BENGALURU: Prostate cancer is the second most common cancer and accounts for 7.1% of the total cancers in men. It has a 60% incidence rate in males over the age of 65 years. In India, the incidence of prostate cancer is 2.9 to 7.5%. Early diagnosis is critical for improving the outcomes. The five-year survival rate of local and regional prostate cancer is approximately 100%. However, delay in diagnosis may progress cancer into advanced stage (distant cancer), and the five-year survival rate significantly drops to 30%. Advanced technologies such as transperineal MRI-TRUS fusion biopsy are sensitive and have fewer procedural complications.
What is prostate cancer?
The prostate gland is a walnut-shaped small gland present in between the penis and the bladder. It produces the seminal fluid that nourishes the sperms and helps them in transport. Uncontrolled division of the cells of the prostate gland leads to prostate cancer. Some of the prostate gland cancers are very slow-growing and confined to the prostate.
However, some other prostate gland cancers are aggressive and require immediate medical intervention to prevent their growth.(The writer is consultant urologist & transplant Surgeon, Columbia Asia Hospitals Whitefield, Columbia Asia Referral Hospitals Yeshwanthpur, Columbia Asia Hospitals, Hebbal)
Symptoms
Blood in urine and semen
Trouble in urination
Erectile dysfunction
Unexplained weight loss
Bone pain
DIAGNOSIS
Prostate-specific antigen levels: This is a screening test for prostate cancer. The doctor advises the patient to undergo a blood test to determine the level of prostate-specific antigen. High levels of this antigen may be due to prostate cancer, inflammation, prostate enlargement, and infection.
Digital rectal examination: This is a screening method where the doctor inserts a lubricated and glove finger into the rectum for prostate examination.
Ultrasound: Performing a tran-srectal ultrasound to evaluate any abnormality in the prostate gland.
Biopsy: Collection of prostate tissue samples to determine the presence of malignant cells.
Advancements in diagnostic procedures
For the last two-and-a-half decades, determining the level of prostate-specific antigen and trans-rectal ultrasound-guided prostate biopsy (TRUS-Bx) has been the standard diagnostic procedure. However, the new advanced technology for diagnosing prostate cancer combines three techniques. These are Magnetic Resonance Imaging, Transperineal Biopsy, and Transrectal ultrasound. The technology is known as Transperineal MRI-TRUS Fusion Biopsy. Simultaneous implementation of these technologies offers a plethora of advantages. The benefits of these techniques include less risk of infection, high specificity and sensitivity, 95-97% accuracy, and avoiding unnecessary biopsies. This diagnostic technique will be helpful for those who are suspected of having prostate cancer. It is also effective for diagnosing prostate cancer in diabetic and elderly patients and patients with anal and rectal diseases. Low-grade early prostate cancer patients considered for active surveillance may also undergo this advanced procedure.