What is Prostate Cancer? Is it slow growing or an aggressive cancer?
Prostate is a walnut-size gland located at base of urinary bladder in men. Sometimes, a cancerous growth of this gland is seen. Most of the Prostate Cancers are slow growing, however, there is a subset of aggressive Prostate Cancers which must be identified and treated before it turns lethal.
Why are we seeing a rise in Prostate Cancer diagnosis in the last decade or so?
Considering the Indian demography, there is a rise in the ageing male population, and as Prostate Cancer is the disease of the elderly its incidences are rising. Moreover, with better availability of diagnostic centers and hospitals and awareness about the disease in general population, more & more incidences are being detected.
What are the risk factors and typical age?
This is a disease associated with ageing, so the risk increases as the age increases and is more commonly seen in men over 50 years of age. It is more often seen in African males and in persons with a history of Prostate Cancer in their family.
What are the symptoms?
Interestingly, this disease doesn’t have any symptoms in early stages. However, as the disease progresses, a person can have difficulty in passing urine, a need to frequently visit the washroom (particularly at night), blood in urine and semen. When the disease is very advance it can cause back pain and weakness of the legs.
How is it diagnosed?
For the diagnosis of this disease evaluation by a Urologist to feel the Prostate is most important. Besides this, a blood test (Serum, PSA) and Sonography are the primary screening methods. In suspicious cases MRI of the Prostate and biopsy are done.
How to detect its stage and how can it be treated?
For finding out the stage of the disease a CT scan of the abdomen, bone scan or PET scan is necessary. Treatment is based on the stage of the cancer. In localized cancers cure is possible by either surgery (Open Conventional/Laparoscopic/Robotic) or Radiation therapy. In advanced cases where cure is not possible this disease can be managed by hormone therapy (Castration) and Chemotherapy.
What is the success rate and follow-up treatment?
Early Prostate Cancer can be cured with a good success rate, however, they need to follow-up every 3 to 6 months. Advanced Prostate Cancer can be managed with good results in a significant number of cases.
Are there any ways to reduce the risk?
To decrease the risk early detection is the key and it is advisable to have a healthy lifestyle, which includes a healthy diet with adequate vegetables and fruits, avoiding smoking and red meat, and to exercise regularly.
What is the role of the drug Fiasteride in reducing the risk?
The role of Fiasteride in prevention of Prostate Cancer is not clearly defined.
Some studies claim ejaculation can have a preventative effect. True?
There are some studies that claim ejaculation can have a preventative effect. However, the preventive effect of ejaculation on Prostate Cancer is yet to be substantiated by good clinical studies.
The author, Dr. Abhay Kumar is a Consultant Urology & Uro-Oncology at Narayana Superspeciality Hospital, Howrah.