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PROSTATE CANCER

Understanding Prostate Cancer

Prostate cancer occurs when abnormal cells in the prostate gland grow uncontrollably, forming a malignant tumor. It is one of the most common cancers in men, particularly those over 50. Early detection significantly improves treatment outcomes,cure  and survival rates.

At Dr. Amit Goel – Best UroOncologist in Gurugram, we provide comprehensive care for prostate cancer, including early screening, advanced treatment, and long-term monitoring.

Important Note: Benign Prostate Hyperplasia (BPH) Treatment happens in the Central (Inner) part of Prostate Gland and Cancer Prostate usually happens in the Peripheral (Outside) part of the Prostate gland and Endoscopic Treatment of BPH in no way increases chances of Prostate cancer occurence to a patient, or increased spread of cancer in future.

Also once treatment of BPH is done endoscopically, still the patient needs to get screened for Prostate cancer, as BPH and Prostate Cancer involves different zones of Prostate Gland.

Prostate cancer can occur in different forms, and each type has its own pattern of growth, aggressiveness, and treatment approach. Patients receive specialised care for all types of prostate cancer, with advanced diagnostic tools and a multidisciplinary team ensuring the best course of treatment for every individual case.

 

1.Adenocarcinoma of the Prostate

This is by far the most common type, making up nearly all cases of prostate cancer. It begins in the glandular cells of the prostate that produce seminal fluid. Adenocarcinomas can grow slowly or aggressively, which is why detailed evaluation is critical. Diagnosis is confirmed through PSA testing, imaging, and biopsy. Treatment may range from active surveillance for slow-growing cases to surgery, radiation therapy, hormone therapy, or newer targeted options for advanced stages.

 

2. Small Cell Carcinoma

Small cell carcinoma is a rare but highly aggressive form of prostate cancer. Unlike adenocarcinoma, it often does not raise PSA levels, making early detection more difficult. It spreads rapidly to other parts of the body, including the bones and liver. Treatment typically involves systemic therapies such as chemotherapy combined with radiation, with a focus on controlling disease progression and relieving symptoms.

 

3. Squamous Cell Carcinoma

This uncommon type arises from the flat, surface cells of the prostate rather than the glandular tissue. It is usually fast-growing and often resistant to hormone therapy, which makes it more challenging to treat. Management often includes surgery and radiation therapy, aimed at controlling local growth and preventing spread.

 

4. Transitional Cell Carcinoma

Also referred to as urothelial carcinoma, this cancer usually starts in the bladder or urethra but can extend into the prostate. Patients may notice urinary symptoms early on, which helps in detection. Treatment strategies depend on the extent of spread and may involve surgery, chemotherapy, and radiation, often planned in combination to achieve the best results.

 

5. Sarcomas and Other Rare Types

Prostate sarcomas and other unusual tumour types are extremely rare but can behave more aggressively than common prostate cancers. They may arise from connective tissue around the prostate. Because of their rarity, they require specialised evaluation and a customised treatment plan, which may include surgery, radiation, and systemic therapies. Each case is reviewed in detail by oncology experts to ensure patients receive the most effective care possible.

 

  • Difficulty starting or stopping urination
  • Weak or interrupted urine stream
  • Frequent urination, especially at night
  • Blood in urine or semen
  • Pain in the lower back, hips, or pelvis (Bone pain) Can be due to advanced (Metastatic) disease to the bones.
  • Erectile dysfunction
  • Often, early-stage prostate cancer may show no symptoms, which is why screening serum PSA (Total) is crucial.
  • Age: Most common in men over 50
  • Family History: Increased risk if close relatives like father, Brother, Paternal Uncles have had prostate cancer.
  • Genetic Factors: Certain gene mutations (e.g., BRCA1/2)
  • Lifestyle & Diet: Obesity, high-fat diet, and sedentary lifestyle may increase risk
  • Ethnicity: Higher prevalence in African-American men

Accurate diagnosis is essential for effective treatment:

  • Serum Total Prostate-Specific Antigen (PSA) Test: Measures PSA levels in the blood
  • Digital Rectal Examination (DRE): Physical examination of the prostate
  • Transrectal Ultrasound & Multiparametric MRI: Imaging for detailed evaluation.
  • Whole Body Ga68 PSMA PET Scan: For Tumour metastasis outside Prostate.
  • Prostate Biopsy done under Transrectal ultrasound /MR Fusion : Confirms cancer type, grade, and aggressiveness 
  • Important Note- Prostate Biopsy is the standard of care worldwide before treatment of Prostate cancer  and it does not lead to increased aggressiveness or spread of cancer.

Prostate Cancer Treatment Options

Treatment depends on cancer stage, patient age, overall health, and aggressiveness of the tumor:

A. Active Surveillance

Active monitoring is a widely used approach for men with low-risk, early-stage, or slow-growing prostate cancer. In such cases, the disease may not pose an immediate threat to health, and aggressive treatment can often be delayed without compromising outcomes. The process of active surveillance typically involves:

  • Routine PSA testing and digital rectal examinations (DRE): These regular check-ups help track changes in prostate size and detect any signs of disease progression.
  • Periodic biopsies and imaging scans: Biopsies and advanced imaging techniques, such as MRI, provide a clearer understanding of how the cancer is behaving over time.
  • Close monitoring of symptoms: Patients are encouraged to report any new urinary or general health concerns promptly.
  • Timely transition to treatment if necessary: If test results indicate that the cancer is becoming more aggressive or spreading, active treatment options such as surgery, radiation, or systemic therapies are initiated without delay.

Active surveillance provides a balanced approach, offering peace of mind to patients by ensuring the cancer is monitored closely, while also preserving quality of life until active treatment becomes essential.

Robotic-assisted Radical Prostatectomy for prostate cancer: Gold standard treatment for Organ confined prostate Cancer. Offers the best chance of cure for Prostate Cancer as Prostate gland is removed with Tumour as whole along with Seminal Vesicles and Part of Vas Deferens with /without Pelvic Lymph Nodes.

Pelvic Lymph Node Dissection: In cases where cancer is suspected to have spread to nearby lymph nodes, this procedure is performed alongside prostatectomy to check and remove affected nodes.

  • Very good Continence Preserving and Potency preserving Robotic Radical Prostatectomy Surgery done now in expert hands.
  • Robot-assisted surgery allows surgeons to perform precise, minimally invasive prostatectomies. This technique reduces blood loss, minimises scarring, and supports faster recovery. The Dr Amit Goel urologic oncologists is trained in latest robotic procedures, ensuring high success rates and improved patient outcomes.

Radiation is often recommended as an alternative to surgery or in combination with other therapies. It helps destroy cancer cells while preserving surrounding healthy tissue.

  • External Beam Radiation Therapy (EBRT): Modern methods such as Intensity-Modulated Radiation Therapy (IMRT) and Image-Guided Radiation Therapy (IGRT) deliver precise doses, reducing side effects to nearby organs like the bladder and rectum.
  • Brachytherapy: Tiny radioactive seeds are implanted into the prostate gland to release radiation over time. This internal treatment allows targeted therapy with minimal impact on healthy tissue.
  • Reduces male hormone levels to control cancer growth.
  • As Prostate Cancer is a hormone sensitive Cancer growth of which gets fueled due to male hormone Testosterone. Stopping the effect of Testosterone (Androgen Deprivation) controls the growth of Prostate cancer.
  • Useful particularly when cancer has spread beyond the prostate or recurs after initial treatment. Depending on the case, treatment may involve surgical removal of the testes or the use of medications to suppress or block hormones. This therapy is often combined with Surgical treatment, radiation or chemotherapy to improve effectiveness.

1. Chemotherapy

Chemotherapy is recommended in advanced stages of prostate cancer, especially when the disease does not respond to hormone therapy. It uses powerful drugs to target and destroy cancer cells throughout the body. This approach can slow disease progression, relieve symptoms, and improve quality of life.

 

2. Targeted Therapy

Targeted therapy offers a more precise approach, focusing on specific genetic mutations or molecular markers driving cancer growth. This method allows for highly individualised treatment, often leading to better outcomes with fewer side effects compared to traditional chemotherapy.

 

3. Immunotherapy

For select patients, immunotherapy is an option that helps the body’s immune system recognise and attack prostate cancer cells. It may be used in cases where other treatments have not been effective, offering an additional line of defence.

  • Regular PSA tests and imaging to detect recurrence early
  • Lifestyle counselling and supportive care for long-term health

While some risk factors cannot be changed, prostate cancer risk can be reduced by:

  • Maintaining a healthy weight and active lifestyle
  • Eating a balanced diet rich in fruits, vegetables, and omega-3 fatty acids
  • Avoiding smoking and excessive alcohol consumption
  • Undergoing regular screenings, especially if at high risk.

While some risk factors cannot be changed, prostate cancer risk can be reduced by:

  • Maintaining a healthy weight and active lifestyle
  • Eating a balanced diet rich in fruits, vegetables, and omega-3 fatty acids
  • Avoiding smoking and excessive alcohol consumption
  • Undergoing regular screenings, especially if at high risk.

Frequently Asked Questions

Ques 1. Can prostate cancer be prevented or its risk reduced?

Ans. Although it cannot be completely prevented, certain measures such as  adopting a healthy lifestyle, balanced diet, regular exercise, maintaining a healthy weight, and avoiding smoking, may reduce risk or slow disease progression. Regular health check-ups and PSA screenings are also recommended for early detection.

Ans. Some patients explore supportive therapies such as physiotherapy, yoga, meditation, or dietary supplements. These do not replace standard treatment but may help manage side effects, improve mental well-being, and enhance recovery. Always consult your doctor before starting any complementary therapy.

Ans. Patients may experience anxiety, stress, or depression during diagnosis and treatment. Concerns about sexual health, recovery, and long-term outcomes can add to emotional strain. Counselling, support groups, and mental health professionals can provide coping strategies and reassurance.

Ans. A well-balanced diet helps maintain strength, manage side effects, and support recovery. Patients may need adjustments depending on treatment type, including foods that reduce inflammation, support urinary health, and help manage fatigue or gastrointestinal symptoms. Dieticians can provide personalised plans.

Ans. Patients should arrange follow-up consultations via telemedicine, ensure access to local medical support for emergencies, maintain prescribed medications, and monitor for any recurring symptoms. Travel insurance that covers post-treatment complications is recommended.

Ans. Some treatments can interact with existing conditions or medications. For example, hormone therapy may affect bone density or heart health. Doctors consider all existing medical conditions when planning treatment and provide guidance on managing medications safely.

Ans. Warning signs may include severe pain, heavy bleeding, sudden urinary changes, fever, or persistent fatigue. Early intervention can prevent complications. Patients should contact their healthcare provider promptly.

Ans. In some cases, genetic testing can identify inherited mutations that increase cancer risk. This information can guide treatment choices and help family members understand their own risk factors.

Ans. Yes, maintaining a healthy lifestyle, regular exercise, balanced nutrition, and avoiding smoking or excessive alcohol can support overall health and may reduce recurrence risk. Regular monitoring remains essential regardless of lifestyle.

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