Cancer is a disease in which abnormal cells divide uncontrollably and destroy body tissues. Cancer in the prostate is the second most common cancer in men and the 5th leading cause of cancer related deaths in men. As per the ICMR data, the incidence of prostate cancer in India is about 10 per 1 lakh population.
Prostate cancer majorly occurs in elderly people, above 60 years of age. However, recently there has been an increase in reports of cancer in younger men above the age of 45 years. As per the review of the Asian Pacific Journal of Cancer Prevention, the cases of prostate cancer would grow to 1.7 million by 2030. The prevalence of the disease in India is lower as compared to western countries, but it is increasing and with our 1.3 billion population it would still translate to a big health issue.
This cancer usually grows slowly, while some variants maybe very aggressive. The disease is confined to the prostate gland in its early stage and that is the time that it maybe curable with treatment. Once the disease spreads beyond the prostate, most commonly to the lymph nodes and bones, it is termed as metastatic disease and therein the the prospect of cure is very meagre. Nevertheless, even with metastatic prostate cancer, with appropriate hormonal and or chemotherapy, the disease can still be kept under somewhat control for a considerable duration of time.
Also read: How to reduce risk of prostate cancer?
Detecting the disease at an early stage is our challenge. This is because there are no symptoms specific to differentiate the malignant form from the benign age related enlargement of the prostate. Gentlemen may experience some urinary symptoms such as increased urinary frequency or having to go many times at night or a sense of urgency to reach the bathroom. Others may have slowing of the stream of his urination or a sense of incomplete emptying of the bladder. Some may have some blood in the urine or blood streaking in the ejaculated semen. None of these symptoms are however specific for prostate cancer but definitely warrant a visit to a urologist so that a detailed evaluation can be suggested.
The normal evaluation of a person presenting with the above mentioned symptoms would include firstly an assessment of the presenting urinary symptoms followed by a clinical examination including a digital rectal examination (DRE) to feel for any suspicious hard areas on the prostate gland, basic urine and blood workup, Serum PSA, an ultrasound scan and a uroflowmetry. From the early detection of cancer point of view, the DRE and blood test called Serum PSA are paramount in importance and any abnormality in these two would necessitate tests to exclude cancer which would be a multiparametric MRI of the prostate and possibly a biopsy of the prostate gland.
If a diagnosis of prostate cancer is confirmed on the prostate biopsy, the next step would be to stage the disease as well as consider various factors such as the age of the gentleman, his other comorbidities if any and an assessment of his overall general health and finally once we have all the information with us it is time to sit down with the patient and his close family members so that a plan for management can be formulated.
The word cancer may be very intimidating to most people. However, in today’s day and age and with the excellent health infrastructure at our disposal a timely detected early prostate cancer can be very well offered curative treatment and even disease beyond the prostate can be kept well under control for significant duration of time.
The precise cause of prostate cancer isn’t known. However, there are a few factors that increase the odds of its event. Any male family member with the illness may put the other gentleman in the family at a higher risk because of genetic predisposition. Hence, such male relatives should initiate screening for prostate cancer after the age of 45years. Obesity is another risk factor so its important to be having a healthy lifestyle with a high fiber low fat diet and regular exercise. Excessive alcohol consumption and smoking are other main considerations that may trigger the development of prostate cancer.
To lower the burden of morbidity and the cost of the disease, it is vital to create mass awareness to bring about early and timely diagnosis of the cancer. It is important to talk about the ailment and encourage people to seek help without much delay.
(Disclaimer: The author is Dr. Vikram Barua Kaushik, Senior Consultant Urology and Renal Transplant, Artemis Hospitals. Views expressed are personal views.)