Prostate Cancer

—Specialisation

Quick Answer

Quick Answer: Prostate Cancer

What is prostate cancer?+

Prostate cancer is a malignant tumour that develops in the prostate gland. Most prostate cancers grow slowly and remain confined; some are aggressive and can spread to lymph nodes and bones. It is among the most common cancers in men.

Who is at risk of prostate cancer?+

Risk rises sharply after age 50. Other risk factors include a family history of prostate cancer, African ancestry, obesity, and a high-fat diet. Men with a first-degree relative affected should start screening earlier (age 40–45).

How is prostate cancer diagnosed?+

Diagnosis combines a PSA blood test, digital rectal examination (DRE), multiparametric prostate MRI, and a targeted prostate biopsy. The Gleason score and PSMA PET scan help determine grade and stage.

What are the treatment options for prostate cancer?+

Options include active surveillance (for low-risk disease), robotic radical prostatectomy, external-beam or brachytherapy radiation, hormone therapy, and chemotherapy — chosen based on stage, age, and personal preference.

Prostate cancer is a malignancy of the prostate gland – part of the male reproductive system. Most prostate cancers grow slowly and remain confined to the gland, but some are more aggressive and can spread to surrounding tissues, lymph nodes and bones. It is one of the most common cancers in men, and is often curable when detected early.

Signs & Symptoms

When the prostate cancer is not developed and in the earlier stages, there will be no clear symptoms. However, when the cancerous cells are grown, the signs and symptoms that are experienced, will be as the following.

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Frequent urination

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Difficult to start the steady stream of the urine

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Difficult to maintain the steady stream of the urine

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Nocturia, which is increased urination, especially during the nights

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Blood found in the urine, called hematuria

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Painful urination, called dysuria

Roughly two-thirds of men diagnosed with prostate cancer are asymptomatic at diagnosis – the cancer is detected on a routine PSA test or rectal examination. This is why screening from age 50 (or earlier with a family history) is important. When the condition goes beyond the acceptable levels and go with the advanced levels, there will be additional following symptoms, like the following.

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Bone pain

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Pain in ribs

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Pain in pelvis

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Leg weakness

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Urinary incontinence

Diagnosis

A definitive diagnosis of prostate cancer requires biopsy: small samples of prostate tissue are examined under a microscope. Before biopsy, less-invasive tests – PSA blood test, digital rectal examination (DRE), and multiparametric MRI – are typically performed to assess risk and guide biopsy targeting. Apart from the above two tests, there are also other tests done to confirm by gathering some more information relative to the urinary tract and prostate. It includes the test called DRE or Digital Rectal Examination that could reveal the abnormalities related to the prostate. Another test is the cystoscopy that could reveal the condition of the urinary tract, viewed from inside the bladder. Transrectal ultrasonography is another test that could provide a clear picture of the prostate, through the sound waves.

Prostate Imaging

Prostate imaging is done by either of the methods, like Magnetic Resonance Imaging or ultrasound.

Gleason Score

The tissue samples that are extracted from the diagnosis procedure called biopsy, are examined for the presence or absence of the cancer cells. The evaluation is done through Gleason score or microscopic features. The score reveals the presence and over-expressive protein called prostate specific membrane antigen.

Tumor Markers

PSA (Prostate Specific Antigen) is the most widely used tumour marker and is measured by a simple blood test.

Staging

In addition to the finding of the cancerous cells in the prostate, the following important diagnosis to be done is the staging to understand and determine, what the criticality of the condition is. It can reveal how far and how wide the cancer cells have been spread. It is a key point to define the prognosis and help to select the necessary therapies to treat the condition. The stages will be TNM or Tumor/Nodes/Metastases. Other important aspects are size of the tumor, presence of the metastases, in addition and number of lymph nodes found.

Treatments Available

The treatment for the prostate cancer depends on the multiple factors, in which staging is an important factor. So, the treatment is recommended mostly based on the stage of the cancer.

Early Stage

When the cancer is in the initial stages, the treatment recommended will be the following.

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A-Watchful Waiting

For low-risk disease, treatment may be deferred in favour of active surveillance – regular monitoring with PSA tests, MRI, and repeat biopsies, with definitive treatment reserved for evidence of progression.

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B-Radical Prostatectomy

Radical Prostatectomy: surgical removal of the entire prostate, increasingly performed using robotic-assisted laparoscopic surgery for superior precision, less blood loss and faster recovery.

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C-Conformal Radiotherapy

The treatment is performed by the radiation beam. The shape of the beam is shaped in the exact shape of the affected region in the organ and then overlapped with the radiation beam. The cancer cells in the affected area will be removed and the surrounding healthy tissues will be preserved with the same healthy condition.

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D-Brachytherapy

The treatment involves radioactive seeds to be implanted to the affected region of the prostate.

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E-Intensity Modulated Radiotherapy

Radiation beams are focused on the affected region in the prostate. It makes use of the conformal radiotherapy, assisted by the linear accelerator that is controlled by the computer.