Prostate Cancer: Symptoms and treatment

New Delhi: Prostate cancer is extremely prevalent among asymptomatic men throughout the world. As per a report by the World Health Organisation (WHO), the incidence and mortality estimates per 100,000 age-normalized populations in India is nine and three respectively.

Talking about the risk factors for prostate cancer, Dr. Madhu Y C, Senior Consultant, Surgical Oncology, BGS Gleneagles Global Hospitals said, "Age is the most important risk for prostate cancer. Among adult malignancies, no other cancer is as age-related as prostate cancer. Prostate cancer rarely occurs before the age of 40, but the incidence rises rapidly thereafter."

"African men have one the highest incidences of prostate cancer in the world. Men with a brother or father diagnosed with prostate cancer at age 50 have approximately a twofold increased risk of prostate cancer and those with two or more first-degree relatives affected have approximately a seven- to eightfold increased risk compared with the general population," he added.

The most common symptom of prostatic disease in men older than 50 years is bladder outlet obstruction, including hesitancy, nocturia or increased urination frequency at night, urinary retention, and a diminished urinary stream. The diagnosis is established by a TRUS-guided transrectal needle biopsy, biopsy Gleason score,digital rectal examination and S.PSA levels. Staging work up by bone scan, computed tomography (CT) or magnetic resonance imaging (MRI) and Ga68-PSMA (Prostate Specific Membrane Antigen) PET CT SCAN.

Dr. Madhu further said that the treatment of prostate cancer depends on the stage of the disease.

"Early prostate cancers (stage I and II) may be treated by either the surgical method of radical prostatectomy with pelvic lymph node dissection or radical radiotherapy. Locally advanced cancer can be treated by chemo therapy and radiotherapy."

"If the cancer is in the metastatic phase, where it spreads to the other organs like bone, liver, and lungs, the treatment will be a combination of chemotherapy and hormonal therapy. LHRH agonist, abiraterone, Enzalutamide, oestrogens, ketoconazole, and steroids along with supportive care must accompany treatment."

Prostate cancer may be prevented by the following methods:

Hormonal Manipulation: Preclinical and clinical data suggest a potential role for finasteride in the chemoprevention of prostate cancer.

Antioxidants: Evidence from clinical trials suggests a promising role for selenium and vitamin E as potential chemo preventive agents against prostate cancer, possibly through their antioxidant activity

Early Detection/Screening: periodic DREs and PSA testing plays a major role in early detection of prostate cancer.