Prostate Cancer - Causes, Stages, Diagnosis and Treatment

Prostate cancer is one of the most common cancers affecting men, beginning in the prostate gland, which is situated between the urethra and bladder. Prostate cancer develops when abnormal cells start growing in the prostate gland. The actual cause of prostate cancer is not known, but the risk of prostate cancer increases with age and in those with first degree relatives having prostate cancer.

Prostate cancer is usually a slow growing cancer and has treatment in all stages; early stages being curable. At Hinduja Hospital, we provide comprehensive cancer care services for the diagnosis, treatment, and management of Prostate cancer in patients of all ages. We offer a patient-centric cancer treatment plan that caters to the individual needs of the patients, using the latest technical equipment for providing accurate diagnosis and treatment.

Causes of Prostate Cancer

The exact cause of prostate cancer is unknown, but certain risk factors can increase the likelihood of a man developing prostate cancer.

• Age: Older men are more vulnerable to prostate cancer, with men over the age of 55 being more likely to develop it.
• Family history: A family history of prostate cancer, especially with closely related relatives having prostate cancer, may increase a patient's risk of getting the disease. Additionally, relatives with breast cancer or ovarian cancer may also increase the likelihood of males related to them in the family developing prostate cancer.
• Race: Certain racial backgrounds may make people more prone to prostate cancer.
• Weight: Being overweight after the age of 50 may increase the risk of developing prostate cancer.

Other possible factors that may increase the likelihood of developing prostate cancer but not always include:

• Alcohol consumption
• Smoking
• Inflammation or infection in the prostate gland
• Sexually transmitted infections
• High-fat diets

Prostate Cancer Symptoms

Prostate cancer may not show any signs in the early stages. However, as the cancer progresses, Prostate Cancer signs may become more prominent, including the following:

• Decreased stream of urine
• Pain or burning during urination
• Passing blood with urine
• Full pain in the lower pelvic zone
• Weight loss
• Loss of appetite
• Pain in the bones, hips, thighs, or lower back

Stages of Prostate Cancer

Staging of cancer may depend upon the extent and severity of the cancer. Knowing the stage of cancer can help determine the course of treatment and what to expect in the future. Cancer can be classified as either localised, locally advanced or metastatic. Localised is limited to prostate and locally advanced is spread beyond prostate or to pelvic lymph nodes. Non-metastatic cancer remains localised in the area of origin and does not spread to other parts of the body. On the other hand, metastatic cancer is cancer spread to other parts of the body.

The staging of prostate gland cancer is typically performed during diagnosis using various techniques. The stages of prostate cancer are as follows:

• Stage 1: Limited to the prostate, one lobe, smaller lesion.
• Stage 2: Limited to prostate but in both lobes.
• Stage 3: Cancer is periprostatic and may involve the seminal vesicles or pelvic lymph nodes.
• Stage 4: Cancer may have spread to different parts of the body, such as the bones, lymph nodes, lungs, liver and non-regional lymph nodes.

Stages 1 and 2 are considered early-stage cancer since the cancer has not yet started to spread.

Diagnosis of Prostate Cancer

When the symptoms start appearing, visiting a specialist may be the best way to get a Prostate Cancer diagnosis. The doctor may ask about the symptoms, medical history, and family history. They may also perform some tests to confirm the occurrence of prostate cancer, which may include:

• Blood tests: A special blood test may be helpful to measure certain proteins in the body known as "Prostate-specific antigen" (PSA). Higher PSA levels suggest presenceof cancer. Sometimes, PSA also rises in infection like UTI or post procedures. PSA levels may also help in cancer staging as well as in tracking how well the patient responds to any cancer treatment.
• Digital rectal exam: A digital rectal exam may be performed to look for abnormalities and inconsistencies in the shape of the prostate gland, which may help in detecting the presence of a tumor in the prostate as well as in staging prostate cancer.
• MRI – Multiparametric MRI (mpMRI) is the diagnostic imaging in patients suspected of prostate cancer. MRI gives us a PIRADS score which can help us to identify patients likely to have cancer in prostate.
• Biopsy: A biopsy may be performed by taking a sample tissue from the prostate gland. The biopsy tissue is evaluated by pathologist. Prostate biopsy is done with ultrasound guidance with either transrectal or transperineal route.
• Other tests like PSMA PET CT Scan are done to stage the disease (it shares presence of any disease spread to other parts of the body).

Treatment of Prostate Cancer

Best Treatment for prostate cancer in Mumbai at Hinduja Hospital may depend upon the stage and severity of cancer. Sometimes, before treatment, patients may be kept under observation and monitoring, especially in the case of early-stage prostate cancer. We ensure the all-round safety and comfort of our patients. The treatment options available for different stages of cancer are discussed below.

Early Stage Prostate Cancer

If prostate cancer has been detected early, the oncologists may not take any immediate action but instead monitor the progress carefully before deciding upon a treatment plan. This approach is taken as a precaution because the side effects of treatment may outweigh the need for immediate intervention. The treatment plans during the early stages of prostate cancer may include:

• Surgery: Uro oncosurgeon would perform radical prostatectomy for removing tumors, as well as surrounding tissues, seminal vesicles, and lymph nodes. This surgery is more commonly with robotic approach rather than open or laproscopy.
• Radiation therapy: Radiation may be used to kill cancer cells in the prostate gland or prevent them from growing back. The radiation therapy performed may be external radiation therapy or internal radiation therapy, depending upon various factors that the doctors may deem fit for the individual patient. Small duration of hormone therapy is used alongside.
• Hormonal therapy: Hormonal therapy may be recommended along with another form of treatment, which may help in restricting the growth of cancerous cells in the prostate gland. Usually, this is applicable in advanced disease. In hormonal therapy, testosterone levels in body are lowered by either removal of both testes or with injections given monthly or quarterly.

Advanced Prostate Cancer

In the case of advanced prostate cancer, it may start spreading to other parts of the body. Treatment options for advanced prostate cancer may include:

• Hormonal therapy: Hormonal therapy helps by stopping or delaying the growth and spread of cancer.
• Chemotherapy: Chemotherapy uses drugs to help stop the growth of cancer cells throughout the body.
• Targeted therapy: Targeted therapy uses drugs or other substances that target and attack specific cancer cells.
• Immunotherapy: Immunotherapy includes using substances to boost the patient's natural immune system to help fight cancer.

Prostate cancer is now relatively common and males with a family history of prostate or other related cancers in females are more vulnerable than others. Screening to detect prostate cancer in the early stages may help achieve cure. Hence, those associated with greater risk factors for prostate cancer may benefit from regular screening of the prostate gland.

At Hinduja Hospital, we are committed to providing the highest quality of prostate cancer treatment in Mumbai to our patients. We offer comprehensive diagnostic, treatment, and management plans for prostate cancer to ensure the overall well-being of our patients. Our team of highly experienced interdisciplinary oncologists and other specialists delivers patient-centric treatment with utmost compassion. We have state of art 3T MRI, Da Vinci Xi robot, Image guided RT given by latest linear accelerators and brachytherapy facilities at our center of excellence. Our rehabilitation specialists ensure all-round comfort for our patients during remission after cancer.

FAQs

Q1. Is prostate cancer curable?

Ans. Prostate cancer may be managed and cured if detected early.

Q2. Is prostate cancer very serious?

Ans. Prostate cancer may become fatal if left untreated. However, with proper treatment, it can be well managed. High risk, high stage and high grade cancer patients can be serious, potentially fatal and need aggressive treatment.