Prostate Cancer Treatment

Robotic Surgery for Prostate Cancer: A newer approach is to do the laparoscopic surgery using a robotic interface (called the da Vinci system), which is known as robotic-assisted laparoscopic radical prostatectomy (RALRP). The surgeon sits at a panel near the operating table and controls robotic arms to do the operation through several small incisions in the patient’s abdomen. Like direct LRP, RALRP has advantages over the open approach in terms of pain, blood loss, and recovery time. So far though, there seems to be little difference between robotic and direct LRP for the patient. Read More...

HIFU Treatment for Prostate Cancer: HIFU is a treatment designed to treat localized prostate cancer using high intensity focused ultrasound (HIFU). A rectal probe generates high intensity ultrasound waves which travel through the rectal wall and are focused in the prostate. This focusing produces intense heat and provokes the destruction of the tissue inside the targeted zone with minimal effect to surrounding tissues. The treatment typically takes 3 hours to perform, usually under a under general aesthetic. The technique is very new in the field of prostate cancer treatments and is still under research with little long term data to verify its effectiveness, However, for some patients especially with recurrent localised prostate cancer following radiotherapy it may offer use second line option.. Read More...

Transurethral Resection of the Prostate (TURP): A surgical procedure to remove tissue from the prostate using a resectoscope (a thin, lighted tube with a cutting tool) inserted through the urethra. This procedure is sometimes done to relieve symptoms caused by a tumor before other cancer treatment is given. Transurethral resection of the prostate may also be done in men who cannot have a radical prostatectomy because of age or illness. TURP is a type of transurethral surgery that does not involve an external incision. The surgeon reaches the prostate by inserting an instrument through the urethra. In addition to TURP, two other types of transurethral surgery are commonly performed, transurethral incision of the prostate (TUIP) Read More...

Prostate Cancer Treatment in India

Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize (spread) from the prostate to other parts of the body, particularly the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, problems during sexual intercourse, or erectile dysfunction. Other symptoms can potentially develop during later stages of the disease.

Early prostate cancer is usually discovered during a routine digital rectal examination (DRE).

Symptoms are often similar to those of benign prostatic hyperplasia (BPH). Men observing the following signs and/or symptoms should see their physician for a thorough examination:

• Blood in urine or semen

• Frequent urination, especially at night

• Inability to urinate

• Nagging pain or stiffness in the back, hips, upper thighs, or pelvis

• Painful ejaculation

• Pain or burning during urination (dysuria)

Cancer occurs when normal cells undergo a transformation in which they grow and multiply without any control. There are four stages of prostate cancer:

•Stage I - In stage I, cancer is found in the prostate only. It is usually found accidentally during surgery for other reasons, such as benign prostatic hyperplasia.

•Stage II- In stage II, cancer is more advanced than in stage I, but has not spread outside the prostate.

•Stage III- In stage III, cancer has spread beyond the outer layer of the prostate to nearby tissues. Cancer may be found in the seminal vesicles.

•Stage IV- In stage IV, cancer has metastasized (spread) to lymph nodes near or far from the prostate or to other parts of the body, such as the bladder, rectum, bones, liver, or lungs. Metastatic prostate cancer often spreads to the bones.

Digital rectal exam (DRE) : The doctor inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps or abnormal areas.

Prostate-specific antigen (PSA) test:A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. PSA levels may also be high in men who have an infection or inflammation of the prostate or BPH (an enlarged, but noncancerous, prostate).

Transrectal ultrasound : A procedure in which a probe that is about the size of a finger is inserted into the rectum to check the prostate. The probe is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. Transrectal ultrasound may be used during a biopsy procedure.

Biopsy :The removal of cells or tissues so they can be viewed under a microscope by a pathologist. The pathologist will examine the biopsy sample to check for cancer cells and determine the Gleason score. The Gleason score ranges from 2-10 and describes how likely it is that a tumor will spread. The lower the number, the less likely the tumor is to spread.

There are 2 types of biopsy procedures used to diagnose prostate cancer:

Transrectal biopsy: The removal of tissue from the prostate by inserting a thin needle through the rectum and into the prostate. This procedure is usually done using transrectal ultrasound to help guide the needle.

Transperineal biopsy: The removal of tissue from the prostate by inserting a thin needle through the skin between the scrotum and rectum and into the prostate.

If prostate cancer is diagnosed, the other tests( e.g Radionuclide bone scan, MRI. Pelvic lymphadenectomy, Seminal vesicle biopsy) are done to find out if cancer cells have spread within the prostate or to other parts of the body.

Surgery

Surgery is a common treatment for early stage prostate cancer. doctor may remove the whole prostate or only part of it. In some cases, doctor can use a method known as nerve-sparing surgery. This type of surgery may save the nerves that control erection. But if you have a large tumor or a tumor that is very close to the nerves, you may not be able to have this surgery.

Type of Prostate cancer surgery

Radical retropubic prostatectomy: The doctor removes the entire prostate and nearby lymph nodes through an incision (cut) in the abdomen.

Radical perineal prostatectomy: The doctor removes the entire prostate through a cut between the scrotum and the anus. Nearby lymph nodes may be removed through a separate cut in the abdomen.

Radical perineal prostatectomy: The doctor removes the entire prostate through a cut between the scrotum and the anus. Nearby lymph nodes may be removed through a separate cut in the abdomen.

Laparoscopic prostatectomy: The doctor removes the entire prostate and nearby lymph nodes through small incisions, rather than a single long cut in the abdomen. A thin, lighted tube (a laparoscope) is used to help remove the prostate.

Cryosurgery: This type of surgery for prostate cancer is under study at some medical centers.

Pelvic lymphadenectomy: This is routinely done during prostatectomy. The doctor removes lymph nodes in the pelvis to see if cancer has spread to them. If there are cancer cells in the lymph nodes, the disease may have spread to other parts of the body. In this case, the doctor may suggest other types of treatment.

• External Beam Radiotherapy : This is a treatment where high-energy X-rays are aimed at a cancer to cure or control it. The X-rays come from a machine called a linear accelerator. This is known as external beam radiotherapy.

• Radiotherapy : Radiotherapy uses high energy waves to treat cancer. If your cancer has not spread beyond the prostate gland you can have radiotherapy to try to cure it. This is called radical radiotherapy. This type of treatment involves giving a high dose of radiation to the prostate gland.

• Hormone therapy : Cancer of the prostate depends on the male hormone testosterone for its growth. By reducing the amount of testosterone in your body, the growth of cancer cells can be slowed down or stopped. It can shrink the tumour and urinary symptoms can often disappear fully.

• Chemotherapy : Chemotherapy is the use of drugs to cure or control cancer. Chemotherapy may be used if your cancer has spread beyond the prostate and is no longer controlled by hormone therapy. In some cases, chemotherapy will improve your quality of life with better control of your symptoms.

You may want to ask some questions before your treatment begins: