Prostate is the gland in the male reproductive system. It plays an important role in the production of semen and provides important nutrients to the sperms so that they remain viable and motile. Sometimes the division of cells constituting the prostate gets out of control i.e. they continue to divide abnormally. Initially, these rapidly dividing cells remain confined to the prostate only so there are no major symptoms at this stage; but at the later stages, they may invade other surrounding structures (called local spread) or can get transported to other distant sites of the body (called as metastasis). The spread and severity of cancer vary from patient to patient. Some may spread very slowly and need minimal or no treatment at all while others may be very aggressive and can spread widely.

Incidence of prostate cancer

Prostate cancer is one of the most common cancers among men. One in six men will be diagnosed with prostate cancer in his lifetime. However, only 1 in 36 men will die from the disease. Although the rates vary widely between countries, it is least common in South and East Asia, and more common in Europe, North America, Australia and New Zealand. Prostate cancer is least common among Asian men and most common among black men, with figures for white men in between.

More than 80% of men will develop prostate cancer by the age of 80. However, in the majority of cases, it will be slow-growing and harmless. It often ends up getting over-diagnosed and could in fact harm the patient and treatment in such men exposes them to all of the adverse effects, with no bleak possibility of extending their lives

Challenges in Diagnosis and treatment

Prostate cancer does not play by any rules and its detection and treatment are always subjected to debate among medical professionals. Sometimes no symptoms arise until the disease is well-established. In men over 50 years of age, or with a family history of prostate disease, PSA (prostate specific antigen) blood test and digital rectum examination should be done annually to rule out any signs of prostate carcinoma.

If PSA rises at a rate more than normal for your age or digital rectum examination is showing some findings suggestive of prostate cancer, further investigation should be done. This includes Transrectal Ultrasonography of prostate and Biopsy of the prostate tissue (confirmatory test).

The wide array of available treatment choices sometimes add to the confusion. This state of confusion should be avoided and comprehensive evaluation of the case should be done by experts. Notwithstanding the form of treatment, full and frank discussion should be made with each specialist concerning possible effects of treatment, especially incontinence and impotence; and as a patient, one should be armed with all the questions in order to be given definitive answers.

This becomes all the more imperative with the wide array of available treatment choices. Remember the final decision must be an informed one made by you after thoroughly discussing and understanding the pros and cons of each treatment choice.

Although no treatment (including surgery) guarantees freedom from recurrence, one can greatly improve the quality of life by adopting an absolutely positive outlook, a healthy lifestyle and diet, and by not fearing to share your experience with others, especially in a support group

 How to cope with Prostate Cancer?

As mentioned above, prostate cancer can be extremely slow growing and of such a low grade that no treatment may be required at times.  Treatment may also be inappropriate in some cases if a person has other serious health problems or is not expected to live long enough for symptoms to appear.

Men diagnosed with such low-risk prostate cancer are eligible for active surveillance. Active surveillance involves monitoring the tumour for signs of growth or the appearance of symptoms. The monitoring process may involve serial PSA, physical examination of the prostate, and / or repeated biopsies. The goal of surveillance is to avoid over-treatment and serious, permanent side effects of the treatment that outweighs the symptoms of prostate cancer itself. This approach is not used for aggressive cancers, but it may cause anxiety for people who wrongly believe that all cancers are terminal. For 50% to 75% of people with prostate cancer, it may cause no harm and the patient dies with the cancer rather than from the cancer.

Even if the treatment is required, several factors (like stage of the disease, the Gleason score, and the PSA level,  age, long term life expectancy, general health, and potential side effects of the treatment considered) should be considered in conjugation with each other to decide the best possible treatment options.

There are a lot of existing and emerging treatment options that provide a new hope to prostate cancer patients, especially to those in advanced stages of disease. MediCounsel team keeps track of the latest advances and research so as to help our patients take an informed decision regarding their treatment choices. Our research team also does the patient-centric research in view of these medical literatures to prepare a comprehensive recommendation report and provide maximum possible benefit for the patient.

We have recommended on several cancer and prostate-related cases. To know more visitwww.medicounsel.com or write to us on info@medicounsel.com

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