Prostatectomy

The Prostate gland found in men is a small walnut-shaped gland in men that produces the seminal fluid that nourishes and transports sperm. Prostate cancer is one of the most common types of cancer in men. This type of prostate cancer grows slowly is initially confined to the prostate gland, where it may not cause serious harm.

Prostate cancer that's detected early when it's still confined to the prostate gland— has a better chance of successful treatment.

Exact cause of prostate cancer not known. Gene Mutation is linked to this type of cancer with accumulation of these cancerous cells causing the tumour mass in the gland.

Prostatectomy can be under the following:

  • Radical prostatectomy is surgery to remove the entire prostate gland and surrounding lymph nodes as treatment for men with localized prostate cancer. A surgeon can perform a radical prostatectomy using different techniques, including:
  • Robot-assisted radical prostatectomy. The surgeon makes several small incisions in your lower abdomen to remove the prostate. He or she sits at a console, using instruments attached to a computer-assisted mechanical device (robot). The robotic device allows a more precise response to movement of the surgeon's hands.
  • Open radical prostatectomy. The surgeon typically makes an incision in your lower abdomen to remove the prostate (retropubic surgery).
  • Laparoscopic radical prostatectomy. The surgeon makes several small incisions in your lower abdomen and inserts special tools to remove the prostate.
  • Simple prostatectomy, on the other hand, is generally recommended for men with severe urinary symptoms and much enlarged prostate glands (rather than prostate cancer), and can be performed open or robotically. This enlargement of the prostate is called benign prostatic hyperplasia, or BPH. Simple prostatectomy doesn't remove the entire prostate, as in a radical prostatectomy, but instead removes just the obstructive part of the prostate that's blocking the flow of urine.

The Symptoms of the prostate cancer initially are not visible however as the disease advances it can cause:

  • Trouble urinating
  • Decreased force in the stream of urine
  • Blood in semen
  • Discomfort in the pelvic area
  • Bone pain
  • Erectile dysfunction

Factors that can increase your risk of prostate cancer include:

1. Age. The risk of prostate cancer increases with elderly patients

2.  Family history. If men in your family have had prostate cancer, your risk may be increased. Also, if you have a family history of genes that increase the risk of breast cancer (BRCA1 or BRCA2) or a very strong family history of breast cancer, your risk of prostate cancer may be higher.

3. Obesity. Obese men diagnosed with prostate cancer may be more likely to have advanced disease that's more difficult to treat.

Complications

  • Cancer that spreads (metastasizes). Prostate cancer can spread to nearby organs, such as your bladder, or travel through your bloodstream or lymphatic system to your bones or other organs.
  • Incontinence. Both prostate cancer and its treatment can cause urinary incontinence.
  • Erectile dysfunction. Erectile dysfunction can result from prostate cancer or its treatment, including surgery, radiation or hormone treatments. Medications, vacuum devices that assist in achieving erection and surgery are available to treat erectile dysfunction.

Prevention of prostate cancer:

  •  Choose a healthy diet full of fruits and vegetables.
  • Avoid high-fat foods and instead focus on choosing a variety of fruits, vegetables and whole grains.
  • Exercise improves your overall health, helps you maintain your weight and improves your mood. There is some evidence that men who don't exercise have higher PSA levels, while men who exercise may have a lower risk of prostate cancer.
  • Maintain a healthy weight.

Screening for prostate cancer

Digital rectal exam (DRE). During a routine DRE the texture, shape or size of the gland will be examined for need of further tests.

Prostate-specific antigen (PSA) test: A blood sample is drawn from a vein in your arm and analysed for PSA, a substance that's naturally produced by your prostate gland.

If a DRE or PSA test detects an abnormality some more investigations are recommended for the same:

1) Ultrasound. If other tests raise concerns, a trans rectal ultrasound is used to further evaluate your prostate. A small probe, about the size and shape of a cigar, is inserted into your rectum. The probe uses sound waves to create a picture of your prostate gland.

2) Collecting a sample of prostate tissue (prostate biopsy). Prostate biopsy is often done using a thin needle that's inserted into the prostate to collect tissue. The tissue sample is analysed in a lab to determine whether cancer cells are present.

3) MRI fusion. MRI fusion to assist in prostate biopsy and diagnosis is being used more and more.

Prostate cancer staging

Once a prostate cancer diagnosis has been made, it is necessary to determine the extent (stage) of the cancer. If the cancer may have spread beyond your prostate, one or more of the following imaging tests may be recommended:

  • Bone scan
  • Ultrasound
  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET) scan
  •  Prostate-specific membrane antigen (PSMA) studies to help detect the extent of newly diagnosed prostate cancer and whether the disease has spread to nearby lymph nodes.

Staging of prostate cancer:

I.  Stage I. This stage signifies very early cancer that's confined to a small area of the prostate. When viewed under a microscope, the cancer cells aren't considered aggressive.

II.  Stage II. Cancer at this stage may still be small but may be considered aggressive when cancer cells are viewed under the microscope. Alternatively, cancer that is stage II may be larger and may have grown to involve both sides of the prostate gland.

III. Stage III. The cancer has spread beyond the prostate to the seminal vesicles or other nearby tissues.

IV. Stage IV. The cancer has grown to invade nearby organs, such as the bladder, or spread to lymph nodes, bones, lungs or other organs.

Treatment

- Immediate treatment may not be necessary. Instead, doctors sometimes recommend active surveillance such as, regular follow-up blood tests; rectal exams and possibly biopsies may be performed to monitor progression of your cancer.

If the cancer is progressing, you may opt for a prostate cancer treatment such as surgery or radiation.

 1) Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes.

2) Radiation therapy

  • Radiation therapy uses high-powered energy to kill cancer cells. Prostate cancer radiation therapy can be delivered in two ways:
  • Radiation that comes from outside of your body (external beam radiation). During external beam radiation therapy, a machine moves around your body, directing high-powered energy beams, such as X-rays or protons, to your prostate cancer.  Treatments are given for five days a week for several weeks.
  • Radiation placed inside your body (brachytherapy). Brachytherapy involves placing many rice-sized radioactive seeds in your prostate tissue.
  •  Side effects of radiation therapy can include painful, frequent or urgent urination, as well as rectal symptoms such as loose stools or pain when passing stools. Erectile dysfunction can also occur.

3)   Hormone therapy is treatment to stop your body from producing the male hormone testosterone. Prostate cancer cells rely on testosterone to help them grow. Cutting off the supply of testosterone may cause cancer cells to die or to grow more slowly.

4)  Chemotherapy: Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form or both.

Oncology Services at Wockhardt Hospital:

Wockhardt Hospitals, a chain of tertiary care super-specialty hospitals has more than 25 years of experience in the creation and management of Super Specialty Hospitals in India.

At Wockhardt Hospital we believe that diagnosis and management of a cancer patient does not end with the treatment of cancer, and hence it follows a well-designed patient counselling services and support system and forms part of goals in our oncology department. Our oncology team at Wockhardt Hospital uses cutting edge technology & latest pharmaceuticals to provide complete treatment for of cancer.

At Wockhardt Hospitals our esteemed and dedicated team of oncologist team, provides both inpatient and outpatient services for patients diagnosed with cancer. This care is delivered by a multidisciplinary team of oncologists working together. Our oncologists at Wockhardt hospital along with expertise in this vast field and supported with advanced technology assist in providing the best quality patient care to our cancer patients in administration of chemotherapy and radiation oncology.

The Department of Surgical Oncology is the only surgical oncology department for cancer treatment aims to provide holistic, all round surgical care for solid tumours comprising of Head & Neck Cancers, Breast Cancer and Cancers of the female reproductive organs. Our qualified surgeons all have specialized fellowship training and work in a multidisciplinary setting with other specialists to provide the latest treatments and innovations in surgical cancer care.

Wockhardt Hospitals have been regarded as centers of excellence in medical science with facilities in North Mumbai (Mira road), South Mumbai (Mumbai Central), Navi Mumbai (Vashi), Nagpur, Nasik, Rajkot and Surat. Wockhardt Hospitals is having state-of-the-art infrastructure whose prime objective is patient safety first and quality of care at the core of its strategy. The guiding philosophy is to serve and enrich the Quality of Life of patients and to make life win.

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