Prostate cancer is a type of cancer occurring in men. The prostate is a small gland that produces the semen. Prostate cancer develops when there is an abnormal cell activity in the prostate.

When to see a doctor?

Symptoms usually show up during later stages of the disease. You have to see a doctor if you experience any of the following:

• Difficulty to urinate
• Slow stream of urine
• Presence of blood in semen
• Discomfort or pain in the pelvic area
• Bone pain
• Erectile dysfunction

How is diagnosis and treatment carried out?

Diagnosis

A blood test and a physical examination are performed to check the status of the prostate.

• Prostate Specific Antigen (PSA) test- A blood sample is analyzed for PSA, a substance produced by the prostate gland. If the reading of PSA is higher than normal, it indicates an abnormality in the prostate gland.
• Digital Rectal Examination (DRE)- This is a physical examination done to assess the size, shape and texture of the prostate gland. The doctor inserts a gloved, lubricated finger into the rectum to check for any abnormalities.

If your tests show a positive result, the next step is a biopsy. Tissue samples are retrieved from the prostate region and sent to a pathologist to identify whether the cells are malignant (cancerous) or benign (not cancerous).

Staging the cancer

Once tested positive for prostate cancer, your doctor will determine the extent to which the cancer has spread in the body. Few imaging tests are done to determine this:

• Bone scan
• Ultrasound
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET) scan

Depending on which stage the cancer is in, your doctor will set a treatment plan for you.

Prostate cancer treatment options

• In cases of low-risk cancer, no treatment is required. Instead, doctors suggest active surveillance that includes regular blood tests, rectal exams, and biopsies to monitor the progression of your cancer. If the tests show your cancer is progressing, you may opt for surgery or any other treatment method. Active surveillance is also recommended for last stage prostate cancer to ease the symptoms.
• Surgery performed to remove the cancerous prostate gland is known as radical prostatectomy. It may be performed as an open surgery where an incision is made in the lower abdomen. Robotic prostatectomy is another option where the surgery is robot-assisted and lesser invasive.
• Radiotherapy uses high powered radioactive waves or substances to destroy the cancer cells. Radiation may be given from an outside source (external beam radiation therapy) or may be placed inside the body near the tumor in the form of radioactive seeds which deliver a steady dose of radiation over a period of time (brachytherapy).
• Hormone therapy is used in the treatment of advanced stage prostate cancer. The aim is to stop the production of testosterone hormone by the body so that the cancer cells die. Options for hormone therapy include medications that interfere with hormone production and surgery to remove the testicles(orchiectomy).
• Cryosurgery or cryoablation involves freezing the cancerous tissue by introducing very cold gas to the site in order to destroy them.
• Chemotherapy uses chemical drugs to kill the cancer cells. The drugs may be taken orally or intravenously.
• Immunotherapy or biological therapy uses your own immune cells to fight the cancer. The immune cells are taken and genetically modified in a laboratory to fight prostate cancer. It is then injected back to the body.