Prostate Cancer: Understanding, Diagnosis, And Treatment

Prostate cancer is a prevalent form of cancer in the elderly population that affects the prostate gland, a small walnut-shaped gland in the male reproductive system. It is the second most common cancer among men worldwide, making it a significant health concern. In this article, we will explore various aspects of prostate cancer, including its causes, risk factors, symptoms, diagnosis, and treatment options.

Understanding Prostate Cancer

The prostate gland is responsible for producing seminal fluid that nourishes and transports sperm. Prostate cancer occurs when abnormal cells within the prostate gland multiply uncontrollably, forming a tumor. While the exact cause of prostate cancer remains unknown, certain risk factors increase a person's likelihood of developing the disease. Age is the primary risk factor, with the majority of prostate cancer cases occurring in men over the age of 60. Family history, ethnicity, and certain genetic mutations also play a role in prostate cancer development.

Signs and Symptoms

In its early stages, prostate cancer often does not cause noticeable symptoms. However, as the disease progresses, the following signs and symptoms may occur:

  • Frequent urination, particularly at night
  • Difficulty in initiating or stopping urination
  • Weak or interrupted urine flow
  • Blood in the urine or semen
  • Erectile dysfunction
  • Pelvic pain or discomfort
  • Bone pain, especially in advanced stages of the disease

It is important to note that these symptoms can be indicative of other non-cancerous conditions as well. Therefore, a proper medical evaluation is essential for an accurate diagnosis.

Diagnosis and Screening

Early detection of prostate cancer greatly improves treatment outcomes. Several methods are used to diagnose and screen for prostate cancer, including:

  • Prostate-Specific Antigen (PSA) Test: This blood test measures the levels of PSA, a protein produced by the prostate gland. Elevated PSA levels can indicate the presence of prostate cancer, but further tests are needed to confirm the diagnosis.
  • Digital Rectal Examination (DRE): In this physical examination, a healthcare provider inserts a gloved finger into the rectum to assess the size, shape, and texture of the prostate gland.
  • Biopsy: If the PSA levels are elevated or abnormalities are detected during a DRE, a biopsy may be performed. This involves collecting small tissue samples from the prostate gland for examination under a microscope. This is usually done by Trans Rectal Ultrasound guided biopsy (TRUS) or Trans Urethra Resection of prostate (TURP) usually done to relieve Urinary Obstruction in Benign Prostatic Hypertrophy or Enlargement (BHP).

Treatment Options

Treatment for prostate cancer depends on various factors, including the stage and aggressiveness of the cancer, the patient's overall health, and personal preferences. The following are common treatment options:

  • Active Surveillance: For slow-growing or early-stage prostate cancer, active surveillance may be recommended. Regular monitoring of PSA levels, imaging tests, and periodic biopsies are performed to ensure timely intervention if the cancer progresses.
  • Radiation Therapy: High-energy X-rays or other forms of radiation are used to destroy cancer cells. It can be delivered externally (external beam radiation therapy) or internally (brachytherapy). Presently radiation therapy can be delivered in a highly focused beam technique (like IGRT or IGRT+VMAT/Rapid Arc Techniques) on modern Radiation machine (Linear Accelerator).
  • Surgery: Radical prostatectomy involves the surgical removal of the prostate gland and surrounding tissues. This can be done through open surgery or minimally invasive techniques such as laparoscopic or robotic-assisted surgery.
  • Hormone Therapy: Prostate cancer cells rely on male hormones (androgens) to grow. Hormone therapy aims to block or reduce the levels of these hormones to slow down the cancer's growth and thus act as adjuvant to Radiation Therapy, Surgery or Chemotherapy.
  • Chemotherapy: In advanced and/or hormone resistant cases, chemotherapy drugs may be used to kill cancer cells or control their growth. It is often used when prostate cancer has spread to other parts of the body.
  • Immunotherapy: This treatment modality stimulates the body's immune system to recognize and attack cancer cells. Immunotherapy drugs, such as checkpoint inhibitors, can help enhance the immune response against prostate cancer cells.
  • Targeted Therapy: Targeted drugs are designed to specifically target certain genetic mutations or proteins present in cancer cells. These drugs interfere with the cancer cells' growth and survival, offering a more precise and effective treatment approach.

It is important to note that treatment plans following International Cancer Treatment guidelines (NCCN) but are individualized based on each patient's unique circumstances. Often, a combination of treatment modalities may be recommended to achieve the best possible outcome.

Supportive Care and Survivorship

    Prostate cancer treatment can have various physical and emotional side effects. These may include urinary incontinence, erectile dysfunction, fatigue, and emotional distress. Supportive care measures, such as rehabilitation services, counseling, and support groups, are available to help manage these challenges and improve quality of life during and after treatment.
  • Regular follow-up appointments are crucial for monitoring the effectiveness of treatment and detecting any signs of recurrence. Prostate cancer survivors are encouraged to adopt a healthy lifestyle, including regular exercise, a balanced diet, and avoiding tobacco and excessive alcohol consumption, to reduce the risk of cancer recurrence and maintain overall well-being.


Prostate cancer is a significant health concern for elderly gentlemen, and understanding its causes, symptoms, diagnosis, and treatment options are crucial for effective management. Early detection through regular screening and prompt medical intervention can lead to better treatment outcomes. With advancements in medical science and personalized treatment approaches, the prognosis for prostate cancer has improved significantly and a significant proportion of Prostate Cancer patients now are able to live a near normal symptom free life even in those patients with advanced stage disease. By raising awareness and promoting regular check-ups, we can strive towards reducing the impact of prostate cancer and improving the lives of those affected by the disease.

Remember, if you have any concerns or experience symptoms related to prostate health, consult with a healthcare professional for proper evaluation and guidance.

Dr.Sudarsan De
Department of Radiation Oncology
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