Prostate Cancer

The prostate gland is an apricot-shaped reproductive organ located beneath the urinary bladder and surrounding the urethra in males. The prostate gland produces secretions which form part of the volume of semen. A muscular portion of the prostate gland helps expel the secretions into the urethra during ejaculation.

Who are at risk for developing prostate cancer?

Age: Men above 50 years of age have higher risk, and the risk for cancer increases with advance in age.

Family History: Men with one or more first-degree relative with prostate cancer have increased risk.

Race: Incidence of prostate cancer is less in Asian males as compared to White males or Black males.

Food: High animal fat intake increases the risk of prostate cancer, while diet rich in fruit and vegetables will decrease the risk.

Staging of Prostate Gland

Stage 1 and 2 – Localized Disease

The tumor is confined to the prostate gland. In Stage 1, the tumor is microscopic in size. In Stage 2, the tumor is larger in size and may be palpable by digital rectal exam.

Stage 3 and 4 – Locally Advance Disease

The tumor extends outside the prostate gland.

Treatment of Prostate Cancer

There are two methods of treatment:

  1. For Stages 1-2 Cancer which is confined to the prostate can be completely cured with the proper treatment.
    Surgical Therapy: either by radical surgery or minimally invasive (laparoscopic) surgery is appropriate for patients with cancers localized in the prostate gland, who have a life expectancy of 10 years or greater. The most common complications include impotence (seen in 50-80% of patients) and urinary incontinence (seen in 10-30%)
    External Beam Radiation: can be used to treat localized prostate cancer, with a survival rate of 80% or more. Using this method avoids any blood loss however radiation must be given 5 consecutive days per week. Side effects include diarrhea, radiation proctitis, impotence, skin reactions, hematuria and hemorrhagic cystitis.
    Brachytherapy: involves placing radioactive seeds directly into the prostate gland. The two isotopes most commonly used are lodine-125 and Iridium-192. Iodine-125 is most effective in patients who have low-grade cancers, while Iridium-192 is more effective in patients with intermediate to high risk. The brachytherapy procedure takes about 1 hour. A 70-80% survival rate is similar to radical prostatectomy and external beam radiation. Side effects include urinary retention, urethral stricture, impotence, diarrhea and rectal bleeding.
  2. For Stages 3-4: Treatment for locally advanced disease is palliative in nature, especially in patients with Stage 4 disease. Treatment to limit or relieve symptoms due to prostate cancer may come in the form of hormonal therapy through medical castration (medications to suppress male hormones) or surgical castration (removal of bilateral tests). In case resistance to hormone therapy develops, chemotherapy may be helpful.

Symptoms Which May Indicate Abnormality of Your Prostate Gland

  • Frequent urination at night
  • Having to bear down to completely empty the bladder
  • Urinary incontinence
  • Back pain or bone pain
  • Pain during urination
  • Bloody urine

Checking For Prostate Cancer

  1. Digital rectal examination by your doctor is the first step in checking the prostate. If any abnormality is discovered by your doctor, further investigation must be done.
  2. Prostate-Specific Antigen (PSA) is produced by the prostate gland and is measured by taking a blood sample. Higher levels usually indicate abnormality of the prostate gland.
  3. Trans Rectal Ultrasound (TRUS) is a method of examining the prostate gland through an ultrasound probe placed in the rectum. Abnormal findings may be biopsied during a TRUS examination.

Urinary Tract Disease Clinic

Mission Hospital offers diagnostic services and treatment of urinary tract and prostate gland diseases.

  • Erectile dysfunction
  • Infection of the urinary tract
  • Urinary tract stones
  • Cancer of the urinary tract