Latest Advances For Combating Prostate Cancer In Preliminary Stages

Annually nearly thirty-five thousand men are detected with prostate cancer in the United Kingdom and more than ten thousand face fatalities due to the disease. The disease is known to affect the small gland that fits around the urethra and is responsible for the production of seminal fluid.

Being treated early plays a decisive role. Nearly 98% of men that are detected with the cancer that has not metastasized beyond the gland could have a life expectancy rate of 5 years and more. This survival rate plummets to 30% when the cancer has metastasized.

The diagnostic and treatment options for prostate cancer in its initial stages are stated below.

• Active Surveillance

Active Surveillance generally translates to getting a PSA test done. The PSA test is conducted for checking any rise in the levels of special markers present in the blood known as PSA or prostate specific antigens. This test is conducted at a 3-monthly interval for a span of 2 years, after which the test is done at a 6-monthly interval.

These patients would additionally be undergoing a routine DRE or Digital Rectal Examination during which the doctor would palpate the prostate using a finger for checking any kind of changes.

This is the sole alternative left for elderly men whose life expectancy is presupposed to be no more than a decade. Such patients would be having a tumor that has a below 5 Gleason score (low score). The Gleason score is employed for the measurement of belligerence of the cancer from the tissue sample taken.

Pros: In several prostate cancer cases, the disease could have slow progression and be asymptomatic. Hence, these men having prostate cancer would not require treatment on an urgent basis.

Cons: There is bound to be soaring apprehensions among such patients who might be sensing that their cancer is not being directly dealt with. The surveillance could additionally skip the detection of cancers that could abruptly take a more belligerent stand.

• Photodynamic Therapy

A special drug has to be consumed by the patient that is receptive to light and is activated solely when a beam of laser is directed at it. The drug gets absorbed by the malignant cells and get annihilated by a laser beam directed on them through a pliable tube inserted rectally. This therapy has been in the trial stages since seven years, but is still solely obtainable on restricted basis via the NHS.

Pros: This therapy obliterates cancer cells with pin-point accuracy and does not need the entire prostate to be removed.
This non-invading therapy lasting for merely thirty minutes lowers side effects like ED (Erectile dysfunction) and enuresis. Another positive aspect about this therapy is no scarring occurring at the location where the affected normal tissues re-grow.

Cons: It is not extensively obtainable and there is dearth of any big-sized follow-up prostate cancer trials. As the entire prostate is not removed, hence there is likelihood of the cancer relapsing.

• Radical Prostatectomy

In this prevalent operative procedure, the prostate gland is totally removed by employing open surgery or keyhole techniques. During open surgery, the surgeon makes a small slit at the base of the abdomen.

Pros: Optimal outcome with more than ninety percent prospects of being able to further avail a decade of premium life subsequent to surgery and several of whom get cured.

Cons: Several cases of long-standing issues like enuresis and erectile dysfunction have been noted in men that have undergone open surgery. Analogous side effects have been observed following keyhole surgery, however, with lesser scars and shorter hospitalisation needed.

• Robotic Radical Prostatectomy

This is the gold standard operative procedure for total removal of the prostate employing keyhole technique wherein a robot accurately mimics every movement of the surgeon. This line of treatment is usually chosen by men in the young age bracket having preliminary stage cancer and do not desire their sex drive or potency to be affected in any way.

Pros: Robotic surgery is gaining immense popularity due to its 2 positive aspects, namely, greater precision and sparing of the vital nerves located behind the prostate gland that are responsible for controlling enuresis and erectile function.

The stomach cavity is distended by the use of carbon-dioxide by increasing the pressure within for creation of a tent-similar space to conduct the further procedure. The elevated pressure within the tent in comparison to the surroundings is intended to restrict blood loss.

This surgery has proven effectiveness of seventy percent in averting impotency among elderly men below seventy years of age which surpasses the efficacy rate derived from standard radical prostatectomies wherein nearly sixty percent of patients face impotency subsequently.

Cons: With a merely eighteen robots being available in the United Kingdom in NHS hospitals, and several more in the pipeline, hence the procedure is not commonly obtainable. Done privately, the patient would need to shell out nearly ten thousand pounds for the operative procedure.

• Computerised EBRT

EBRT or external beam radiotherapy is the commonly used prostate cancer treatment among men in the United Kingdom for annihilating cancer cells restricted to a local region employing high-intensity, focused X-rays.

Pros: High accuracy, no requirement of hospitalization due to outpatient procedure, and provides analogous results as that observed with radical prostatectomy.

Cons: Few might sense burning during urination for some time subsequent to the procedure while there are others who face erectile dysfunction problems.

• Computerised Brachytherapy

This procedure is offered in elevated and low dosages wherein radiation sources are planted inside the body either within or in close proximity to the tumor in the prostate.
During low-dose brachytherapy, radiation-emitting capsules or seeds are introduced within the tumor that continues emitting low-power radiations lasting up to months on end.
During elevated-dose brachytherapy conducted under general anesthesia, fine tubes are inserted into the prostate with the assistance of computers for guiding the doctors through the procedure.

Pros: Brief hospitalization – a day’s time – and swift recuperation. Minimal harm is done to the urethra, bladder and rectum during the procedure that is commonly available.

Cons: Not ideal in case of prostate enlargement. Several men sense intense inflammation in that spot and there might be constriction at the narrow part of the bladder.

• High Intensity Focused Ultrasound or HIFU

In this rather new-fangled line of treatment, the cancer cells are scorched employing high frequency ultrasound waves that are directed on the malignant cells in the prostrate by a probe introduced rectally. The adjacent normal tissues are shielded with the assistance of a balloon inundated with water intended for cooling purposes.

Pros: Could prove effectual treatment for treating prostate cancer restricted to particular area, much like surgery or radiotherapy.

Cons: Long-standing enuresis and erectile dysfunction. Least-invasive keyhole surgery has analogous side-effects, but with minimal scars being incurred and brief hospitalization. However, this procedure is not commonly obtainable.

• Cryotherapy

The treatment involves the freeze-killing of the cancer cells. Specialized probes known as cryoprobes are introduced via the perineum within the prostate through which Argon gas is passed for freezing the cancerous prostate tissues.

Pros: It could assist in retaining potency and could prove as effectual as surgery or radiotherapy in treatment of prostate cancer restricted locally.

Cons: Not commonly obtainable and the patient might be needed to shell out thousands in pounds to get privately treated. As total obliteration of cancerous growth might not happen, hence the patient might need to get the treatment done once more.
Long standing outcome is still unclear and the patient might need to choose between retaining potency or to go in for restorative treatment.