Prostate Cancer Treatment

Diagnosis of prostate cancer is made by biopsy and histological examination of the biopsy specimen by a pathologist. Procedures like PSA (prostate specific antigen) blood test and DRE (Digital rectal examination), used in screening are not sufficient for making a diagnosis of cancer of the prostate. Screening procedures help only in identifying persons who might be suffering from cancer of the prostate.

Biopsy

Cancer of the prostate, unlike breast cancer, which starts as a single tumor and grows outwards , starts as multiple small tumors at different locations within the prostate gland. Therefore during biopsy samples are collected from different locations in the prostate gland. This is referred to as multiple core biopsy. A minimum of six cores are usually recommended in cancer of the prostate.

Patients suffering from prostatitis(infection of prostate ) are advised not to undergo biopsy until a course of antibiotics is completed, to cure the infection. Patients with persistent high PSA levels but negative biopsies are advised to undergo a repeat biopsy.

During biopsy a needle is inserted into the tumor through the perineum, under the guidance of ultrasound, and cell specimens are taken from different locations within the prostate gland. After the biopsy the samples are examined by the pathologist under the microscope to look for cancer cells

Gleason grading

Cancer cells differ in their morphology from normal prostate gland cells. The degree to which they differ from the normal cell is what determines the cancer grade. The most commonly followed method of grading cancer of prostate is gleason grading.

The higher the gleason grading the more aggressive the tumor is likely to be and also more likely to spread to other organs of the body.

Prostatic cancer is the most common cancer in men over the age of fifty.

Adenocarcinoma is the most common form.

Prostate cancers seldom produce symptoms until the cancer is in the advanced stage so early diagnosis is essential as in the early stages the disease is curable.

Location and Function
The Prostate is an organ forming part of the male reproductive system. It is located immediately below the bladder and just in front of the bowel. Its main function is to produce fluid which protects and enriches sperm.

In younger men the prostate is about the size of a walnut. It is dough nut shaped as it surrounds the beginning of the urethra, the tube that conveys urine from the bladder to the penis. The nerves that control erections surround the prostate.

Signs and Symptoms

o Waking frequently at night to urinate
o Sudden or urgent need to urinate
o Difficulty in starting to urinate
o Slow flow of urine and difficulty in stopping
o Discomfort when urinating
o Painful ejaculation
o Blood in the urine or semen
o Decrease in libido (sex urge)
o Reduced ability to get an erection

Most men tend to accept the onset of one or more of these symptoms as being a natural consequence of aging. However, anyone experiencing any of the above symptoms is advised to consult a doctor without delay. Early expert diagnosis and treatment is important and may avert potentially serious health consequences.

Prostate cancer is usually one of the slower growing cancers. In the past, it was most frequently encountered in men over 70, and many of those men died of other causes before their prostate cancer could kill them. This led to the old saying “most men die with, not of, prostate cancer”.

However, that is certainly is not true today. Three developments have changed things considerably:

o Men are living longer, giving the cancer more time to spread beyond the prostate, with potentially fatal consequences.
o More men in their early sixties, fifties and even forties are being detected with prostate cancer. Earlier on-set, combined with the greater male life expectancy, means those cancers have more time to spread and become life-threatening unless diagnosed and treated.
o Prostate cancer in younger men often tends to be more aggressive and hence more life-threatening within a shorter time.

Risk Factors and Testing
Risk factors for prostate cancer include diets high in fat and low in vegetables. Risk factors include age; 75% of cases are in men over 65 years. Prostate cancer is most often discovered by physical examination or by screening blood tests, such as the PSA (prostate specific antigen) test.

The PSA test measures the blood level of prostate-specific antigen, an enzyme produced by the prostate. The risk of prostate cancer increases with increasing PSA levels.

The majority of men who reach age 85, in fact, have cancerous prostate cells, but the disease is developing so gradually that it never threatens their quality of life.

Genetic factors play a role, particularly for families in whom the diagnosis is made in men under 60 years of age, and the risk of prostate cancer rises with the number of close relatives who have the disease.

Preventative measures
Researchers at Harvard University found that men who ate cooked tomatoes or foods made with them (tomato sauce or ketchup, for instance) more than twice a week were less likely to develop prostate cancer.

Daily use of anti-inflammatory medicines such as aspirin, ibuprofen, or naproxen may decrease prostate cancer risk.

Frequent ejaculations also seem to have a definite protective effect against Prostrate cancer.

Many prostate cancers are not destined to be lethal, and most men will ultimately die from causes other than of the disease. Because many prostate tumors are slow growing, survival rates are excellent when the disease is detected in its early stages.

Treatment
The most appropriate treatment is primarily determined by the stage and aggressiveness (how quickly it is growing and spreading) of the disease when it is discovered. Detecting prostate cancer early is the key to beating the disease.

Many factors affect the decision whether or not to treat the disease: the patient’s age, whether the cancer has spread, the presence of other medical conditions, and the patient’s overall health.

Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy including brachytherapy and external beam radiation, High Intensity Focused Ultrasound (HIFU), chemotherapy, cryosurgery, hormonal therapy, or some combination.