In India, about 15 lakh patients are diagnosed with prostate cancer every year, out of whom about 85 per cent are diagnosed in stage four. The prostate gland is a small walnut-shaped gland placed just below the urinary bladder in males. It produces and contains a fluid that forms part of the semen, which in turn helps in maintaining sperm health. If prostate cancer is detected in stage one, the recovery rate can be 100 percent. However, if there is a delay in detection and it is diagnosed in stage four, chances of cure come down to 28 percent.
“Prostate cancer must be detected early to ensure full recovery. About one in six men may have prostate cancer in their lifetime. If there’s a family history of prostate cancer — if one’s father, brother, son or even an uncle had the disease — one in five men could develop prostate cancer in their lifetime,” pointed out Dr Indraneel Banerjee, consultant, uro-oncologist, and robotic surgeon at Apollo Gleneagles Hospitals, Kolkata.
One way of early detection of prostate cancer is through prostate cancer screening, which usually involves a blood test and a physical examination. Screening should be done even when there are no symptoms, as it is possible for prostate cancer to develop even without any urinary dysfunction.
“Asymptomatic men in the age group of 55 to 69 years should get themselves screened for prostate cancer. For those between 40 and 54 years, screening is advised only if they have a family history of prostate cancer or have urinary symptoms. For those above 70 years, screening is generally not recommended. But if a man aged over 70 years is in good health and expects to live for another 10 to 15 years, or is on regular medication, screening can be done,” explained Dr Banerjee.
Among the blood tests conducted for prostate cancer detection is the Prostate Specific Antigen (PSA) test. Dr Banerjee warned patients that even though a PSA reading of less than 4 is often assumed to mean there is no chance of prostate cancer, it is advisable to consult a urologist or a uro-oncologist to interpret the test results and receive a confirmation as the test results depend on many factors. In some cases, advanced imaging studies like an MRI scan or a prostate biopsy may be necessary.
Near complete cure (90-100%) is possible only with surgery if the patients are diagnosed with localized low or intermediate risk group prostate cancer. In high risk group patients, as part of the of multi modality treatment the patients may need radiation therapy after surgery. However, as compared to radiation therapy, most of the patients do not need hormonal injection after surgery and with the removal of the prostate gland the urinary symptoms are also relieved. .With the advent of Robotic surgery, the patient will have less pain-less blood loss and shorter hospital stay as compared to open surgery.
In case prostate cancer is detected late, radiation, instead of surgery, is the preferred option. “Radiation has the potential to work at all stages of prostate cancer, including the fourth stage when there is limited metastasis. Studies show that side-effects are far less in case of radiation. As such, radiation is a painless and non-invasive procedure,” said Dr Sayan Paul, senior consultant and radiation oncologist, Apollo Gleneagles Hospitals, Kolkata.
Besides surgery and radiation, a third alternative is the use of medicine for therapy, as summarized by Dr Indranil Ghosh, consultant, and medical oncologist, Apollo Gleneagles Hospitals, Kolkata: “Hormone therapy is generally what is used to control the cancer in most patients; it has very few side-effects. If the cancer has reached the last stage and spread considerably, one can go for chemotherapy. Nowadays we also have targeted therapy that is based on the genetic analysis of the tumour and is designed to achieve absolute precision.”
Notwithstanding the various treatment options, a frequently asked question among patients remains, how to stop prostate cancer in the first place?
“There is nothing specific to recommend. Just lead a healthy life, do your share of exercises and eat a balanced diet,” said Dr Banerjee.