Prostate cancer is caused by malignant growth inside the prostate, most often in the peripheral area. Prostate cancer is the most frequent tumor of the male, although due to its slow growth, it is the third cause of death by cancer, behind those of lung and digestive. So, early detection and proper prostate cancer treatment in Delhi can minimize the mortality rate.
Between 30 and 40% of males 50 to 80 years old can have prostate cancer without clinical symptoms (latent). In these cases, only a prostate revision will diagnose these cancers.
The frequency of prostate cancers increases with age and this cancer is more frequent in men with parents or siblings who have had prostate cancer.
Prostate cancer usually grows slowly. Cell changes can start 10 or 20 years before the tumor is large enough to give symptoms. Sometimes prostate cancer can cause distant spread (metastasis).
BPH is not related to prostate cancer and does not increase the risk of prostate cancer, but nevertheless the clinical symptoms of BPH and cancer can be very similar.
What are the symptoms of prostate cancer?
Prostate cancer develops in the peripheral zone of the prostate and usually produces no symptoms or produces them very late when it has already grown considerably. Only one in nine men with prostate cancer present clinical symptoms and able to start initial prostate cancer treatment in Noida.
In addition, the clinical manifestations of prostate cancer are very similar to those of BPH and the clinic can not differentiate between cancer and benign growth.
When prostate cancer has spread outside the prostate, especially to the bones, it causes bone pain.
Prostate cancer is not found if it is not sought since it only produces symptoms when it is very advanced. Dr. Shailendra Goel recommends that all men over fifty years of age review their prostate ( prostate check) annually to rule out the presence of prostate cancer.
Remember that a prostate cancer treatment in Ghaziabad in an initial (localized) stage can be cured.
What factors favor prostate cancer?
- First, age: Prostate cancer usually occurs after age 50 and its frequency increases with age.
- Family history: males with a father or siblings who have suffered prostate cancer have a threefold higher risk. If there are 3 affected males in the same family, the risk is 10 times higher. If family members who have had prostate cancer have had it at a young age (45, 50, 60 years), the risk of prostate cancer is higher for males in the family.
- Race: African-Americans have the highest risk of prostate cancer. Below are the whites and Hispanics. Asians have the least risk of prostate cancer.
- Food: Prostate cancer is more common in men with a high-fat diet. The deficit of Vitamin D favors the appearance of prostate cancer.
Who can I go to check my prostate?
The doctor who specializes in prostate problems is the urologist in Ghaziabad. At Max Hospital, we are specialists in Integral Health of the Male and we carry out a personalized study adapted to the needs of each patient.
In men older than 45 years, in the comprehensive review, we value:
- Whether or not there is prostate cancer
- If the growth is benign, what clinical symptoms it produces in the patient and if prostate cancer treatment in Delhi is necessary
- How the prostate affects sexuality
- How the erection works
- The level of sexual desire
What is a revision of the prostate?
The revision or prostate check is simple but must be done well, in a personalized way and in a confidential environment.
It is mandatory to carry out a good clinical history by an experienced urologist in Noida, dedicating the necessary time for the patient to tell us all their prostate, sexual problems, etc … The clinical history must be completed with a good physical examination of the kidneys, abdomen, bladder, testicles and especially the prostate.
The realization of a digital rectal examination allows us to assess the size of the prostate and detect if there are hard nodules suggestive of cancer. This digital rectal examination does not have to be annoying if the best urologist in Ghaziabad does it with care and without haste.
Also, the basic review of the prostate should include analysis of blood by determining PSA (Prostate-Specific Antigen) and creatinine (kidney function) and a urinalysis.
In certain patients, it may be advisable to perform other tests: Nuclear Magnetic Resonance (MRI) of the prostate, Select Mdx study in urine, ultrasound, flowmetry, voiding residue, etc. The best urologist in Noida must decide which patients need these tests.
How to differentiate between a benign growth and prostate cancer?
The initial diagnosis will be based on the determination of the PSA (specific prostate antigen) and a Rectal Touch made by an expert urologist in Greater Noida.
PSA is a more prostate-specific marker than cancer-specific, which makes it imperfect. For example, PSA may be elevated in patients without prostate cancer, but who have a large prostate with benign prostatic hyperplasia, or in patients with prostatitis or urine infection.
There are no “magic” levels of Total PSA that allow us to ensure that a man is not at risk of developing prostate cancer. In general, we consider normal a total PSA figure below 4 ng/ml, but PSA levels should be assessed individually and other factors analyzed (age, family history, digital rectal examination, prostate size).
In addition to the total PSA, we have a fraction called free PSA that allows us to calculate the quotient that results from dividing the free PSA by the total PSA. The higher the free PSA / total PSA ratio the more likely it is for benign growth (HBP). Conversely, when the free PSA is low and the total PSA is high (free PSA ratio / low total PSA) the greater the probability of prostate cancer.
In doubtful cases, we can assess the b(as it has been increasing over time) and the so-called PSA density(it consists of dividing the PSA by the volume of the prostate.
We also have more specialized tests: Multiparametric Nuclear Magnetic Resonance (RMN-mp) of the prostate, the urinal biomarker SelectMdx and the 4Kscore test.
A well-performed Nuclear Magnetic Resonance (MRI-mp) (expert radiologist) can detect the presence of suspicious areas of prostate cancer (PIRADS 4, PIRADS 5) and in these cases, an MRI-ultrasound fusion biopsy should be considered.
The MDx Select Test is performed in the urine emitted after a prostate massage. In this urine, two tumor bio-markers are determined (HOXC6 and DLX1). In the MDx Select Test, the results of these biomarkers are combined with clinical parameters (age, total PSA, prostate volume, digital rectal examination and family history of CaP) and it offers us a score that allows us to select the men with the highest risk of suffering high-grade prostate cancer.
Finally, in patients with suspected prostate cancer (elevated PSA, suspicious digital rectal examination, MRI with suspicious areas of prostate cancer, the definitive test that confirms the presence of prostate cancer is a prostate biopsy.
What is a prostate biopsy?
It consists of obtaining small samples of the prostate (puncturing with a fine needle) and analyzing them under a microscope (pathologist) to know precisely if prostate growth is benign or there are malignant cells (prostate cancer).
There are two techniques to perform a prostate biopsy:
- B transrectal ultrasound-guided biopsy (classic)
Guided by the ultrasound we puncture the prostate through the rectum to take 12 to 18 small fragments of different areas of the prostate. The echographic image does not distinguish areas suspected of cancer. With this classic technique, a mapping of the prostate is performed, but prostate cancer may exist in non-biopsied areas.
- Perineal biopsy guided by MRI fusion and ultrasound.
A prostate MRI is performed initially and if suspicious areas are detected, the patient is offered a prostate biopsy guided by magnetic resonance imaging.
The perineal biopsy guided by Fusion NMR-ECO offers us much more accurate information about the suspicious areas of prostate cancer that we must biopsy. The 59% of men who had previously had 2 or more biopsies and had negative results (biopsies with the classic technique), when performing a perineal biopsy guided by fusion were diagnosed with cancer.
In patients with suspected prostate cancer (elevated PSA, suspicious digital rectal examination) we recommend performing a prostate MRI and if there are suspicious areas we perform a perineal biopsy guided by MRI fusion and ultrasound. If the MRI scan is normal in many cases, a prostate biopsy can be avoided. In certain patients, we perform the Mdx Select Test.
Is it important to know if prostatic growth is benign or malignant?
It is vital, very important. If there is malignant growth (cancer) and it is diagnosed in the early stage (localized), it can be adequately treated with excellent results.
If cancer has already grown outside the prostate (disseminated), it can be controlled but not cured.
On the other hand, if the growth is benign, we can indicate a prostate cancer treatment in Noida to improve your voiding symptoms.
How often should I check myself?
All men over 45 years old should consult their urologist in Vaishali once a year.
In men with a family history of prostate cancer and vasectomized prostatic revision should begin at 40 years.
Can a benign growth be malignant?
Benign hyperplasia is a growth of the central part of the prostate. However, around this hyperplasia, there is still peripheral prostate tissue and a Ca P may develop.
BPH is not related to prostate cancer and does not increase the risk of prostate cancer. Some men with BPH may develop prostate cancer. However, as the symptoms are very similar it is important to make a differential diagnosis as we have just described.
How is prostate cancer treated?
The definitive diagnosis of prostate cancer is made by biopsy.
Transrectal biopsy guided by ultrasound (classical technique) informs us of the presence of cancer and the degree of malignancy. The perineal biopsy guided by Fusion also indicates the exact location of cancer and tells us if there is cancer in one or more areas.
Subsequently, a simple study must be performed to determine if it is inside the prostate (localized cancer) or has spread outside (disseminated cancer). In localized prostate cancer there are five types of treatments:
- Active surveillance. It is considered in low-risk prostate cancers. Periodic controls are performed and if it progresses radical surgery is performed.
- Focal Treatment: This focal therapy allows prostate cancer treatment in Ghaziabad -eliminating only the area of the prostate where the cancer is. It is a breakthrough because it allows the prostate to be preserved and has very few complications. To be able to offer a Focal Treatment we need to have an MRI and a Fusion Biopsy that accurately tells us where the cancer is and assures us that there is no cancer in other areas of the prostate. The prostate cancer treatment in Delhi is done with sedation. Guided by the fusion of NMR and ultrasound, through the perineum several needles are introduced to the cancerous area and by applying different techniques (cryotherapy, electroporation, HIFU) we can selectively eliminate the cancerous area and a margin of safety. At 2 hours after finishing the treatment, the patient goes home.
- Brachytherapy Through ultrasound and through the perineum, radioactive seeds are injected into the prostate to destroy the prostate tumor. It is usually applied in patients with low-risk cancers.
- External radiotherapy. Localized radiation therapy is administered to the prostate in order to kill the tumor cells. It requires 35 sessions of radiotherapy and usually presents adverse effects (rectitis, diarrhea, worsening of the clinical voiding, urgency, difficulty to urinate). The long-term results are good but require periodic checks.
- Radical Prostatectomy (Laparoscopic, Open, Robotic). The 3 techniques pursue the same, completely remove the prostate and seminal vesicles. It offers good results but is more aggressive and has a greater number of complications (incontinence, erectile dysfunction, etc …)
At Max Hospital, we value all the data (patient characteristics, PSA, MRI, the result of prostate biopsy), explain to the patient the techniques that allow curing their cancer and the advantages and adverse effects of each one of them. they. With all the data on the tables, the patient chooses the treatment that best suits their circumstances.