancer can cause: hematuria (blood in urine), pain in lower back, hips and thighs, painful ejaculation, loss of appetite, Loss of weight etc
Most of the prostate cancers are evaluated by the urologist with:
PSA is prostate Specific Antigen, a chemical found in blood. This is made by the prostate and prostate cancer cells. It is normally found in very low levels in blood. The rise in PSA levels is a marker of various prostatic ailments like enlarged prostate, prostatic inflammation, prostatic infections and in prostate cancer. PSA test is to be done in consultation with the urologist.
Screening is a tool to detect disease in asymptomatic individuals. PSA screening is recommended in men between 55-65 years of age and in men >45 years of age having a family history of prostate cancer.
PSA test is done on yearly basis for screening and as per the recommendation of treating urologist.
A biopsy is a minor surgical procedure where tissue is taken from the prostate for examination under microscope by the pathologist for confirmation of prostate cancer. TRUS is transrectal ultrasound, TRUS guided biopsies of prostate is the standard method to diagnose the prostate cancer.
Early prostate cancer is generally T1 and T2 prostate cancer. In these stages the prostate cancer is confined to the prostate lobes and has not spread to adjacent structures. These prostate cancers have very good prognosis. In these prostate cancers the outcome of surgical resection is very good.
Radical Prostatectomy is the surgical operation done for treatment of prostate cancer. In Radical prostatectomy the prostate along with the seminal vesicles and vas deferens is removed from the body and the bladder is reanastomosed to the urethra.
Laparoscopic/ Robotic Radical Prostatectomy is the minimal invasive technique to do radical prostatectomy surgery. In it through small incisions the whole cancer surgery is done with minimal post operative pain, surgical scars and bleeding.
Locally Advanced Prostate Cancer comprises of prostate cancer which has spread outside the prostate gland I.e. T3 and T4 prostate cancer and Prostate cancer which has spread to lymph nodes I.e node positive prostate cancer.
The locally advanced prostate cancer is best treated with a combination of hormonal ablation and local control with. Newer research is showing also role of radical prostatectomy in these cases post neo-adjuvant hormonal ablation.
Neo adjuvant Hormonal therapy is when hormonal injections are given in locally advanced prostate cancer and after these injections the cancer shrinks in its size. Post neo adjuvant hormonal therapy now newer research is coming which is showing more number of these patients are now going for surgical resections.
Metastatic / stage IV prostate cancer is when the cancer has spread to other organs from the prostate gland. This prostate cancer generally spreads to the bones and other organs. This is the most advanced stage of prostate cancer; now with newer drugs even this stage of prostate cancer can be treated effectively and overall survival of patient can be prolonged.
The treatment options in this stage for prostate cancer ranges from hormonal ablation, chemotherapy, second line hormonal therapy and radioactive nuclear treatment of the disease kindly visit the specialist for further treatment.