What is prostate?

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What is prostate cancer?

Most common Prostate cancers are called adenocarcinomas. These cancers that develop from the gland cells that secrete the prostatic fluid.

What are the symptoms of Prostate cancer?

Prostate symptoms can be of two types. One is not able to store urine, frequent passage urine. Other is problems in passing urine, straining to pass urine and taking long time to pass urine. But these are not specific for cancer prostate. They can be present even in age related benign enlargement of prostate. (Benign Prostatic hyperplasia)

How do I know whether I am having prostate cancer or not?

When there are symptoms of prostate enlargement it may be due to age-related enlargement that is very commonly seen (benign prostate hyperplasia) or cancerous enlargement. The diagnosis of prostate cancer can be made only by doing a prostate biopsy. As biopsy is a disturbing procedure it is done only when prostate cancer is suspected. The urologist suspects cancer prostate when the gland is abnormal to feel during a digital rectal examination, when serum PSA is elevated or abnormalities seen in prostate gland during imaging with multiparametric MRI/Trans-rectal Ultrasound.

What is PSA?

Prostate specific antigen or PSA is a protein produced by cells lining the prostate glands. The PSA test measures the level pf PSA in a man’s blood. The results are reported as nanograms of PSA per ml of blood. Elevated levels are suspicious of cancer prostate. There are other causes like infection that can cause elevation of PSA levels in blood.

How is prostate biopsy done, is it painful?

Prostate biopsy involves passing a needle through the wall of the rectum (Trans-rectal biopsy) into the prostate gland. This is the most common way of performing a prostate biopsy. Can also be done by inserting needle through the area of skin between the anus and scrotum(Trans-perineal biopsy). The biopsy is done under ultrasound or MRI guided. Mild discomfort will be present. To prevent pain prostatic block is given by injecting local anaesthetic around the prostate nerves. The biopsy is done as a day care procedure.

My grandfather died of prostate cancer, will I get cancer prostate?

Prostate cancer seems to run in some families, which suggests that in some cases there may be an inherited or genetic factor. Still, most prostate cancers occur in men without a family history of it. Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. (The risk is higher for men who have a brother with the disease than for those who have a father with it.) The risk is much higher for men with several affected relatives, particularly if their relatives were young when the cancer was found.
How to protect me from prostate cancer if one of my relative is affected by prostate cancer?
Early diagnosis is the best way. This is done by yearly screening PSA test from age of 35 years. Healthy lifestyle will be helpful.

How dangerous is prostate cancer?

Some prostate cancers grows and spread quickly, but most grow slowly. In fact, autopsy studies show that many older men died of other causes had prostate cancer within. They never had the symptom of cancer. Inappropriate excessive google knowledge is more dangerous than the cancer itself.

What are the treatments available?

Treatments are according to the stage in which the patient is presenting. Stage one is the earliest, stage 4 is the advanced. The usual treatments are:

1.Radical prostatectomy

Removal of prostate ,urethra within the prostate, seminal vesicles , Vas deferens and regional lymph node. Done in early stages. Can be done by open or robotic surgical technique.

2. Radiation Therapy:

High energy rays are used to kill cancer cells. Various techniques are used.

3. Hormonal therapy

Prostate cancer cells are sensitive to male hormone testosterone deficiency. Medical or surgical castration is the baseline of advanced stage cancer treatment.

4. Chemotherapy.

Is destruction of cancer cells with drugs. Used in advanced stage.

Dr Kabilan Saminathan
Head – Urology and Andrology