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Detection and Treatment

In its early stages, prostate cancer may not produce significant or obvious symptoms, making diagnosis and early intervention difficult in some cases.

Phillip Gregory

How is Prostate Cancer Detected?

The most common methods used to detect warning signs associated with prostate cancer are the PSA test (prostate-specific antigen test) and the DRE (digital rectal examination).

PSA Test (Blood Test):

Males over the age of 50 should discuss prostate cancer with their doctor and be screened for the disease on an annual basis. This can be done through a simple PSA blood test, which checks for elevated level of prostate specific antigen (a protein produced by both cancerous and non-cancerous tissue in the prostate).

Digital Rectal Examination (DRE):

Men can also receive a digital rectal examination, where the doctor examines the prostate for any irregularities in shape and size. If either of these tests confirm a patient may be at risk of prostate cancer, their doctor will arrange a biopsy. During a prostate biopsy, prostate tissue samples are removed and examined in the laboratory which can result in a cancer diagnosis based on results.

Further tests will then determine how aggressive the cancer is and if the cancer has spread around the body. This will also determine the course of treatment.

 

Treatment of Prostate Cancer

Depending on various factors, including what stage the prostate cancer is, will determine treatment methods.

Active Surveillance

Men who are diagnosed with low-grade prostate cancer may not need treatment immediately and doctors will recommend active surveillance.

As prostate cancer often grows slowly, the side effects of treatment can be worse than the potential benefits for some patients. This surveillance process will include having regular PSA blood tests, along with occasional digital rectal examinations, biopsies or ultrasounds.

Surgery

Some patients may have surgery to remove their prostate, particularly if the cancer is confined to the prostate gland. This is referred to as a radical prostatectomy, of which there are currently two types:

  • Retropubic prostatectomy: where the prostate gland is removed through an incision in the abdomen
  • Perineal prostatectomy: where the prostate gland is removed through an incision in the perineum.

A prostatectomy can either be done by making a large incision or by laparoscopy (keyhole surgery) where a number of small cuts will be made. Thanks to advances in research and technology, patients can now opt for a robotic prostatectomy which is a laparoscopic surgery where a robot assists the surgeon.

Radiotherapy

Radiotherapy is another way of treating prostate cancer. It can come in two forms, either external or internal radiation therapy.

  • External beam radiotherapy: radiation is directed from a machine outside of the body towards the prostate
  • Internal radiation therapy: small radioactive implants called ‘seeds’ are placed inside the prostate and give off radiation in low doses.

Androgen Deprivation Therapy (Hormone Therapy)

Androgen deprivation therapy involves reducing the levels of the androgen hormone (e.g. testosterone) within the prostate to stop it from helping the prostate cancer to grow or, in some cases, helping it to shrink.

There are several types of hormone therapy for prostate cancer:

  • Surgical removal of male testicles, which produce androgens
  • Administering medication that stops the production of androgen
  • Medication that blocks androgen receptors in prostate cancer cells so they can’t receive androgens to help the cancer survive.

Chemotherapy

Chemotherapy can also be used to treat prostate cancer that has spread around the body. It can be an option for cancers that do not respond to hormone therapy and is administered through an arm vein, a pill or both.

 Immunotherapy

Sipuleucel-T is an immunotherapy treatment for prostate cancer which harnesses the patient’s own immune system to seek out and destroy the prostate cancer cells. This is used to treat prostate cancer that is either advanced or has spread to other areas of the body.

 

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