Prostate Cancer In India Likely To Double By 2020
According to the Indian Medical Council of Research, prostate cancer in the second leading cancer among Indian males. It is likely to double by 2020. This makes it more important than ever for Indian men to understand the early signs symptoms of prostate cancer, because it grows slowly. Early detection is the key to reducing risk factors and improving the success rate of treatment.
We caught up with Medical Oncologist Dr Peush Bajpai of Manipal Hospitals to understand diagnosis and treatment options of prostate cancer.
Where Is The Prostate Gland?
Only men have a prostate. It is a small gland that sits below the bladder near the rectum.It surrounds the urethra, the passage in the penis through which urine and semen pass. The prostate gland is part of the male reproductive system. It produces most of the fluid that makes up semen that enriches sperm. The prostate needs the male hormone testosterone, to grow and develop. The prostate is often described as being the size of a walnut and it is normal for it to grow as men age. Sometimes this can cause problems, such as difficulty urinating. These problems are common in older men and not always symptoms or signs of cancer.
How Common Is Prostate Cancer In India?
Prostate Cancer is among the top 10 leading sites of cancers in India. According to Globocan statistics, new prostate cancer cases detected are nearly 25,696; number of deaths: 17,184.
The data shows that almost all regions of India are equally affected by this cancer. The incidence rates of this cancer are constantly and rapidly increasing in the country. The cancer projection data shows that the number of cases will double by 2020.
What Are The Symptoms?
In the early stages, there may be no symptoms. In the later stages, some symptoms of prostate cancer might include:
- Feeling the frequent or sudden need to urinate
- Finding it difficult to urinate (for example, trouble starting or not being able to urinate when the feeling is there, or even poor urine flow)
- Discomfort when urinating
- Finding blood in urine or semen
- Pain in the lower back, upper thighs or hips.
These symptoms are usually apparent after 5th decade in males and may not essentially mean that you have prostate cancer. Most of them are also found in benign prostatic hyperplasia. But if one experiences any of these symptoms, go and see your doctor.
What Increases The Risk Of Prostate Cancer?
Factors that are most strongly linked to an increased chance of developing prostate cancer:
Age: Prostate cancer is an age-dependent disease, which means the chance of developing it increases with age. The risk of getting prostate cancer by the age of 75 is 1 in 7 men. By the age of 85, this increases to 1 in 5.
Family History: If one has a first degree male relative with prostate cancer, or if there is a history of breast or ovarian cancer on the paternal or maternal side, then one has a higher chance of developing it than men with no such history. The risk increases again if more than one male relative has prostate cancer. Risks are also higher for men whose male relatives were diagnosed when young.
Genetics: Genes are found in every cell of the body. They control the way the cells in the body grow and behave. Every person has a set of many thousands of genes inherited from both parents. Changes to genes can increase the risk of prostate cancer being passed from parent to child. Although it can’t be inherited, a man can inherit genes that can increase the risk.
Diet: There is some evidence to suggest that eating a lot of processed meat or food that is high in fat can increase the risk of developing prostate cancer.
Lifestyle: There is evidence to show that environment and lifestyle can affect the risk of developing prostate cancer. Smoking tobacco has one of the most clear chances of an individual developing it.
How Is It Detected & Diagnosed?
A doctor will usually do a blood test and/or physical examination to check the health of the prostate.
The detection involves:
1) Blood test (Prostate Specific Antigen (PSA) test): The result shows whether there is an increase in this specific protein. Depending on the result, one might need further investigation by a specialist. A high PSA test result does not necessarily mean cancer. Prostate diseases other than cancer can also cause a higher than normal PSA level.
2) Digital Rectal Examination (DRE): Because of where the prostate is located, the doctor inserts a gloved, lubricated finger into the rectum to check the size of the prostate and assess if there are any abnormalities. A normal DRE result does not rule out prostate cancer.
As for the diagnosis, if the tests show the risk of prostate cancer, the next step is a biopsy. A biopsy is the only way to confirm the diagnosis. A small sample of tissue is removed from the prostate, using very thin, hollow needle guided by an ultrasound. The prostate is either
accessed through the rectum (transrectal) or the perineum (transperineal), which is the area between the anus and the scrotum.
A biopsy is usually done as an out-patient procedure and the doctor will likely advise a course of antibiotics afterwards to reduce the chance of infection. The tissue is sent to a pathologist to identify whether the cells are malignant (cancerous) or benign (not cancerous).
Can You Reduce The Risk Of Prostate Cancer?
There is no evidence that the following protective factors can stop the cancer from developing. But they can improve your overall health and possibly reduce the risk of prostate cancer:
Good Diet: Eat meals that are nutritious. Food that is good for the heart is good for the prostate.
Physical Activity & Exercise: There is some evidence to show that physical activity and regular exercise can be protective factors for cancer. Try to exercise at least 30 minutes in a day.
Can It Be Treated?
Not all patients of require immediate treatment. There is a very low risk disease pattern which might just require a regular monitoring. Prostate cancer treatment could be classified into:
Local treatment: Surgery or radiotherapy are the main modalities in local treatment with the recent advances being robotic surgery and modern radiotherapy techniques.
Systemic treatment: Hormonal therapy which is mainly targeted therapy (in form of pills) and chemotherapy.