Prostate cancer is one of the most common types of cancers found in men where abnormal cells grow out of control in the prostate gland. It may be confined within the gland or may be aggressive and spread to other parts of the body and cause serious complications. Therefore, screening for prostate cancer at earlier stages is always beneficial so that effective treatment can be provided. Treatment for prostate cancer mainly depends on the type and stage of cancer and therefore appropriate screening is essential. Screening of prostate cancer can be done by:
Digital rectal exam: In this method, surgeon may inspect your prostate gland for any lumps by inserting the gloved finger through your rectum.
Prostate-specific antigen test: Prostate-specific antigen (PSA) is a protein produced by prostate gland and the blood concentration of this protein is measured in this test. Elevated levels of PSA imply the possibility of prostate cancer. However other tests should also be performed in order to confirm the diagnosis because PSA concentration may be elevated in other conditions too.
Prostate biopsy: Prostate biopsy may be more dependable screening method for prostate cancer. Tissue from prostate is excised and viewed under microscope for any abnormalities. Following the observation, cancer will be graded and higher the grade more severe is the cancer.
Several treatment options are available for treating prostate cancer. The standard approaches include:
Active surveillance, also known as watchful waiting, is a process where a patient is observed over a period of time. Various tests such as blood PSA, digital rectal examinations, imaging studies, and biopsies may be performed at various intervals to document the progress of the disease.
Radiation therapy is a procedure where high-energy rays are used to destroy cancer cells.
External Beam Radiotherapy (EBRT) consists of a beam or multiple beams of radiation that can be used for destroying tumours and surrounding cancer cells. It contains high energy photons that target and destroy the cancer cells. The radiation beams are generated from a machine called a linear accelerator. The linear accelerator generates high-energy X-rays or electrons that destroy the tumour cells without touching the skin of the patient or the tumour tissue. Along with the cancer tissues the beam also destroys the surrounding healthy tissues.
Intensity-modulated radiation therapy (IMRT) is one of the advanced forms of high-precision radiotherapy that radiates high energy photons to destroy the cancer cells. The device uses computer-controlled linear accelerators that deliver radiation doses to a tumour or surrounded tissues of the tumour. It also uses 3D imaging procedure that further helps by providing better three-dimensional image of the tumour during computed tomography (CT) or magnetic resonance images (MRI). The 3D view of the tumour assists the physician to plan for better calculation of the doses and intensity of the radiation therapy.
Three-dimensional Conformal Radiation Therapy (3D-CRT) is a technique where the beams of rays are shaped to match the tumour and are beamed from several directions. Computers are used to locate and treat the tumour more precisely causing minimal damage to the adjacent tissues.
Brachytherapy, also known as internal radiation therapy, is a technique where pellets of radioactive materials are placed directly into the prostate via a special needle. Low dose or high dose radioactive materials may be used depending on the patient’s conditions and the surgeon’s preference. Low dose materials are left in place where as high dose materials are removed after a few minutes of treatment. Brachytherapy is often combined with external beam radiation given at a lower dose. During brachytherapy as most of the radiation is concentrated at the prostate itself, it spares the adjacent tissues from damage.
Androgens are male hormones that stimulate the growth of cancer cells in the prostate. Androgen deprivation therapy, also known as hormone therapy, reduces the levels of androgen and prevents it from getting through to the prostate cancer cells. Some types of hormone therapies lower the androgen levels in the body whereas others block the execution of these hormones.
Chemotherapy involves the use anti-cancer drugs. These drugs are either given intravenously (through the veins) or orally (by mouth). This type of treatment is extremely useful in cases where the cancer has spread to different parts of the body. These drugs work against the cells that divide quickly thereby slowing down the growth of cancer and its associated symptoms. Chemotherapy can affect the cells of other parts of the body such as the bone marrow, hair follicles, mouth, and intestines and can cause side effects. Some of the possible side effects include loss of appetite, nausea, vomiting, diarrhoea, fatigue, mouth sores, and hair loss. Most of the side effects are temporary and disappear along with the discontinuation of chemotherapy. Some chemotherapy drugs can have more severe side effects and your doctor will explain to you the risks and benefits before starting your therapy.
Cancer is not always associated with pain. Some patients may experience pain and there are different types of medicinal and non-medicinal methods to alleviate pain. The type of medicine and the way in which a medicine is administered depends on the type and extent of the pain.
Some of the common types of medicines used to manage pain include non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen; opioids or narcotics such as morphine, fentanyl, and codeine; anti-depressants such as amitriptyline and nortriptyline; anticonvulsants (anti-seizure medicines) such as carbamazepine, gabapentin, and phenytoin; and steroids such as Prednisone and dexamethasone.
Some of the non-medical methods include exercise, relaxation, skin stimulation, biofeedback, imagery, transcutaneous electric nerve stimulation (TENS), acupuncture, physical therapy, and emotional support and counselling.