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Prostate cancer is cancer that occurs in a man’s prostate-a walnut-sized exocrine gland in the male reproductive tract that makes seminal fluid which performs the function of protecting, supporting, and transporting the sperm. The prostate gland also plays an important role in urine control.

Prostate cancer is a relatively slow-growing cancer as in early stage. Prostate cancer grows slowly and remains confined to the prostate gland and causes no serious harm and if not detected early it becomes aggressive and can spread quickly to lymph nodes, in other parts of the body or bones.

Prostate Cancer: Symptoms

As prostate cancer is asymptomatic, it is usually diagnosed in a later stage. Below are sign and symptoms of prostate cancer: -

·       Frequent need to urinate

·       Weak or interrupted urinary stream (urine flow)

·       Blood in the urine or semen

·       The urge to urinate frequently at night

·       Blood in the seminal fluid

·       Pain or burning during urination (Dysuria)

How Prostate Cancer is Diagnosed?

PDigital rectal exam (DRE): The doctor inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps or abnormal areas.

Prostate-specific antigen (PSA) test: A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate or BPH (an enlarged, but noncancerous, prostate).

Transrectal ultrasound (TRUS)- This is carried out by inserting a probe into the rectum that gives a clear picture of the prostate using sound waves that bounce off the prostate. This procedure is usually done during a biopsy procedure.

Biopsy :The removal of cells or tissues so they can be viewed under a microscope by a pathologist. The pathologist will examine the biopsy sample to check for cancer cells and determine the Gleason score. The Gleason score ranges from 2-10 and describes how likely it is that a tumor will spread. The lower the number, the less likely the tumor is to spread. There are 2 types of biopsy procedures used to diagnose prostate cancer:

Transrectal biopsy: The removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure is usually done using transrectal ultrasound to help guide the needle.

Transperineal biopsy: The removal of tissue from the prostate by inserting a thin needle through the skin between the scrotum and rectum and into the prostate.

If prostate cancer is diagnosed, the other tests( e.g Radionuclide bone scan, MRI. Pelvic lymphadenectomy, Seminal vesicle biopsy) are done to find out if cancer cells have spread within the prostate or to other parts of the body.

Bone Scans and X-rays– It is done to monitor cancer that started in the bones or that has spread to the bones from another part of the body.
Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) Scans –It is done to measure the tumor’s size and to pinpoint the location of cancer that has spread beyond the prostate.

Treatment Options for Prostrate Cancer

Radical (Open) Prostatectomy Surgery-

A radical prostatectomy is the surgical removal of entire prostate and the nearby lymph nodes. This procedure is performed by an incision through the lower belly or by key hole techniques (‘laparoscopic’ or ‘endoscopic’ or ‘robotic’) and a catheter (a narrow rubber tube) is put in the bladder to carry urine out of the body until the area heals.

Minimally Invasive Laser Prostate Surgery for Prostate Cancer Green Light Laser PVP:

Green Light Laser Therapy is a minimally invasive treatment option that combines the effectiveness of the traditional surgical procedure known as transurethral resection of the prostate (TURP). The GreenLight laser system delivers the ultimate BPH solution GreenLight is suitable for most patients with an enlarged prostate, the GreenLight procedure is creating a new standard of care — a standard that offers freedom from enlarged prostate / Prostate cancer symptoms .Most patients return home a few short hours after the GreenLight procedure and can return to normal, non-strenuous activities within days. The advantages of this approach over the traditional TURP (transurethral resection of the prostate) are many: Rapid urine flow improvement,Quick return to normal activities ,Virtually bloodless procedure , Outpatient procedure in otherwise healthy patients.

Laparoscopic radical prostatectomy: This is a minimally invasive procedure in which several small incisions are made in the abdomen. A laparoscope and other operating instruments are inserted through these incisions to remove the prostate.

Robot-assisted laparoscopic radical prostatectomy: This newer procedure uses robotic equipment to assist the surgeon in removing the prostate. There is little difference in the outcome for open or laparoscopic surgical methods. The results depend on the skill and experience of the surgeon rather than the type of surgery.

Radiotherapy: Radiation therapy uses high-energy rays or particles to destroy cancer cells. Radiation may be used for prostate cancer: as the primary treatment to destroy cancer cells, after surgery to destroy cancer cells left behind and to reduce the risk of the cancer recurring (adjuvant radiation therapy), after surgery if the cancer comes back around the area where the prostate gland was (salvage radiation therapy), to relieve pain or to control the symptoms of advanced prostate cancer (palliative radiation therapy)