Narayana Health Care

What is Prostate Cancer?

The prostate is a small walnut-shaped gland in men that produces the seminal fluid that nourishes and mobilizes sperm. When cancer happens in the prostate gland it may present as slow-growing and confined which may not require medical assistance or it may grow to severely and move to close by organs.

The chances of the total cure of prostate cancer are much higher in cases where it is confined and small. This prognosis can only happen if it is detected at an early stage. Early detection can only come about through screening.

Should I be screened for Prostate Cancer?

This topic has been debated over and over to finally establish the theory that if prostate cancer screening is essential or accessible. This is partly because of active surveillance which means even with prostate cancer an older man can survive a normal and healthy life. But certain prostate cancer can grow rapidly and are an immediate threat to the individual. There is no way to differentiate between either. And the cost incurred in the screening is way less than life-threatening cancer which it might become.

What are the warning signs of Prostate Cancer?

• Burning or painful urination
• Difficulty initiating and stopping urination
• Frequent urge to urinate at night
• Loss of bladder control
• Decreased flow or pace of urine stream
• Blood in the urine (hematuria)
• Blood in semen
• Erectile dysfunction
• Painful ejaculation

The problem with these warning signs is that they may or may not present at an early stage. Most prostate cancers are silent and do not produce any symptoms until later. Even then there is a specific protocol by the American Cancer Society and is followed worldwide.

You only need to get screened if you are:

• 40 – If you have a family history
• 45 – If you are African American
• 50 – If you have no family history and are not African American
• 55-69 – Discuss with your doctor
• Over 70 Screening is not recommended

Even so, your doctor may advise if or if not you need to be screened.

How does the screening take place?

There are 2 tests in place:

• Prostate-Specific Antigen test – Blood test

1. Free PSA test (<25% Free PSA indicates a greater risk of having cancer)
2. PSA velocity or the rate of rising over time (faster increase means more risk)

• PSA density, or the PSA per volume of prostate (higher density means more risk)

1. PSA-based markers (for instance the prostate health index, 4K score)

• Digital rectal exam (DRE) through hand

If any of the above tests result in prostate cancer suspicion, it is confirmed by –

• Other markers, a urinary PCA3 test
• Magnetic resonance imaging (MRI) of the prostate
• Biopsy

I am 50, why screening may not be for me?

Just age doesn’t keep you in a high-risk category. There are other factors too like ethnicity etc. which have already been discussed above. Moreover, screening may slip certain facts which may be of vital importance. Similarly in screening something may be detected which otherwise was harmless. Neither can the screening differentiate between fast-growing fatal tumors or slow-growing harmless tumors. On top of everything, the side effects of the treatment are too much interfering with the patient’s quality of life.

Prostate Cancer screening is an available solution to early detection of Prostate Cancer and helps you detect it way before any warning sign appears. To get yourself screened is a call; you need to make after collecting all possible information about it, through all possible sources.

Dr. Amit Goel, Consultant – Urology, Narayana Superspeciality Hospital, Gurugram