What is prostate cancer?
Prostate cancer is one of the leading causes of cancer death in developed countries.
The prostate cancer does not cause severe and specific symptoms. Usually when patients experience symptoms is in an advanced stage. Men with urinary symptoms, blood in the urine, bone pains should be investigated to exclude prostate cancer.
Nowadays, however, its diagnosis is made early, mainly by the measurement of the special prostatic antigen (PSA) and the digital examination of the prostate.
The specific prostate antigen (PSA), is a blood test that helps the urologist detect suspected prostate cancer. PSA though can be increased by infections and inflammation of the prostate. For this reason, only the Urologist can, in combination with the digital examination of the prostate decide whether the patient should have further investigation.
Additional investigation for suspected prostate cancer include the MRI scan and the Prostate biopsy.
A prostate biopsy is the only test that can document the diagnosis of cancer. It is performed under local anaesthesia and multiple pieces are taken with a special needle and with the guidance of ultrasound. Today it is possible to combine ultrasound with magnetic resonance imaging and do the most modern fusion biopsy. With this method we can more accurately detect suspicious areas in the prostate and receive samples from them.
The specific prostate antigen, or PSA, is a blood test that helps the urologist detect any suspected prostate cancer. Unfortunately, there is no limit, a definite PSA value above which we can safely say that there is a high probability of prostate cancer and proceed with a biopsy. The PSA also can be increased by infections and inflammation of the prostate. For this reason, only the Urologist can, in combination with the digital examination of the prostate and the MRI scan of the prostate decide whether the patient should have further investigation to exclude or confirm the presence of prostate cancer.
There are three options for treating the prostate cancer : surgical removal of the prostate, radiotherapy, and hormone therapy. The choice of treatment is made by the urologist in consultation with the patient and depends on the stage of the disease and the particular characteristics of the patient (age, medical history).
Surgical removal of the prostate is called radical prostatectomy and and is the most radical therapeutic approach. The removal of the whole prostate can be achieved through small incisions using the Da Vinci surgical robot controlled by the surgeon. This method has lowest risk of cancer recurrence vs other options, but potential more side effects including erection problems and urinary leakage.
Radiation therapy is another method of treating prostate cancer. It is done either by external radiation of the prostate or by the so-called method of brachytherapy. Brachytherapy is the transplantation of small radioactive spores into the prostate gland that irradiate the prostate internally. Of course, both methods are not without complications, such as radial cystitis and enteritis, urinary incontinence, erectile dysfunction, etc.
Hormonal therapy is called androgenic blockade and is achieved with drugs given either in the form of injections or in the form of pills. These drugs are designed to lower blood testosterone levels, a male hormone that is the "food" of prostate cancer. The progression of the disease is stopped, and even metastases subside as long as the disease responds to treatment. Loss of erection ability and hot flashes are common side effects.
When all other methods have failed, there is chemotherapy, which can relieve pain and improve patients' quality of life.
As one can easily understand, the weapons that the Urologist has at his disposal against prostate cancer are many. This is why it is considered a treatable condition. However, a basic condition for its effective treatment is its early diagnosis.