Do you know 1 in 8 men are diagnosed with prostate cancer in their lifetime? It’s the second most common cancer found in men worldwide, and the risk of developing it increases in elderly men. The disease starts when cells begin to grow out of control in the prostate gland. The 5-year survival rate for prostate cancer in India is 64%. Old age, obesity, improper diet and genetic alterations have been identified as some of the main contributing factors towards an increased cause of prostate cancer. Medicircle is conducting interviews with eminent Doctors and Specialists of India to impart basic knowledge of prostate cancer and different treatments available for the same. 

Dr. Shailendra Kumar Goel is Director, Department of Urology, Robotic & Kidney Transplant Surgery, at Max Super Speciality Hospital, Vaishali, Ghaziabad.  He has more than 23 years of experience in the field of Urology, Uro-oncology & Kidney transplants. He has been associated with Jaypee Hospital, Kailash Group of Hospitals, Metro Group of hospitals, SGPGIMS and GTB Hospital in the past. He has received the 'Seva Ratan Samman' Award by Cabinet Health Minister Shri Harsh Vardhan Ji. He has Developed newer techniques in Laparoscopic Pyeloplasty and published them in the coveted Journal of Urology.

Prostate cancer is the most curable cancer

Dr. Shailendra says, “Abnormal growth or rampant growth of cells in any part of the body is called cancer. The prostate gland is located at the junction of the urinary bladder and urinary passage. It is generally present in males. BPH is an enlargement of prostate glands that is non-cancerous. Sometimes the enlargement takes the form of cancer which is called prostate cancer.

Among all cancers, it is one of the most curable cancer. The survival rate even after contracting cancer is in decades. If treated timely and effectively, the patient can live a normal lifespan with a quality life.”

Important facts based on studies – Prostate cancer

Dr. Shailendra expresses, “The reason behind prostate cancer is not known yet. Some studies have suggested that

It is most common in blacks like Africans. The Indian diet protects against prostate cancer. Continental and oriental diets can increase the risk of developing prostate cancer. Following a healthy lifestyle is very helpful for prostate cancer. Prostate cancer has a genetic basis. So, if your father or brother is having prostate cancer, the risk increases.  Ejaculation helps in preventing prostate cancer. Sexual activity is good for prostate health, it is protective against prostate cancer. 

Diagnosis

Dr. Shailendra stresses, “Prostate screening test includes

PSA Test - All men in their 40s should undergo PSA (Prostate-Specific Antigen) test per year. Digital rectal examination by a Urologist.

If prostate cancer screening detects an abnormality, your doctor may recommend further confirmation tests 

Doctors may perform MRIs. To validate further, the doctor may advise Needle Biopsy. It is a non-painful procedure. This confirms the presence of cancer with its severity. PSA PET scan determines whether cancer has spread beyond the prostate gland or not. This helps in determining the stages. 

Staging of prostate cancer

Dr. Shailendra describes various stages of prostate cancer

Stage I – If cancer is limited to the prostate gland

Stage II – If cancer reaches margins of gland

Stage III – If cancer has spread to its connective body parts

Stage IV – If cancer spreads to other body parts

When prostate cancer spreads, the most affected area is bones, followed by lymph nodes, kidneys, brain, and so on. 

Treatment

Dr. Shailendra expresses, “Prostate cancer is curable. For treating early stages (I and II), robotic surgery is best. The surgery involves removing prostate glands. In those cases where robotic surgery can't be performed, the recommended treatment procedure is radiotherapy wherein high-powered energy is being used to kill cancer cells with minimum side effects. Hormonal therapy is often used to treat advanced-stage prostate cancer. Here the condition is controlled and not fully cured.”

Prostate cancer recurrence

Dr. Shailendra adds, “PSA is a marker to screen men for prostate cancer. After surgery or radiotherapy, PSA levels usually drop to a stable and low level. Usually, after surgery, the chances of recurrence are very low but still, patients need to be a little careful. He should go for a medical check-up every 3 months as determined by your doctor.  In case of recurrence, we have the 2nd, 3rd, 4th line of treatment. For aggressive type of tumors, we can also use chemotherapy.” 

Dr. Shailendra concludes, "To live a healthy life, follow healthy lifestyle, use your prostate, and all men in their 40s should undergo annual PSA test screening. 

(Edited by Renu Gupta)