Types of Prostate Cancer
- Localized cancer –contained within the prostate
- Locally advanced cancer
- Recurrent cancer comes back after previous treatment
- Metastatic cancer – when the cancer has spread to other parts of the body.
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Risk Factor for Prostate Cancer
- Age– the chances of having prostate cancer increase with advancing age.
- Ethnicity- Black men more likely to get prostate cancer.
- Family history– having a first degree relative with prostate cancer increases the risk.
- Diet, obesity are also important contributing factors.
Signs and Symptoms
Clinically the patient presents with symptoms of:
- Urination troubles like frequent urging, difficulty in commencing urination, blood in urine
- Excess level of PSA (protein specific antigen) in blood
- Bone fractures seen in metastatic cases of cancer prostate
- There may be urinary /fecal incontinence in advanced cases
Tests and Diagnosis
- Medical health history of the patient taken into account
- Prostate cancer is commonly detected by PSA (prostate specific antigen) test of blood
- DRE– Digital Rectal Examination and Trans rectal ultrasound also performed which aid diagnosis
- Biopsy is usually performed to confirm diagnosis
- To determine the stage of cancer, imaging studies like bone CT scan or MRI scan
- Depends on the spread of cancer in the prostate gland
- In early stages the aim of treatment is cure
- In advanced stages the aim is to expand life and relieve symptoms
- Health and age of patient
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Screening at regular intervals to closely monitor the state of patients prostate, without immediate treatment.
The main benefit of surgery is the prostate with the cancer is removed .
Prostatectomy : Usually performed for:
- Clinically Localized cancer.
- If age young and fast growing tumor.
- Here the surgeon removes the entire prostate gland and may remove surrounding tissues, lymph nodes and the seminal vesicles.
- Taking out lymph node reduces the risk of cancer recurrence.
- It may be performed laparoscopic ally or by open approach.
- Monitoring in recovery
- Drain put for excess fluids
- Catheter put in
- Stocking and pumps to reduce the risk of clot formation
- In 7-10 days cystogram performed and catheter removed
- Within 2-4 weeks return to normal activities
- Medication given to help erection
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Risks associated with surgery
- Blood clots
- Damage to nearby organs
- Erectile dysfunction
- Urinary incontinence
This therapy uses high energy beams of X- rays to treat prostate cancer by damaging the cells. It is useful in cases when:
- When cancer is low grade and limited locally to the prostate
- As treatment of choice along with hormonal therapy for cancer that has grown into surrounding tissue
- For cancer that recurs
- For metatstatic advanced cancers for palliative relief
Types of Radiation Therapy
- Brachytherapy– also called seed implantation, herein small radioactive pellets are placed on prostateand they give off their radiation at low dose over several weeks or months.
- External Beam Radiation also known as EBRT in which beams are focused on prostate from outside the body.
After Effects of Radiation
- Bowel problems– diarrhoea, blood in stool
- Urinary symptoms– radiation cystitis, urinary incontinence
- Erection problems
- Does not cure, it’s a temporary therapy and just slows the cancer growth or used as palliative therapy in metatstatic cases.
- It aims to decrease production or block action of hormone, which leads to destroyed prostate cancer cells and shrunk prostate tumor.
- Hormone therapy can be given alone or combination with other treatment.
Types of Hormone Therapy
- Orchiectomy : Surgical removal of testicles.
- Drug therapy : block signal from brain thus lower hormone, effects may be reversible.
- LH-RH Analogue therapy- blocks the production of hormone.
- Anti Androgen Therapy- blocks action of hormoneused before LHRH therapy to prevent androgen flare.
After Effects of Hormonal Therapy
- Hot flushes
- Reduced sex drive
- Decreased ability to have erections
- Decresed muscle strength
- Can cause bone thinning
- Can lead to dyslipidaemia
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Factors Affecting Cost of Prostate Cancer Surgery
The cost to the patient depends on a variety of factors like:
- The hospital, the patient chooses
- Room– Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate and room service)
- Fee for the team of doctors
- Standard tests and diagnostic procedures
- Type of surgery performed
- Cost of Radiation /Hormone therapy
- Cost of the follow–up care required after the procedure