Prostate Cancer

Introduction

Males have a small walnut-shaped gland called the prostate that generates seminal fluid, which nourishes and transports sperm. The prostate is located beneath the bladder (a hollow organ that stores urine) and in front of the rectum (the last part of the intestines).

Symptoms

Males who do experience symptoms may notice: difficulty starting and maintaining urination, a frequent urge to urinate, especially at night, a weak urine stream, blood in the urine or semen, painful urination or ejaculation, pain in the back, hips, or pelvis.

Prevalence in India

The incidence of prostate cancer varies significantly around the world. Despite the fact that the prevalence and features of prostate cancer have been thoroughly investigated in several countries, data on the exact incidence of prostate cancer in India is limited. It is second most commonly occurring cancer in men. Roughly, Prostate cancer is detected in around one out of every eight males.

Risk factor

Age is the most common risk factor. The older a man is, the greater the chance of getting prostate cancer. Besides that, race and family history are both significant risk factors. Modifiable risk factor includes obesity, more amount of animal protein, processed food.

Diagnosis

PSA test

PSA is a blood test that is primarily used to detect prostate cancer. The test determines how much Prostate-Specific Antigen (PSA) is present in blood. PSA is a protein produced by both malignant and noncancerous tissue in the prostate gland, which is located below the bladder in males. The PSA test can detect elevated PSA levels, which could indicate the presence of prostate cancer in its early stages.

Other tests

If a doctor suspect’s cancer after taking personal and medical history, they may suggest more tests, such as urine test to look for other biomarkers, Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans. A MRI scan can be used to identify the cancer's extent (stage). MRI scans can reveal whether the malignancy has progressed to the seminal vesicles or other surrounding structures. If prostate cancer has been found, MRI can be done to help determine the extent (stage) of the cancer.

Treatment

The type and stage of cancer, potential side effects, as well as the patient's preferences and overall health, all influence treatment options and recommendations. Some common treatments are— radiation therapy, chemotherapy, biological therapy, hormone therapy. The management of localized prostate cancer is based on stage, grade, PSA, and subjective assessment of comorbidities and life expectancy.

Surgery

Surgery is a treatment option for prostate cancer that has spread to other parts of the body. It's occasionally used in combination with other therapies to treat advanced prostate cancer. The type of surgery depends on the stage of the disease, the patient’s overall health, and other factors.

•    Radical (open) prostatectomy
•    Robotic or laparoscopic prostatectomy
•    Transurethral resection of the prostate (TURP)

Radiation therapy

Radiation therapy kills cancer cells by bombarding them with high-powered energy.

After surgery

The survival rate after prostate cancer surgery is primarily determined by the cancer's stage. Men with local or regional prostate cancer, on the other hand, are virtually always: The 10-year relative survival rate is 98%. The 15-year relative survival rate is 95%. If prostate cancer is in its last stages, the survival rate is 4-5%.

Prostate cancer and COVID-19 pandemic

The COVID-19 pandemic has posed a challenge to our health-care system, raising various issues in the management of PC patients. During the epidemic, patients can consult with doctors through video call, but visual examination is essential.

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