Prostate Cancer​

The prostate gland is a small organ, which is a part of the male reproductive system. It is shaped like a walnut and is essentially responsible for producing the seminal fluid and transporting the sperm. It is one of the most common types of cancer in men. Prostate cancer grows slowly and hence does not metastasize quickly. Therefore, it is usually less harmful than other types of cancer.

Almost all known prostate cancers are adenocarcinoma. Adenocarcinoma develops from the cells that produce the prostate fluid, which is added to the semen. Other types of cancers, although very rare, which affect the prostate gland include:

• Neuroendocrine tumours
• Sarcomas
• Small cell carcinomas
• Transitional cell carcinomas

Precancerous conditions:

Research has shown that prostate cancer normally starts as a precancerous condition. These conditions can be:

Prostatic intraepithelial neoplasia (PIN): In this condition, the anatomy or the structure of the cells of the prostate glands starts to change and is clearly visible under a microscope. Based on how the cell structures look under the microscope, the prostatic intraepithelial neoplasia can be classified as:

• Low-Grade PIN: The patterns in the structure appear relatively normal.
• High-Grade PIN: The patterns in the cell structure are relatively abnormal. This might be a possible risk and precursor to prostate cancer.

Proliferative inflammatory atrophy (PIA): The prostate cells in PIA look smaller than normal size with signs of inflammation. However, researchers and professionals do consider that Proliferative inflammatory atrophy can lead to high-grade PIN and thus cancer.

Prostate cancer may not show any specific signs or symptoms in the early stages, however, later stages of cancer may exhibit any of the following symptoms or problems in males:

• Blood in the semen
• Blood in the urine
• Decreased pressure while urinating
• Erectile dysfunction
• Pain in the bones
• Problems while urinating
• Unexplained weight loss

Symptoms of rostrate cancer appear at the later stages of cancer, and therefore, we suggest, that as soon as you experience any discomfort or problems, you consult our specialist immediately.

The screening tests for prostate cancer include the following diagnostics procedures:

PSA Blood Test: The prostate-specific antigen blood test or the PSA antigen blood test measures the level of a prostate antigen in the blood. Since this antigen is produced only by the prostate gland and the cancer cells in the gland, high levels of PSA can indicate abnormalities. Benign enlargement of the gland can also indicate high levels of PSA. Another reason for high PSA levels could be prostatitis- an inflammation of the prostate gland.

Digital Rectal Examination: Also, known as DRE, in this examination the specialist will put up a lubricated and gloved finger into the rectum to feel for any abnormal shape or thickness in the prostate gland. For the procedure, the patient has to lie either on the stomach or on his side, on the table

Both, Digital Rectal Examination (DSA) and prostate-specific antigen blood test are performed, to get ore clear results and screenings.

Other diagnostic tests that are performed are:

• Biopsy: A thin and flexible tube is inserted to gently scrape off a small amount of tissue from the prostate gland. Then this removed piece of tissue is sent to the pathologist to be viewed under a microscope for the search of cancer cells.
• Imaging techniques: Computerized tomography scan (CT scan), Magnetic Resonance Imaging (MRI) or a bone scan means that internal pictures of the body are taken as these machines rotate around your body. This will give a detailed image of the internal organs.

There are various risk factors that can add to the development of cancerous cells in the body. Some of these risk factors are avoidable while others are not avoidable. The risk factors include:

• The risk of prostate cancer in a male individual increases with age.
• Family History: If an immediate relative or a blood relative has developed cancer, then the chances of an individual, to have prostate cancer increases

Obesity: Overweight or obesity has been known to be associated with the risk of prostate cancer as well. It is also been suggested, that the treatment regimen is less effective in the obese.

Genetic factors: Inherited genes, such as BRCA 1 and BRCA 2, which are also responsible for cancers in the female reproductive system, can cause prostate cancers as well. Lynch syndrome is also known to be associated with prostate cancer.

The treatment regimen for any type of cancer is based upon the type, stage and aggressiveness nature of cancer and the patient details as well. Based on these factors, our specialists will recommend the best treatment possible:

Regular Monitoring: If the PSA levels are only slightly elevated, no treatment can be recommended, however, these levels will be checked regularly and monitored at regular intervals to avoid any complications.

Surgery: Our specialists may suggest a prostatectomy, that is, removal of the prostate gland. This can be done in either way: in open surgery or laparoscopic surgery.

Radiation therapy: In radiation therapy, two types of treatment can be provided based on the symptoms and requirements:

• Brachytherapy: Our specialists will place a radioactive seed or capsule into the prostate gland. This will help in targeted delivery.
• Conformal radiation therapy: This therapy targets a small area in the gland, thus minimizing the risk of destruction in the healthy cells.

Chemotherapy: It will make the use of drugs to kill the cancer cells.

Targeted therapy:Patients having genetic mutations like for example, BRCA 1 and/or BRCA 2, are offered targeted treatment in advanced stages to get maximum effects and least side effects.

Hormonal therapy: Male hormones such as androgens, that include testosterone and dihydrotestosterone are blocked or reduced by this therapy. These hormones are considered to provide a suitable environment for the cancer cells to grow.

Depending upon the individual, a few complications can occur too. The commonly known complications of the treatments are:

• Incontinence
• Erectile Dysfunction

Most of the risk factors are unavoidable, however, a person may follow some measures and plan to say as healthy as possible:

• Eating a healthy and balanced diet comprising of fruits, vegetables and whole grains
• Avoiding unnecessary food supplements, especially if no doctor has approved them.
• Following a continuous pattern of exercises and physical activity
• Maintaining a healthy weight
• Getting continuous checkups and screening if you are at high risk.