What is Prostate Cancer?

Prostate Cancer is a type of cancer that develops in the prostate gland, a small walnut-shaped gland in men that produces seminal fluid (which nourishes and transports sperm).

What are the symptoms of Prostate Cancer?

Early Symptoms

• Frequent urination (especially at night)
• Difficulty starting or stopping urination
• Weak or interrupted urine flow
• Feeling of incomplete bladder emptying
• Pain or burning during urination (less common)

Symptoms of Advanced Prostate Cancer

• Blood in urine (Haematuria) or semen
• Painful ejaculation
• Erectile dysfunction
• Pain in the hips, back, ribs, or thighs (if cancer has spread to bones)
• Unexplained weight loss and fatigue

How to detect Prostate Cancer?

1. Digital Rectal Exam (DRE)

• What it is: A doctor inserts a gloved finger into the rectum to feel the prostate for lumps or abnormalities.
• Purpose: Quick, simple check for irregularities.
• Limitation: Can miss small or hard-to-reach tumours.

2. Prostate-Specific Antigen (PSA) Blood Test

• What it is: Measures PSA level in the blood (a protein made by the prostate).
• High PSA can indicate:

• Prostate cancer
• Benign Prostatic Hyperplasia (BPH)
• Prostate infection (prostatitis)
  • Normal range: Usually below 4 ng/mL, but varies by age.

3. Imaging Tests

• Transrectal Ultrasound (TRUS): Uses sound waves to create images of the prostate.
• MRI Scan: Detailed imaging to detect suspicious areas, especially before biopsy.

4. Biopsy (Confirmation Test)

• What it is: Removal of small tissue samples from the prostate to check for cancer cells.
• When done: If PSA or DRE results are abnormal

5. Advanced Tests (For High-Risk or Unclear Cases)

• MRI-Targeted Biopsy: Combines MRI imaging with biopsy for better accuracy.
• Genomic Testing: To assess aggressiveness of cancer.

What are the available treatments for Prostate Cancer?

1. Active Surveillance (Watchful Waiting)

• When used:
• For slow-growing cancers that are not causing symptoms.
  • How:
• Regular PSA tests, DRE, and sometimes biopsies.
  • Goal:
• Avoid unnecessary treatment and side effects until cancer shows signs of progression.

2. Surgery (Prostatectomy)

• Radical Prostatectomy:
• Removes the entire prostate gland and some of the surrounding tissue.
  • Approaches:
• Open surgery
• Laparoscopic (keyhole)
• Robotic-assisted surgery
  • Used for:
• Localized cancer in healthy patients.

3. Radiation Therapy

• External Beam Radiation Therapy (EBRT): Directs radiation at prostate from outside the body.
• Brachytherapy: Radioactive seeds implanted inside the prostate.
• Purpose: Kill cancer cells, often for localized or locally advanced cancer.

4. Hormone Therapy (Androgen Deprivation Therapy, ADT)

• Why: Prostate cancer cells need testosterone to grow.
• Methods:

• LHRH agonists/antagonists (reduce testosterone)
• Orchiectomy (surgical removal of testicles)
• Anti-androgens
  • Often combined with radiation for advanced cases.

5. Chemotherapy

• Used for advanced or hormone-resistant prostate cancer.
• Common drugs: Docetaxel, Cabazitaxel.

6. Targeted Therapy

• PARP inhibitors (for patients with BRCA mutations).
• Targets genetic changes in cancer cells.

7. Immunotherapy

• Sipuleucel-T: Personalized cancer vaccine for advanced cases.

8. Palliative Therapy

• For advanced/metastatic cancer to relieve symptoms and improve quality of life.