Prostate cancer

Overview – Prostate cancer is among the most common cancers in men worldwide. The prostate is a walnut-shaped gland located between the bladder and the penis.

The risk factors for prostate cancer are obesity, family history of prostate cancer, old age.

 

Symptoms

  • Prostate cancer in the early stages may cause no symptoms.
  • Most advanced prostate cancer may present with trouble urinating, blood in the semen, decreased force in the stream of urine, bone pain, erectile dysfunction, weight loss, weakness, fractures.

 

Complications

  • Broken bones and fractures because of metastases to bones
  • Urinary incontinence
  • Erectile dysfunction

 

Screening

  • Whether healthy men need to be screened for prostate cancer depends on your risks, benefits. Talk to your doctor if prostate cancer screening is right for you. Most medical organizations do not agree on the issue of screening.
  • Digital rectal examination and prostate-specific antigen tests are done for screening.

 

Diagnosis

  • Digital rectal examination and prostate-specific antigen tests are done to look for abnormality. Ultrasound, prostate biopsy (a procedure to collect a sample of cells from your prostate), MRI fusion are done further to determine whether the abnormality is prostate cancer.

 

Lifestyle management

  • Follow a healthy diet and exercise regimen as recommended by your doctor. Your diet should include a variety of fruits, vegetables, and whole grains which contain many vitamins and nutrients.
  • If you are a high risk for prostate cancer such as a family history of prostate cancer talk to your doctor about treatments to reduce the risk of prostate cancer. Finasteride, dutasteride are medications that have shown to reduce the risk of developing prostate cancer as suggested by some studies.
  • Talk to your doctor if you are experiencing sexual dysfunction because of cancer.

 

Medical management

  • Treatment options depend on the stage of cancer, overall health, benefits and side effects of the treatment.
  • Active surveillance may be recommended for low-risk prostate cancer. Blood tests, rectal exams and possibly biopsies may be performed to monitor the progression of your cancer.
  • Radical prostatectomy (removing the prostate gland) is done using a robot to assist surgery, or by making an incision in the abdomen. Radical prostatectomy carries a risk of urinary incontinence and erectile dysfunction.
  • Radiation therapy can be delivered in two ways –
  • external beam radiation, where radiation comes from outside of your body
  • Brachytherapy, which involves placing many rice-sized radioactive seeds in your prostate tissue that deliver radiation for a long period of time.
  • Hormone therapy that suppresses the production of testosterone, or blocks the testosterone from reaching the cancer cells. Prostate cancer cells rely on testosterone to grow. Leuprolide, goserelin, triptorelin, histrelin, ketoconazole, and abiraterone are medications that suppress the production of testosterone. Bicalutamide, nilutamide, and flutamide are medications that block the testosterone from reaching the cancer cells.
  • Removing the testicles may also be an option to reduce the testosterone levels in the body.
  • Chemotherapy is the preferred option for men with prostate cancer that has spread to remote body locations, or for men who do not respond to hormone therapy.
  • Immune therapy (biologic therapy) such as sipuleucel-T uses the body’s immune system to fight cancer cells may be a treatment option for advanced, recurrent prostate cancer.

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