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Ca Prostate
Prostate Cancer means cancerous changes involving the Prostate Gland in a male. It is a Malignant Tumor.

Any male above the age 60 & sometimes even younger males can develop this Cancer. Roughly speaking, longer you live, higher is your chance of developing this Disease.

Causes of Prostate Cancer
Unfortunately, no one knows exactly what causes this cancer. There is some evidence suggesting genetic linkage & association with a high fat diet. However, the most unanimously accepted risk factor is age. A man at the age of 70, has roughly a 60% chance of developing prostate cancer.

Symptoms of Prostate Cancer
The disease commonly produces either irritative (frequency & urgency of urination) or obstructive (slow urinary flow, interrupted flow, delay in starting urination) urinary symptoms. Sometimes patients can develop urinary infection or blood in the urine (hematuria). Rarely the disease may not produce any symptoms or might produce non-urinary symptoms such as pain in the bones, suggesting spread of the disease in the bones.

Diagnosis of Prostate Cancer
If you have any of the above symptoms or if there is a very strong family history, it is best to get yourself shown to a urologist. He will examine the prostate by inserting a finger in the rectum (Rectal Examination).

Investigations (tests) necessary to confirm the Diagnosis
Once the disease is suspected, the blood is checked for PSA levels (Prostate Specific Antigen). A high PSA level can be either due to prostate cancer or sometimes due to benign prostatic enlargement or prostate infection. PSA is also very useful in following up the disease course after the treatment has been started. As in any other cancer, it is essential to prove the diagnosis with the help of a biopsy [prostate biopsy], which will be scanned by a pathologist. This is the only confirmatory test for this disease. Prior to the biopsy, a trans rectal ultrasound (TRUS) is carried out & a biopsy of any abnormal appearing area is taken; using a special needle. Sometimes the biopsy is done; by guiding the biopsy needle using a finger as a guide. Such a biopsy is often combined with a telescopic examination of the urinary passage called cystoscopy.

Other Investigations
All patients need to have a bone scan at some stage, to check if the disease has spread to be the bones. Some patients need further X-rays such as C.T.Scan etc. & your doctor will decide about the need for the same.

Treatment of Prostate Cancer

Fortunately, today there are many treatment options available for prostate cancer, depending on the stage of the disease (early or late).

Watchful Waiting - This disease can be very slow growing, and in some patients this option may be appropriate, especially if the patient is above the age of 80 years. This simply means no active treatment is offered. However, the patient is seen at periodic intervals by his urologist along with some blood tests & scans when necessary.

Radical Prostatectomy - This means surgical removal of the entire prostate gland. Patients with (very) early disease & who are otherwise fit, for a (very) major surgery are suitable candidates for this option. The long-term results of this are still equivocal. Besides being a major operation, it may have certain side effects such as impotence & urinary incontinence (involuntary urinary leakage).

Radiation Treatment - This can be radical or palliative.

Radical treatment is given with a view to cure, in very early disease. This treatment produces tumor shrinkage with the help of special X-rays. The radiation can be delivered externally or by implanting radioactive seeds inside the body. This modality also has certain complications, which will be discussed in detail with the patient before making any decision. In early disease, this treatment has given encouraging results, similar to radical surgery.

Palliative treatment is reserved for palliation of symptoms such as repeated episodes of blood in the urine or painful bones due to bony metastasis only in very advanced case of prostate cancer.

Hormone Therapy - This is essentially reserved for those whose cancer has grown beyond the prostate gland. Normal as well as cancerous prostate depends on steady supply of male hormones (testosterone) for its growth. All hormone manipulations are aimed at cutting down this testosterone supply, either surgically or by medication. The aim is to create a "male menopause". Various ways of giving hormone treatment involves

Bilateral Orchiectomy - This involves removal of that part of the testis, which produces testosterone. It is a minor procedure, usually requiring only overnight hospital stay. Orchiectomy will inevitably lead to loss of sexual desire & impotence. As this will be irreversible, it must be understood very clearly by the patient prior to the surgery.

Medication - this involves usage of various tablets with or without injections. Each has certain advantages & disadvantages & your doctor will discuss that in detail with you. Needless to say, drugs will act as long as they are being taken. Some of these drugs, especially injections are not yet freely available in India & are indeed very expensive. As regards their efficacy, both surgical & medical hormone treatments are comparable in their efficacy. Some drugs can preserve potency & your urologist will counsel you about the same.

Laser or TUNA are not yet considered suitable for prostate cancer. However, TUR prostate, which is removal of obstructing prostatic tissue transurethrally using electric current, is certainly performed in selected cases of prostate cancer. Your urologist will advice you about the need for such surgery or otherwise in your case.

Alternative Therapies for Prostate Cancer
The answer to this is not very clear, as not many scientific reports are available on research carried out using alternative treatment such as Ayurved or Homeopathy. You can certainly discuss this with your doctor & in some selected cases, your doctor might suggest alternative treatment.

The knowledge about having prostate cancer certainly comes as a major blow to the patient & his family. It is helpful to involve your close family members in the decision-making. In addition to the medical help, love & help from the family members go a long way in creating a positive attitude in the patient’s mind. There is enough scientific proof to suggest that positive attitude enhances the efficacy of any medical treatment. Besides, this cancer is often slow growing & can thus be kept under control for years.