Prostate Cancer Treatment

Prostate is the tiny walnut shaped and sized gland present in males in between the bladder and genital organs. The main function of the prostate is to produce seminal fluids which protect and nurture the sperms and help in transporting the sperms during ejaculation.

Prostate cancer is the most common type of cancer affecting men but mortality is less as it can be treated completely with the help of multiple treatment options like surgery, radiation therapy and chemotherapy.

The prostate cancer typically advances slowly and primarily remains restrained to the prostate gland and thus requires minimal treatment. However, some prostate cancers may need quick attention and aggressive treatment for complete cure.

Early detected prostate cancer that is confined to the glad itself has good chances of complete cure. Prostate cancer may not show any signs and symptoms when it is at its early stage but more advanced cancer may cause symptoms like Blood stained semen, discomfort and pain in pelvic region, difficulty in micturition, bone pain, erectile dysfunction etc.

It is thus important at this point to seek the doctor’s advice and get the lab test done which shall aid to know the stage of prostate cancer to determine the appropriate treatment accordingly. The stages of prostate cancer are:

1. Stage I: Cancer is confined to a small area of prostate gland and cells are not at all aggressive.
2. Stage II: Cancer is small but the cancer cells may reflect as aggressive or the cancer is large and may have grown enough that it involves prostate glands on both the sides.
3. Stage III: Cancer has advanced outside the prostate and affected seminal vesicles and adjacent tissues.
4. Stage IV: Cancer has advanced to plague nearby organs including urinary bladder, bones, lymph nodes, lungs or other tissues and organs.

What Causes Prostate Cancer?

The exact cause of prostate cancer is still unknown but there are certain risk factors that are identified to cause prostate cancer. These include:

1. Age: The risk of getting prostate cancer increases with the advancing age.
2. Race: It has been found that black men are at higher risk of getting prostate cancer than men of other color or race.
3. Obesity: Obese patients usually develop more advance cancer that becomes difficult to treat.
4. Family history: People may be at higher risk if they have a family history of prostate cancer or breast cancer.

Prostate Cancer Treatment Options

Prostate cancer can be treated with the following options which depend on the size and site of the cancer, stage of the cancer and extent to which the disease has spread.

• Radiation Therapy:

  It comprises of high intensity energy to destroy the cancerous cells and is delivered in 2 ways;

  • External beam radiation therapy:

    Radiation from outside the body is focused on the prostate gland using high powered energy beams like protons or X-ray.

  • Brachytherapy:

    Radiation is delivered from inside the body. It involves placement of radioactive seeds which are rice-sized that emit a low dose of radiation for a long period. The seeds are implanted in the prostate using ultrasound guided needles.

• Hormone therapy:

  The cancer cells of the prostate are dependent on the male hormone testosterone for their growth. Thus, hormone therapy aims at inhibiting the production of testosterone that may stop the growth of the cells or may cause them to die. This therapy includes;

  • LH-RH (luteinizing hormone-releasing hormone)

    agonists to stop the production of testosterone. The medicines include goserelin, leuprolide, histrelin and triptorelin.

  • Anti-androgens block

    the testosterone to reach the cancer cells. These include flutamide, bicalutamide and nilutamide.

• Chemotherapy:

  It is used to destroy the fast growing cells by using injectable drugs. It is the treatment of choice for the men whose cancer has advanced to other areas of the body or for the men who have not responded well to the hormone therapy.

• Biological therapy:

  Also known as immunotherapy in which your own body’s immune system is made to fight the cancer. In this way some of your immune cells are taken and genetically modified in the lab and are injected back into your body to fight the cancer cells.

• Surgery:

  The surgery to treat prostate cancer is to remove the prostate gland and is known as Radical prostatectomy. Radical prostatectomy is the surgery done to remove the entire prostate and any nearby tissues i.e seminal vesicles and some nearby lymph nodes that may contain cancer. It is the surgery of choice in men whose cancer is limited to the prostate. Following are the different approaches of the prostatectomy;

  • Laparoscopic prostatectomy:

    This is a minimally invasive method in which the prostate is removed through small incisions in the abdomen with the help of laparoscope.

  • Robot assisted laparoscopic prostatectomy:

    The surgical instruments are attached to the robot (mechanical device),and the surgeon uses the controls to direct the device to move the instruments. This surgery is gaining immense popularity as it is a more precise, less traumatic and minimally invasive procedure. The most popular robotic prostatectomy includes the da Vinci surgical systems which aids to provide dexterity, precision and advanced visualization compared to open and laparoscopic surgery. Using da vinci robotic prostatectomy the surgery can be done through small incisions of 1-2 cm.

  • Nerve sparing prostatectomy:

    It is performed when the cancer is entwined with the nerves to maintain the normal function and structure of the nerve.

  • Radical prostatectomy with retro pubic approach:

    Traditional open surgery to remove the prostate gland. The prostate is removed through an incision on the lower abdomen.

  • Radical prostatectomy with perineal approach:

    Prostate is reached through an incision between the anus and scrotum.