Prostate Cancer & Its Treatment
Prostate cancer is one of the common cancers afflicting men. Prostate cancer is usually detected late in life and progresses very slowly. Sometimes it is said that before prostate cancer can endanger the life, something else would kill the patient.
What is prostate cancer?
It is a cancerous growth of the prostate gland. This disease usually strikes men in their 60s and 70s.
Prostate cancer appears more common in certain races as compared to others. It is noted that American blacks have a much higher incidence and men from Japan have a low incidence of prostate cancer.
The present study shows that there is no significant correlation between prostate cancer and marital status or fertility of an individual. No differences were found between cancer and control groups with respect to circumcision, weight, height, blood group, consumption of tobacco or alcohol, or specific medical or surgical history.
Pathology:
The human body is made up of billions of cells. These cells multiply and ensure growth, tissue renewal and wound healing. Cancer is an illness characterized by the significant growth and proliferation of abnormal cells. These cells form tumors, which are called cancerous or malignant growths. In man, the prostate is one of the parts of the body most frequently affected by cancer.
These cancerous or malignant tumors hinder the function of the organ in which they develop, as well as crush and destroy other normal organs. A certain type of process (metastasis) can occur in which some of the cancer cells become detached from a malignant tumor and are disseminated, for example in the blood flow. They colonize in other parts of the body, where they cause the development of new tumors.
Cancer arising from the glands located in the prostate is called adenocarcinoma of the prostate or prostatic cancer. It is slow-growing and may take 10 to 15 years before it is large enough. If cancer penetrates the capsule of the prostate and spreads to adjacent organs such as the bladder or the rectum, then it is called locally advanced prostatic cancer. If prostatic cancer spreads to distant organs, such as bones, then it is known as metastatic prostate cancer. However, the cancer cells lodged in the bones are still prostatic in origin and it is not bone cancer per se.
Symptoms of Prostate Cancer:
Cancer of the prostate usually progresses very slowly. Early prostate cancer causes no pain. It is only when it invades other tissues or nerves in the neighboring areas or it goes to the bones that it starts causing pain. Symptoms of prostate cancer may vary from person to person; however, the more common one is as follows:
- With cancer of the prostate, the gland expands in size and presses on the urethra. This poses a problem with the flow of urine and the patient may have difficulty starting the process of urination.
- Difficulty in maintaining a steady, good stream of urine.
- Urination once began stops in between and then again urine flow starts.
- Difficulty in holding back urine called as incontinence
- Painful or burning urination, which is called dysuria.
- Painful ejaculation.
- Blood or pus in urine or semen.
- An extreme urgency or frequent need to pass urine, especially at night (
- Complete inability to urinate.
Symptoms associated with metastatic prostatic cancer include:
- Frequent pain or stiffness in the lower back, hips, and upper thighs.
- There could also be fractures, especially in the bones of the spine, without any serious fall or injury.
- Such patients could also present primarily with paralysis of the lower limbs, which is called paraplegia.
It can be clearly seen that the most frequent symptoms of prostate cancer are identical to those of BPH. It is for this reason that, if you have these symptoms, you should consult your family doctor. In most cases, the cause will be a benign tumor (BPH). Regular check-ups can detect prostatic cancer in its early stages, which increases the likelihood of a cure. To ensure early detection, annual checkups, including a digital rectal exam (DRE) and a prostate-specific antigen (PSA) test, are recommended after age 45.
Causes of Prostate Cancer:
The precise cause of prostate cancer is unknown, although hormonal, environmental and genetic factors can play a role. The following factors have strong links with prostate cancer:
01 People above the age of 55 have a greater chance of developing prostate cancer. So it is important that one becomes more vigilant after this period.
02 The following occupations (due to exposure to cancer-causing agents at the workplace) have a higher risk for prostate cancer:
Workers who are exposed to the metal cadmium, especially electroplaters who make batteries, welders, and also workers in the rubber industry, appear to have a greater affinity for prostate cancer. It must be emphasized here that research is still going on in these risk-related occupations and clear-cut proof for their cause-and-effect relationship with prostate cancer is still to come forth.
03 There may be a genetic component to prostate cancer, which is certainly more common in the relatives of people who have prostate cancer than in the general population.
04 Various other etiological or causative factors have been put forth for prostate cancer, including a diet rich in fat and viral sexually transmitted diseases, but all these are largely unproven.
Diagnosis of Prostate Cancer:
There are several steps to establishing the presence of prostate cancer. The important ones are as follows:
01 History:
A thorough medical history including various symptoms, age at which problem started, family history of prostate cancer, etc.
02 Digital rectal examination (DRE):
It is a test in which the doctor inserts a gloved finger into the rectum and feels the prostate, its contours, whether there are any hard or lumpy areas, etc.
03 Blood tests:
Blood tests specifically include levels of prostate-specific antigen (PSA) and its various components or/and prostatic acid phosphatase (PAP) in the blood. PSA is a proteinaceous substance produced exclusively by prostate gland cells and released into the bloodstream. The level of this substance in the blood is usually low; however, with prostate cancer, the level rises sharply and over a short period of time. It is important for the patient to realize that just a rise in PSA is not an indicator of prostate cancer; it is a degree of rising in PSA, which is important.
04 Urinalysis:
In urinalysis, the urine is checked after a prostatic massage for cytology (the study of cells) or presence of blood in the urine.
05 Transrectal ultrasonography (TRUS):
There may be other special tests ordered by the doctor, including TRUS, which stands for transrectal ultrasonography. During this examination, the doctor inserts a small instrument into the rectum. This instrument emits painless sound waves, which reflect off prostatic tissue. These waves are then translated into an image on a screen. This is used to map out the contours of the prostate and to look for any abnormal pictures. The doctor can remove a small part of the prostate for microscopic examination. This enables the presence or absence of cancerous cells to be determined.
06 Intravenous urogram (IVU):
The other investigation, which could be ordered by the doctor, is an IVU, which consists of a series of contrast-enhanced x-rays of urinary tract organs.
07 Cystoscopy:
Cystoscopy is another procedure in which the doctor uses a thin, self-illuminating metallic or fiber optic tube (cystoscope) to look into the patient's bladder and urethra and to visualize the prostate at the base of the bladder.
08 Biopsy:
The doctor may perform a biopsy to confirm the diagnosis of prostate cancer. In a biopsy, a tiny portion of the organ is removed and examined under a microscope.
Staging and Grading of Prostate Cancer
To indicate the gravity of the situation, doctors use two terms: stage and grade of the tumor. When we talk about stage of cancer, it refers to the degree of spread of cancer and, if indeed there is spread, to what extent and involving which organs.
Stages of Prostate Cancer
Following are the stages of Prostate Cancer:
Stage I: The cancer is not detectable by a digital rectal examination and does not pose any problem to the patient. The cancer is usually incidentally found during some other surgical procedure to relieve urinary problems.
Stage II: The prostate tumor that can be felt during DRE but there is no evidence of cancer spreading outside the prostate.
Stage III: There is spread outside the prostate to nearby tissues.
Stage IV: Cancer cells are detectable in other distant parts of the body.
The grading of a cancer is a microscopic issue in which the pathologist tells you how aggressive this particular type of cancer is, in which well-differentiated means less aggressive, moderately differentiated is intermediately aggressive, and poorly differentiated is more aggressive.
Homeopathy can be the best palliative treatment for prostate cancer.
There is an important consideration while starting treatment for prostate cancer in early lesions, which are entirely asymptomatic and discovered incidentally. Many of these patients may be very old and the treatment, if too radical, could have possibly more side effects and risks, which could outweigh the possible benefits the patient would derive from it. At this stage, medical care, which aims to reduce the symptoms without curing the patient, is warranted. This treatment is called palliative treatment. Homeopathy, which is gentle, effective, and devoid of side effects, can be the best palliative treatment option. Click here for more details
Written & Approved by-
Dr. Rajesh Shah
M.D. (Hom.)