Prostate cancer

Prostate cancer is a walnut-shaped gland where abnormal cells grow and become cancerous. Only male become victims of prostate cancer. The initial stage of prostate cancer is confined to the gland that can be treated successfully, but aggressive cancers have the chance to spread rapidly outside the gland to other parts of the body.

The actual cause of prostate cancer is still not known, but doctors refer to reasons like old age, obesity, family history of prostate cancer, ethnic groups (African descent and African-Carribean descent), diet (calcium rich diet) and exercises (men who regularly exercises) for the cancer.

If you notice these symptoms of prostate cancer, you should refer to the doctor:

• blood in semen,
• trouble urinating,
• decreased force in urine,
• erectile dysfunction,
• bone pain and
• discomfort in your pelvic area.

Certain tests and screening procedures help to diagnose prostate cancer. Some of these tests include digital rectal exam, prostate specific antigen test (PSA), ultrasound, biopsy of sample tissues, bone scan, computerized tomography, positron emission tomography and magnetic resonance imaging.

Digital rectal exam uses a lubricated, gloved finger to examine the prostate attached to the rectum to check for any abnormalities in size, shape, texture of the gland. For a PSA test, the doctor examines your blood for higher level of PSA. To ensure further examination, doctors may use ultrasound technique that uses a probe, the size and shape of a cigar inserted into the rectum for producing sound waves to help create a clearer picture of your prostate gland.

If initial results show signs of prostate cancer, doctors collect samples of tissues from the prostate gland that is sent to the laboratory for examination. The type of treatments is evaluated by the stage of the disease.

In stage I, the cancer is confined to the prostate gland, while in the advanced stages like stage III and IV, the cancer has spread into other organs, like the lymph nodes, bladder, lungs, bones, and other organs. The treatment options for prostate cancer include surgery, radiation therapy, cryotherapy, hormone therapy, chemotherapy, vaccine treatment, etc. Before prostate cancer treatment, your doctor may want to conduct certain tests and give you some time to prepare.

• Before surgery of prostate cancer treatment, you doctor may want to do some tests, including cytoscopy that uses a visual scope inserted into the body to examine the bladder and urethra. This helps the doctor check your prostate and also your urinary system. Some blood tests may also be done if required.
• Tell your doctor about the medications you are on and whether you have any specific health condition. Doctors usually tell you to stop medications like aspirins and blood thinners that may interfere with your surgery and recovery.
• Stop eating or drinking anything from the midnight of the surgery day. You may be given enema to clear your bowels as part of preparations before prostate cancer treatment.
• Learn from your doctor how long you may have to stay at the hospital post surgery, and so make arrangements according to that.

There are different types of prostate cancer surgeries performed, depending upon the stage and aggressiveness of the cancer.

Robotic radical prostatectomy- You are administered general anaesthesia to help you sleep through the surgery. Antibiotic are given to prevent infections. You surgeon control the surgical instruments by sitting at a remote control at a certain distance from you. He gets a 3-D view of the operating area and uses his two hands and fingers for controlling the device to operate. This is a nerve-sparing technique that allows for more precise incisions.

Open simple prostatectomy- Once you are administered general anaesthesia, the surgeon inserts a flexible, long viewing scope (called cytoscope) through the tip of your penis to examine the prostate area, bladder and the urethra. He then inserts another tube, called a Foley catheter through the tip of the penis and stretches it through the bladder. Once urine is drained through the tube, an incision is done just below the navel, through the bladder to reach the prostate. After the prostate is removed, the incisions are closed.

Open radical prostectomy- After giving you general anaesthesia, the surgeon makes an incision below your navel up to your pubic bone. After dissecting the prostate gland and the surrounding blood vessels and nerves, the surgeons remove the prostate. The incisions are then closed with sutures.

Radiation stimulation- This type of treatment helps to cure earlier stages of cancer and helps relieve any symptoms of the disease. Before the treatment starts, you are placed still on a table in a plastic mould in order to keep you in the exact position throughout the procedure. Radiation beams are directed on the areas of the cancer to kill the abnormal cells. You are normally treated 2-5 days a week for several weeks.

Chemotherapy- This is another procedure that uses chemo oral pills given to the patients, or it may be inserted through an IV channel created in the arm. This procedure helps the chemos to reach the various areas where your cancer has spread through the bloodstream.

After the surgery, you are given pain relievers through intravenous (IV) channel in the arm. Once the IV is removed, you are required to take pain killers. The doctor may encourage you to walk the same day or the day after to check if you can move properly. Usually, you are discharged the day after the surgery, which indicates that the recovery of prostate cancer is quick but it depends upon the after-care treatments you receive. You may be discharged with the catheter in place.

You can return to normal activities 4-6 weeks after the surgery. Remember, you won’t be able to drive for a few days. You will need to visit your doctor for a few times after the treatment.