Medicover Cancer Institute, Visakhapatnam: Prostate Cancer - Awareness, Diagnosis and Treatment.*

.               by Sharma K.V. EDITOR 
Prostate cancer is the second most common cancer in men after lung cancer, says Dr. Abhilash Gavarraju, Consultant Radiation Oncologist.

The problem is more common in the elderly. In India, they suffer from other health problems such as diabetes, heart disease and hypertension, which makes treatment more challenging. The symptoms of prostate cancer are often similar to those of the common benign prostatic hyperplasia. The two problems can also coexist in the elderly. In Western countries, many patients are asymptomatic and only consult a doctor when blood tests show high serum prostate-specific antigen levels. However, in developing countries, including India, symptoms of bladder obstruction, blood in the urine and metastatic (spread to other parts of the body) disease (such as bone pain, cough, difficulty breathing, abdominal pain) are more common.

The main risk factors for this disease are age, family history, high-fat diet, lack of exercise, smoking and alcohol consumption. Tests such as serum prostate-specific antigen, prostate biopsy, Gleason score, PSMA PET CT scan are used for diagnosis and grading of the disease. Although prostate cancer is a slow-growing disease, early detection is important. In India, PSA tests are performed as an opportunistic screening of patients visiting a doctor for health care. Prostate cancer is generally classified as localized disease, where the cancer is confined to the prostate gland. At this stage, the patient can be cured by surgery or radiation. Active surveillance is an option for the elderly or those who are not healthy. Locally advanced disease, where the cancer has spread beyond the prostate gland but has not metastasized to distant sites. Multimodality treatment, which involves a combination of surgery, radiation and hormone therapy, is recommended for these patients. And metastatic disease, where the cancer has spread to distant sites.  Treatment is based on factors such as the patient's health, age, and extent of disease. Surgical castration, chemotherapy, targeted therapy, and hormone therapy are available options.

The most common methods of surgery today are laparoscopic. Robotic/robotically assisted augmentation by trained personnel. Radiation therapy, external beam radiation therapy with hormone therapy provides long-term results similar to surgery. IMRT IGRT is the gold standard technique for EBRT. Chemotherapy/hormone therapy helps to increase survival in metastatic disease. Chemo agents such as DOCETAXEL. Advanced hormone agents such as ABIRATERONE, ENZALUTAMIDE, APALUTAMIDE. GnRH agonists (LEUPROLIDE) and GnRH antagonists (DEGARELIX) are hormone therapy agents.

Prostate cancer occurs mainly in older people, and timely diagnosis. Increasing cure rates. Reducing treatment time. Reducing cost. Reducing side effects.

He said that if you have symptoms of prostate cancer or high PSA levels, early diagnosis can lead to better outcomes.