Know All About The Second Most Common Cancer Amongst Men
Almost 70% of all prostate cancers are diagnosed in men over the age of 60 years
Dr Mohan Keshavamurthy, Director, Urology, Uro-Oncology, Andrology, Transplant & Robotic Surgery, Fortis Hospitals, Bangalore & Chairman, Renal Sciences Specialty Council, Fortis Hospitals, explains all about prostrate cancer
The second most common cause of cancer among men, prostate cancer is also the sixth leading cause of cancer-related deaths in men globally. With rising life expectancy in our country, the burden of prostate cancer is expected to grow significantly. The risk of developing prostate Cancer increases exponentially with age. Almost 70% of all prostate cancers are diagnosed in men over the age of 60 years.
Prostate cancer can be treated successfully in a significant number of cases when diagnosed early, especially with the advent of Nerve-Sparing Robotic Prostatectomytechnique. In somecases, with mild disease, the progression of thedisease is so gradual that patients even manage to survive several years with minimal medication.
Standard clinical guidelines advise men above the age of 45 to get a yearly Serum PSAEvaluation as there are no specific symptoms for prostate cancer.
In case of family history of prostate cancer, men above the age of 40 to get yearly Serum PSAEvaluation.
Management of elevated PSA will involve treating the gentleman with the course of antibiotics, if the repeat PSA is still elevated or shows a rising trend beyond two weeks then specific tests such as free PSA, PSA velocity and PSA density can be used to assess the probability of cancer.
When indicated a transrectal ultrasound or a TRUS biopsy is the diagnostic technique of choice. Cancer prostate once diagnosed has to be graded and staged.
Organ confined intimidate grade cancer is best treated when nerve spearing robotic radical prostatectomy to prevent the common complications of impotence and incontinence which have a higher probability in other techniques of surgical treatment. Higher grade cancer or advanced cancer will need multimodality management.
GLEASON GRADE:
| Grade Group | Gleason Score | Cancer Grade |
| 1 | 6 or less | Low grade cancer |
| 2 | 3+4=7 | Medium grade cancer |
| 3 | 4+3=7 | Medium grade cancer with more abnormal cells |
| 4 | 8 | High grade cancer |
| 5 | 9-10 | High grade cancer |
Advanced Prostate Cancer Treatment Options:
Investigation modality for planning treatment
- PSMA pet scan
- MRI pelvis with pirad scoring
- BK – MR Fusion Biopsy in inderminate cases
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