Prostate Cancer: Types, Causes, Symptoms, Diagnosis Treatment, Cost & Recovery

The prostate gland is a small walnut-shaped organ in men that produces seminal fluid. It is in this organ that prostate cancer occurs. Prostate cancer is a relatively common type of cancer that grows slowly. They are also largely confined to the prostate gland and are, in most cases, harmless. While some types of prostate cancer require minimal or no medical intervention, some types can be aggressive.

When detected early, and with the cancer’s presence restricted to the prostate gland, it represents the best chance for the patient to recover. This is because when caught early, the treatment’s effectiveness increases. Routine screening is a handy tool for doctors to detect prostate cancer before it spreads.

Prostate cancer results from abnormal cells forming and growing within the prostate gland and can be rather distinctive in comparison with other kinds of cancers. Any symptoms related to this type of cancer may not reveal themselves in the form of symptoms or related complications for years to come. This is because tumors growing in the prostate gland do not spread as quickly to other body parts as with other forms of cancer. 

Even if the cancer spreads, the prognosis is often good even individuals with advanced stages of prostate cancer can go on to live their lives with their quality of life and good health intact. A vital part of this is to observe and monitor the growth and take corrective action accordingly. Based on the tumor’s growth, your doctor will chart out the ideal treatment options for you.  

Not all abnormal growths are malignant or cancerous. Some tumors may even be benign and hence are usually localized.

• Benign growths, such as benign prostatic hyperplasia (BPH), are not life-threatening and do not spread to nearby tissue or other body parts. Benign growths can be taken out and are unlikely to grow back.  
• Malignant growths may metastasize or spread to other organs in the vicinity. Even if the tumor is removed, it can grow back. Prostate cancer may end up as life-threatening if it spreads beyond the prostate and into the bladder or rectum. 

Symptoms of Prostate Cancer to Keep an Eye On:

In its initial stages, prostate cancer may not manifest itself in the form of symptoms. The symptoms that betray the fact that cancer has reached an advanced stage are:

• Trouble with passing urine.
• Any weakness in the urine flow. 
• Pain or a burning sensation that may accompany urination
• Presence of blood in the urine and the semen.
• Constant pain in the lower back, pelvis, or hips.
• Sudden loss of appetite. 
• Unexplained weight loss.
• Erectile dysfunction.

Grades and Stages of Prostate Cancer:

The Gleason score and cancer staging are two methods healthcare providers use to determine the extent of cancer and the course of treatment to follow.

The Gleason score helps the provider to understand how abnormal your cancer cells are. The greater the number of abnormal cells, the higher the Gleason score. It is used as a benchmark to grade cancer or its potential to turn aggressive. 

Cancer staging is for determining how advanced or widespread your cancer is. It may be local, regional, or spread beyond the immediate area. 

There are four stages of prostate cancer.

• Early-stage – Stages 1 & 2: The tumor remains contained within the prostate in this stage. This is referred to as “early-stage” or “localized” prostate cancer. 
• Locally Advanced Stage – Stage 3: Should cancer get to stage three, it means that it has now spread outside the prostate, but only to nearby tissues. This stage is called “locally advanced prostate cancer.”
• Advanced Stage – Stage 4: At stage 4, cancer will have expanded outside the prostate gland to include other areas such as the lymph nodes, bones, liver, or lungs. This stage is labeled as “advanced prostate cancer.”

Process of diagnosing prostate cancer:

When done regularly, screenings are a reliable way to detect early signs of prostate cancer. Should you fall into the average risk category, the best time to begin regular screening is at age 55. If you are in a high-risk group, it may be recommended to commence screenings earlier. These checks usually stop after age seventy. 

You may need to undergo additional procedures if screenings detect any signs of prostate cancer. The typical screening methods adopted are:

• Digital rectal exam: Your doctor performs a rectal examination which involves physically feeling your prostate gland. Any bumps or hard areas found could mean cancer. 
• Prostate-specific antigen (PSA) blood test: The prostate gland releases a protein known as protein-specific antigen or PSA. Elevated PSA levels could be an indication of cancer. These levels may rise even if you have benign conditions such as BPH or prostatitis. Prostatitis is a swelling of the prostate gland, often due to bacterial infections.

Procedure for Determining the Extent of Prostate Cancer

Once a diagnosis of prostate cancer has been confirmed, the doctor moves to determine the extent of the tumor. If the doctor suspects it may have gone beyond the vicinity of the prostate gland, imaging tests will help identify the scale to which the cancer may have spread.  

• Bone scan.
• Ultrasound.
• Computerized tomography scan. (CT scan). 
• Magnetic resonance imaging (MRI scan).
• Positron emission tomography (PET scan). 

There are three ways for cancer to circulate in the body. 

• Into nearby tissues. 
• Via the lymph nodes from where it rides through the lymph vessels to the other parts of the body. 
• It gets into the blood and blood vessels, allowing the cancerous cells to access the rest of the body. 

Should the tests reveal prostate cancer, your treatment plan will depend on the following:

• What stage and grade the cancer is?
• Whether the cancer is low, intermediate, or high-risk. 
• Your age and health considerations.
• Preferences regarding potential side effects and long-term 
• Your choices about side effects and long-term effects of the treatment procedure.
• Outcomes from the diagnostic tests undergone.

Once a treatment plan has been chosen, you may, with the doctor’s guidance, do your best to prepare for the necessary therapy. Ensure intake of healthy food and conform to a well-balanced diet. Strive to exercise regularly, and avoid smoking and alcohol. All of this will help you to beat back the tumor better. 

Here are some treatment options available to you for combating the cancer:

Keeping An Eye on the Cancer:

• Active Surveillance: Choosing active surveillance requires regular screenings, scans, and biopsies at regular intervals ranging from one to three years to monitor cancer’s growth. This option works best only if there is a slow progression of cancer and it isn’t manifesting itself with any symptoms. 

The tests to help track the tumor’s growth are a blood test to check your Prostate-specific antigen (PSA) levels, a biopsy, and if needed, an MRI scan. 

In some instances, there is no medical intervention required. If there is a spike in PSA levels and a biopsy shows growth of the cancer, then it would be time to consider options such as surgery or radiation therapy. 

• Watchful waiting: Watchful waiting is tracking cancer but not treating it and is marked by the absence of any surveillance of the tumor. The main risk with watchful waiting is that the cancer could spread between visits to the doctor. 

This approach is resorted to when the patient is older or has existing health issues likely to hinder recovery from surgery or radiation therapy. Also, testing is much less frequent. Instead of eliminating the tumor, treatments usually focus on managing symptoms.

Surgery:

The surgical removal of the tumor is known as a radical prostatectomy. In this procedure, the prostate, seminal vesicles, and affected tissue are surgically taken out. The lymph nodes in the pelvis surrounding the prostate gland are also removed. The procedure is performed under anesthesia and requires a short stay at the hospital. 

There are three types of radical prostatectomy surgery:

• Robotic Assisted Laparoscopic Radical Prostatectomy (RALP): In the RALP procedure, five tiny incisions are made in the lower abdomen through which instruments and a small camera are guided and give the surgeon access to remove the prostate.   
• Retropubic Open Radical Prostatectomy: The surgeon makes an incision in the lower belly through which they will remove the prostate. 
• Perineal Open Radical Prostatectomy: In this procedure, the surgeon takes out the prostate through an opening between the anus and scrotum. 

Radiation therapy:

Radiation therapy (also called radiotherapy) uses high doses of radiation to kill cancer cells and shrink tumors. This is a good option for early-stage prostate cancer. Radiation therapy works as a standalone treatment or in combination with other treatments, such as hormone therapy.

Radiation therapy kills or slows the growth of cancer cells by damaging their DNA. Once the DNA of the cancer cells is damaged beyond repair, they stop dividing and die. Rather than eliminating cancer cells immediately, radiotherapy can take weeks to rid the body of cancerous cells. 

There are two kinds of radiation therapy:

• External beam radiation therapy: External beam radiation therapy (EBRT) targets only the cancer location and not the entire body. This minimizes the risk to healthy tissue and allows a high dose of radiation to reach the prostate tumor.

Radiation is delivered in small quantities daily to the prostate over several weeks. Steps are taken to limit radiation spilling over to the healthy organs surrounding the cancerous tissue. 

• Internal radiation therapy: Also known as Brachytherapy, in this method, the patient’s body is irradiated from within. The surgeon makes use of imaging scans such as an ultrasound or computed tomography to guide the placement of the radioactive substance close to the prostate gland. 

Systemic therapies:

You may need to consider systemic therapies as an option if cancer spreads out of the prostate gland. Systemic therapies are termed as such because they can affect the entire body, including the healthy and cancerous cells alike. 

• Hormone therapy: As the hormone testosterone is known to increase the growth of cancer cells, hormone therapy relies on medication to inhibit this hormone’s role in fueling cancerous growth. The medicines prevent testosterone from reaching cancer cells or reducing testosterone levels. 
• Chemotherapy: Chemotherapy or chemo is a drug-based treatment using powerful chemicals to kill cancerous cells in your body. Chemotherapy attacks all cells in the body, both cancerous and non-cancerous, and is ideal for tackling this condition, as cancer cells can multiply rapidly.
• Immunotherapy: Immunotherapy works on strengthening your immune system to enable it to target cancer cells better. This procedure can be used to treat cancer in its advanced stages, or that recurs. 
• Targeted therapy: Targeted therapy relies on drugs to target cells with genetic mutations that convert healthy cells into cancerous cells so they do not multiply out of control. The targeted drug therapy destroys cells with the BRCA gene as these produce proteins that repair damaged DNA, including those in cancerous cells.

Why Prostate Cancer Occurs:

The exact causes of prostate cancer are unknown. What researchers do know is that there are certain contributing factors to the disease. These are outlined below:

• Age: As men age, there is an increased risk of getting prostate cancer. Regular cancer screening is recommended for men aged fifty and above.
• Ethnicity: Ethnicity plays a vital role in the appearance of prostate cancer. It primarily affects African American men, with one in six affected by it. Asians and Hispanics are less likely to contract cancer.
• Family History: If there is a history of cancer in the family, with the individual developing prostate cancer by sixty, it increases your risk of developing it. Having a close female relative who contracted breast cancer may also play a role in you contracting prostate cancer. 
• Weight: While no link between obesity and the onset of prostate cancer seems to exist, being overweight may increases the chances of cancer developing into an aggressive form that may be harder to contain and survive. 

Prostate Cancer Precautions:

Having a healthy diet that is low in fat and includes fruits and vegetables could help keep cancer at bay. Regular exercise also lowers the risk of cancer by boosting your immunity and warding off health problems. 

Even in the case of men at a greater risk of developing cancer due to age, genetics, or race can minimize their chances of developing prostate cancer by altering their lifestyle to embrace a healthier one. 

● Draw up a healthy diet chart:

A low-fat diet helps reduce the risk of prostate cancer. Some examples of foods rich in fat are red meat, nuts, oil, and dairy products.

● Keep an eye on the waistline: 

Men with a body mass index (BMI) of over 30 runs the risk of being diagnosed with prostate cancer. To reduce the chances of cancer, work on shedding those extra kilos. Your body will thank you. Reduce calorie intake in tandem with increasing the amount of exercise you do. 

•   Increase Vitamin D intake:

Vitamin D can help protect against prostate cancer. Some foods rich in Vitamin D are cod liver oil, wild salmon, and dried shitake mushrooms. The sun is the best and readily available source of Vitamin D. Experts recommend getting at least ten minutes of sun exposure every day.

Prostate Cancer Prognosis:

If affected by prostate cancer, your prognosis depends on how it has spread and your overall health. Screening techniques and advancements in the technology used to treat tumors have improved the outlook for prostate cancer patients. 

With doctors being able to detect cases of prostate cancer early, as it tends to grow slowly and prescribe treatment effectively, the survival rate for this form of cancer is nearly 100% if the tumor is localized and 30% if the cancer is widespread. As it currently stands, the survival rate over 5 years is 98%.

As living with this condition can impact your quality of life and mental health, be sure to adopt strategies to help you cope. Some of these would be:

• Reaching out and seeking the support of family and friends.
• Reaching out to a mental health professional.
• Seeking out support groups for cancer survivors.

Who Needs Prostate Cancer Treatment

Treatment for prostate cancer may not be required in every case, as it is cancer that tends to grow slowly, or in some cases, treatment may not be advisable due to various considerations. 

However, in certain situations, opting for the treatment advocated by the doctors is recommended. These include.

• Locally advanced prostate cancer: Cancer cells spread beyond the prostate gland and warrant treatment as they may spread further, complicating efforts at containing them. As it is still confined to the nearby tissues, treatment would not be as comprehensive if widespread. Treatment options for this stage of tumor include radiation or hormone therapy, or even a combination of both. 
• Metastatic prostate cancer: Should prostate cancer spread to other parts of the body, it is called metastatic prostate cancer. It commonly spreads through the bones and lymph nodes. The tumor metastasizes when the cells in the tumor break away and move through the lymphatic system or the bloodstream to reach other areas of the body. 

Treatment for metastatic prostate cancer is similar to the locally advanced variety. In addition to radiation and hormone therapy, it also uses chemotherapy, targeted therapy, and immunotherapy. Depending on the situation surgery can help alleviate symptoms or address any specific complications depending on the situation. 

• Symptomatic cancer: The presence of the tumor may lead to symptoms such as frequent urination, presence of blood in the urine, weakened flow of urine, body pain, etc. In such a scenario, it is necessary to draw up a treatment for relieving the patient of the symptoms to improve the quality of life. 

Any potential treatment for prostate cancer has to be tweaked to suit the individual concerned. Any regimen is linked to factors including the patient’s age, health condition when undergoing treatment, and the recommendations of the healthcare professionals in charge. 

Therefore it is vital to keep the healthcare team in the loop while deciding the best way to move forward and come up with the best treatment plan tailormade keeping the patient in mind. 

Prostate Cancer Treatment in India:

The treatment for prostate cancer treatment in India, along with complying with international standards, also provides plenty of alternatives based on the severity of the condition. Here are some valid selling points in favor of undergoing prostate cancer treatment in India:

• Well-qualified medical professionals: India is home to well-qualified and skilled oncologists and other specialists involved in treating all kinds of cancers. They are backed by years of experience and knowledge gained from reputed institutions, both at home and overseas. 
• Affordable healthcare: Healthcare costs that will not burn a hole in your pocket when seeking cancer treatment is a significant factor making India an ideal destination for medical tourism. The treatment costs are also inexpensive compared to the patient’s home country. 
• Hospital infrastructure: Hospitals in major Indian cities, such as Delhi, Mumbai, Chennai, and Bangalore, have in place hospitals well equipped with advanced diagnostic and treatment facilities. They are fully capable of ensuring comprehensive care for prostate cancer patients.

Prostate Cancer Treatment Cost in India:

The average cost of prostate cancer treatment in India ranges from one to nine lakhs. This amount can be broken up into individual factors contributing to the overall cost.

• Pre-treatment costs include X-Rays, Ultrasound, CT scan, PET CT, prostate biopsy, etc. 
• Type and stage of cancer, along with the treatment option to be used.
• Follow-up sessions post-discharge.
• Cost of medicines and any post-treatment measures.

Break-up Cost of Individual Procedures:

• Cost of prostate biopsy: Prostate biopsy is a diagnostic procedure that helps determine the presence of cancer cells, if any. The cost of undergoing a biopsy can vary from 8,000 to 25,000 rupees, depending on the kind of biopsy and which medical facility the procedure is being performed.  
• Cost of prostate cancer radiation therapy: The two most common treatments for prostate cancer are external beam radiation therapy and brachytherapy. If external beam radiation therapy is needed, the amount can vary from rupees two to five lakh rupees. Brachytherapy, in which radioactive seeds are implanted into the prostate gland, can cost three to eight lakhs rupees. 
• Cost of prostate laser surgery: Prostate laser surgery, also known as laser ablation, is a minimally invasive surgical procedure. It is ideally used for treating benign prostatic hyperplasia (BPH) or localized prostate cancer. How much it costs depends on the surgeon’s expertise and the hospital of choice. Generally, it varies from one and a half to four and a half lakh rupees. 
• Cost of hormone therapy: Hormone therapy is best suited for advanced prostate cancer cases. Hormone therapy can cost the patient anything from rupees ten to thirty thousand every month. The treatment duration depends on how well the individual responds to the therapy and what stage the cancer is at. 

Top 10 best Prostate Cancer Treatment hospitals in India 

It can be a daunting task to decide where to pursue and how to locate the best Prostate Cancer Treatment hospital in India. But this is a situation that can be easily avoided. To help you, here is a list of hospitals that will help make your decision a little easier. Do check on details such as accessibility and patient reviews before narrowing down on a hospital.

Top 10 best Prostate Cancer Treatment Doctors in India

Picking a doctor who will be with you as you heal from prostate cancer can be termed more significant than choosing a hospital. When considering a doctor, evaluate your rapport with them, but also trust your instincts and follow through with it.

Below is a list of some of the best doctors for prostate cancer treatment in India.