UROLOGIST: AVAILABLE 24 X 7 FOR DELHI & NCR CALL AT 9312658532, 8076983617

Prostate Cancer

Prostate cancer is a malignant growth that occurs in the prostate gland, a small walnut-shaped gland in males that produces seminal fluid. It is one of the most common types of cancer in men, particularly affecting older individuals.

Risk Factors

  1. Age: Risk increases significantly after age 50.

  2. Race: More common in African-American men than in men of other races.

  3. Family History: Having a family history of prostate or breast cancer.

  4. Genetic Mutations: Certain inherited gene mutations, such as BRCA1 or BRCA2.

  5. Diet and Lifestyle: High-fat diets and obesity may increase risk.

Symptoms

Early prostate cancer may not cause any symptoms. As it progresses, symptoms might include:

  • Difficulty urinating or a weak urine stream.

  • Frequent urination, especially at night.

  • Blood in the urine or semen.

  • Painful ejaculation.

  • Erectile dysfunction.

  • Discomfort in the pelvic area.

Diagnosis

  1. Digital Rectal Exam (DRE): A physician feels the prostate gland through the rectum to check for abnormalities.

  2. Prostate-Specific Antigen (PSA) Test: Measures the level of PSA in the blood. Elevated levels might indicate prostate cancer.

  3. Transrectal Ultrasound (TRUS): Uses sound waves to create an image of the prostate.

  4. Prostate Biopsy: Removal of small tissue samples from the prostate to be examined under a microscope.

Staging

Staging determines the extent of cancer and helps guide treatment:

  • Stage I: Cancer is small and confined to the prostate.

  • Stage II: Cancer is larger but still confined to the prostate.

  • Stage III: Cancer has spread to nearby tissues.

  • Stage IV: Cancer has spread to lymph nodes, bones, or other parts of the body.

Treatment Options

The choice of treatment depends on the stage of cancer, patient’s age, overall health, and personal preferences.

  1. Prostate Cancer: Stage-Wise Treatment Options

    Stage I Prostate Cancer

    Characteristics:

    • Cancer is small and confined to the prostate gland.

    • Typically low-grade and not aggressive.

    Treatment Options:

    1. Active Surveillance:

      • Suitable for older men or those with other serious health issues.

      • Regular PSA tests, DREs, and possibly biopsies to monitor cancer.

      • Treatment begins if cancer shows signs of growth or increased aggressiveness.

    2. Radical Prostatectomy:

      • Surgical removal of the prostate gland.

      • Option for younger, healthy men who want to eliminate cancer.

    3. Radiation Therapy:

      • External Beam Radiation Therapy (EBRT) or Brachytherapy.

      • Effective for eradicating cancer confined to the prostate.

    Stage II Prostate Cancer

    Characteristics:

    • Cancer is larger and may involve more of the prostate but is still confined to the gland.

    • Can be low to high grade.

    Treatment Options:

    1. Active Surveillance:

      • For low-grade, slow-growing cancers.

      • Regular monitoring as in Stage I.

    2. Radical Prostatectomy:

      • Preferred for many patients, especially if the cancer is thought to be more aggressive.

      • May involve pelvic lymph node dissection.

    3. Radiation Therapy:

      • EBRT, Brachytherapy, or a combination of both.

      • Often combined with hormone therapy to improve effectiveness.

    4. Hormone Therapy:

      • May be used in conjunction with radiation therapy for high-grade tumors.

      • Reduces androgen levels to shrink or slow the growth of cancer.

    Stage III Prostate Cancer

    Characteristics:

    • Cancer has spread beyond the prostate to nearby tissues.

    • Higher risk of recurrence and progression.

    Treatment Options:

    1. Radical Prostatectomy:

      • Often combined with radiation therapy post-surgery to eliminate residual cancer cells.

    2. Radiation Therapy:

      • EBRT with or without Brachytherapy.

      • Typically combined with long-term hormone therapy.

    3. Hormone Therapy:

      • Androgen deprivation therapy (ADT) used to shrink cancer before surgery or radiation and to slow growth.

    4. Chemotherapy:

      • In some cases, used for advanced or high-risk cancers.

    Stage IV Prostate Cancer

    Characteristics:

    • Cancer has spread to distant parts of the body, such as lymph nodes, bones, or other organs.

    Treatment Options:

    1. Hormone Therapy:

      • Primary treatment to manage cancer growth.

      • Includes ADT and newer androgen receptor inhibitors (e.g., enzalutamide, abiraterone).

    2. Chemotherapy:

      • Drugs like docetaxel or cabazitaxel are used for hormone-refractory prostate cancer.

    3. Radiation Therapy:

      • Palliative radiation to relieve symptoms such as bone pain.

    4. Bone-Directed Therapy:

      • Bisphosphonates or RANKL inhibitors to strengthen bones and prevent fractures.

    5. Immunotherapy:

      • Sipuleucel-T (Provenge) for certain patients to stimulate the immune system to attack cancer cells.

    6. Targeted Therapy:

      • PARP inhibitors for patients with specific genetic mutations (e.g., BRCA1, BRCA2).

    7. Clinical Trials:

      • Patients may consider enrolling in clinical trials for access to new and experimental treatments.

    Personalised Treatment Approach

    • Multidisciplinary Care: Involves urologists, oncologists, radiologists, and other specialists to create a tailored treatment plan.

    • Patient Preferences: Considering patient’s age, overall health, and personal preferences in choosing the best treatment strategy.

    Follow-Up Care

    • Regular follow-up with PSA tests, imaging, and clinical evaluations to monitor for recurrence.

    • Managing side effects and maintaining quality of life through supportive care and rehabilitation.

    Dr. Saurabh Mishra and his team are committed to providing comprehensive and personalized care for each patient, ensuring the best possible outcomes at every stage of prostate cancer.