Aashray urology institute

Carcinoma Prostate

Overview
Carcinoma prostate or cancer of the prostate is the type of cancer that develops into the prostate gland. At Aashray, we provide the latest procedures and treatments to treat cancer of the prostate and produce successful results. 
Prostate_cancer_banner
Quick Links

What Is Prostate?

The prostate is a small and walnut-shaped gland found in men that is located next to the bladder, that is, in the pelvis. It produces semen and prostatic fluid which nourishes and transports the sperm.

Prostate

What Is Carcinoma Prostate ?

Carcinoma Prostate, also known as Prostate Cancer or Cancer of the Prostate, is a type of cancer that is developed in the prostate gland. However, it is important to understand that not all growths observed in the prostate are carcinogenic. The growths can be benign (not cancer) like BPH or malignant (cancer) that is prostate cancer. 

  1. Benign growths in the prostate do not spread to the other parts of the body, can be removed easily, and do not grow back usually; hence, benign growths are harmless and not a threat. 
  2. As opposed to benign growths, malignant or carcinogenic growth could be considered as a threat sometimes as they can detach themselves from the prostate tumor, spread easily via blood vessels or lymph nodes to nearby tissues, organs, and other parts of the body where they attach themselves to grow and form new tumors and cause damage. These growths can be removed; however, they can grow back sometimes. 
Carcinoma Prostate

What Are The Symptoms Of Carcinoma Prostate ?

During the initial stages of prostate cancer, often there are no symptoms but in some cases, cancer can cause symptoms that may feel similar to those of BPH or Prostate Enlargement. 

However, one can always opt for screening to detect the symptoms or changes to indicate cancer as the levels of PSA in the blood are measured during the screening and high levels of the same may indicate the presence of cancer.  

The symptoms of prostate cancer can be as follow: 

  1. Pain in the lower pelvic area, lower back, hips, or upper thighs
  2. Bone pain or bone fracture
  3. Frequent urge to urinate
  4. Facing problems like trouble starting and maintaining urination, pain, burning sensations, weak urine flow while urinating
  5. Blood in the urine or semen
  6. Painful ejaculation
  7. Trouble getting and maintaining an erection
  8. Tiredness and loss of appetite and weight

What Are The Risk Factors For Carcinoma Prostate ?

Dr. Ashit Shah, the chief urologist at Aashray Urology Institute, has listed down risk factors for prostate cancer and they are as follow:

Age

Family History

Smoking, diet, and Exercise  

What To Expect During Health Checkup ?

Screening

  • As mentioned before, screening tests are done to detect symptoms of prostate cancer, the tests include - the prostate-specific antigen (PSA) blood test and digital rectal examination (DRE). Screening means testing for a disease even if you have no symptoms. These tests can be done to detect cancer in its early stages but these tests are not perfect as abnormal results could also be an indication of other diseases or infection.
PSA Test

Prostate Biopsy

  • It is a minor surgery and the sure way of checking if one has prostate cancer. After taking your risk factors and the results of PSA and DRE tests into consideration, you will be suggested to undergo a prostate biopsy. For a prostate biopsy, an ultrasound probe is used to look at the prostate and guide the biopsy. During the biopsy, all the necessary details about the prostate are noted and a small piece of the same is removed to examine it. This small piece is then carefully observed and examined for cancer cells. 

If cancer cells are found, the grade and risk of cancer will be determined.

Prostate biopsy

Imaging Scans

What Are The Grades Or Stages Of Carcinoma Prostate ?

Grading

The grade is a measure to decide the severity of the cancer cells and other factors dependent on it like their growth rate, spread etc. 

Most commonly Gleason grading system is used to grade the tissues between 3 to 5 for prostate cancer. 

  1. If the grade is less than 3, it means the tissue is close to normal. 
  2. If the grade is 3, then it is a slow-growing tumor.
  3. If the grade is 5, then it’s a highly aggressive, high-risk form of prostate cancer.
Gleason grading system

Staging

Staging describes the location of cancer, its size, if it has started spreading etc. Prostate cancer is also measured in tumor stages. Staging the cancer is done by DRE and special imaging studies. These staging imaging tests are generally done for men with a Gleason grade of 7 or higher and a PSA higher than 10. 

Stages Of Carcinoma Prostate

What Are The Treatment Options For Carcinoma Prostate ?

There is a range of options for prostate cancer and factors like grade & stage of cancer, risk level, age, health, treatment goals etc. play a major role while deciding the right treatment for you. 

Treatment Choices For Low-Risk Prostate Cancer

  1. For low-risk cancer and men who do not have symptoms, active surveillance is the best option. It is not an active treatment wherein prostate cancer is treated. In active surveillance, regular follow-up blood tests, rectal exams, and prostate biopsies are performed to monitor the progression of your cancer. During active surveillance, actions like therapy or surgery are taken only when the risk level is increasing, cancer is spreading to other parts, or growing dangerously.  
  2. Another treatment is watchful waiting. In this treatment, prostate cancer is not actively treated but only monitored without any actions. This option is the right choice for people of advanced age, who have serious illnesses, or who cannot or don’t want to go through cancer treatments due to side effects & other such factors. 

Both these options come with no side effects, complications, or risks that are associated with other treatment options such as surgery and therapies. However, these options do have the risk of the cancer growing or spreading during the follow-up visits which may make it harder to treat over time. 


Surgery

1. Robot-Assisted Laparoscopic Prostatectomy (RALP)

2. Retropubic Open Radical Prostatectomy


3. Pelvic Lymphadenectomy

4. Transurethral resection of the prostate (TURP)

  • In this procedure, a resectoscope (a thin, lighted tube with a cutting tool) is inserted through the urethra to remove tissue/s from the prostate. This surgical procedure is done to relieve symptoms caused by a tumor before another cancer treatment is given. TURP is also suggested to men whose prostate cancer hasn't spread and are not eligible to have a radical prostatectomy.
Transurethral--resection-of-the-prostate

What To Expect After The Surgery ?

Surgical options are a good choice if cancer hasn’t spread beyond the prostate. In the case of radical prostatectomy, the main advantage is that the prostate with cancer is removed without any side effects and blood loss. Surgery also helps the doctor to understand your case better and plan further treatment if necessary.  

What Are The Risks And Side-Effects Associated With Surgical Options ?

Like any other major surgery, the risks of infection and bleeding may occur. Some people may experience complications right after the surgery whereas some people may encounter those later. For surgery, the side-effects may be as follow: 

  1. Erectile dysfunction (note - sexual desire is not lost post-surgery)
  2. Urinary incontinence 
  3. Urine leakage when coughing, laughing, sneezing, or exercising
  4. Overactive bladder
  5. Inability to control urine
  6. Impotence
  7. Shortening of the penis (the exact reason for this is not known.)
  8. Inguinal Hernia

Please note that these risks and side effects are uncommon and will not occur in one patient. The utmost care and preventive measures are taken at Aashray Urology Institute to avoid the occurrence of risks and complications. 

Radiation Therapy

1. External Beam Radiation Therapy (EBRT)

  1. There are two types of beams involved in radiation therapy - photon beams and proton beams. In the first type of EBRT. photon beams are used. Photon beams makeup traditional x-rays that carry low radiation charge and can scatter nearby health tissue which may cause side effects. However, with the help of the latest equipment, it is possible to receive EBRT treatment without causing damage to nearby healthy tissue. 
  2. In the second type, proton beams are used in EBRT. proton beams have more charge and heavy mass and can target deep tissue. High-energy protons can travel deeper into body tissue than low-energy photons. With proton beams, radiation can be directed to the specific site. So, the radiation does not go beyond the tumor and does not cause any damage to nearby healthy tissue.

2. Brachytherapy

  1. In the low dose rate brachytherapy or LDR, radiation is contained into rice-sized seeds which are then inserted into the prostate with the help of a thin needle. The seeds deliver a low dose of radiation over a long period of time to kill nearby cancer cells. In LDR, the seeds are left in the prostate even after treatment is finished.
  2. In the high dose rate or HDR brachytherapy, a thin catheter is placed inside the prostate with the help of a hollow needle. As it’s high-dose radiation treatment, the catheter stays in your prostate for a short period of time and is removed once the treatment is done. 
Radiation Therapy

What Are The Side-Effects Of Radiation Therapy ?

Radiation therapy is less invasive than surgery and be it external or internal, it is a good option for early-stage cancer. The main side effects of radiation therapy are as follow:

  1. Urinary incontinence
  2. Erectile dysfunction
  3. Impotence 
  4. Bowel problems 
  5. Tiredness 
  6. Increased risk of bladder and/or gastrointestinal cancer.

Cryotherapy

Cryotherapy or cryoablation involves controlled freezing of the prostate tissue. During cryotherapy, firstly, the prostate is imaged and measured and cryoprobes (special needles) are inserted into the prostate guided by the ultrasound for the freezing process. The freezing is done by using a very cold gas under anesthesia. The tissue is allowed to thaw and the procedure is repeated again and again until the cycles of freezing and thawing kill the cancer cells and some surrounding healthy tissue. This procedure is a good option for those who have small as well as advanced levels of prostate cancer and cannot receive surgery or radiation therapy due to health issues. 

What Are The Risks And Side-Effects Of Cryotherapy?

  1. Urinary incontinence 
  2. Bowel Problems
  3. Erectile Dysfunction
  4. Risk of fistula
  5. diarrhea  
  6. bladder infections
Cryotherapy
Cryotherapy

Focal Therapy

The types of focal therapy are as follow: 

High-intensity focused ultrasound (HIFU)

High-intensity focused ultrasound (HIFU) treatment involves heating the prostate with the help of ultrasound or high-energy sound waves to kill or destroy the cancer cells. 

Focal Cryoablation

This procedure involves destroying the tumor by freezing it. It is done by using a needle-thin probe to circle the tumor with a special solution which then kills the cancer cells. 

Irreversible Electroporation:

In this treatment, a “Nanoknife” is used to pass an electrical current through the tumor. The electricity creates very tiny openings (called pores) in the tumor's cells, leading to cell death.


Focal therapy is a good option for those who have a small tumor that has not spread beyond the prostate. The term focal therapy is used for different treatments that kill small tumors within the prostate without damaging nearby healthy tissue and the prostate.

Hormone Therapy   

Prostate cancer cells use the hormone testosterone to grow and hormone therapy treatment, also known as androgen deprivation therapy (ADT), stops the body from producing the same. Once the supply of testosterone is cut off, it is easier to kill or slow down the growth of cancer cells. Hormone therapy or ADT either with the help of drugs or surgically blocks or lowers the testosterone and starves prostate cancer cells. This therapy is used to treat advanced prostate cancer to shrink cancer and slow its growth.

Medications:

In this type of ADT, certain medications known as luteinizing hormone-releasing hormone (LHRH) or gonadotropin-releasing hormone (GnRH) agonists and antagonists — prevent the body's cells from making testosterone. As a result, your testicles stop producing testosterone.

Surgery

This surgery is performed to remove the testicles and glands that produce testosterone. Removal of testicles reduces testosterone levels in the body sharply. However, it is permanent and irreversible. 

hormone-therapy

What Are The Risks And Side-Effects Associated With Hormone Therapy?      

The following are the risks and side-effects associated with hormone therapy or ADT -   

  1. Heart disease
  2. Diabetes
  3. Nausea
  4. Loss of bone
  5. Hot flashes
  6. Fatigue
  7. Itching
  8. Loss of sexual drive 
  9. Impaired sexual function    

Please note that the mentioned risks are uncommon and will not occur on one patient. The utmost care and preventive measures are taken at Aashray Urology Institute to avoid the occurrence of any risks and complications. 

Chemotherapy 

This is a treatment for advanced-stage cancer. It is used to treat cancer that has spread to the other parts of the body. Chemotherapy is a cancer treatment that uses drugs to kill the rapidly growing other non-carcinogenic as well as cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form, or both. This way drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).  

Dose to reduce the side effects this may cause. Often, chemotherapy is used with other treatments. It is not the main treatment for prostate cancer patients.

What Are The Side-Effects Of Chemotherapy?

To reduce the side effects of chemotherapy, dose and frequency are carefully controlled. The side effects of this treatment depend on the drug, the dose, and how long the treatment lasts. The most common side effects are as follow:

  1. Fatigue  
  2. Nausea  
  3. Vomiting 
  4. Diarrhea  
  5. Hair loss  
  6. A change in your sense of taste and touch is also possible
  7. There is an increased risk of infections and anemia because of lower blood cell counts.

Immunotherapy

This is a type of biological therapy. In immunotherapy, the immunity system of one’s body is used to fight cancer. The cancer cells produce proteins that help them hide from immune system cells; hence, the immune system does/may not attack cancer cells. This therapy interferes with this process as substances made by the body or in the laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. 

Prostate cancer immunotherapy can involve:

Sipuleucel-T (Provenge) Treatment

In this type immune cells produced by the body are taken to the laboratory and are engineered to fight prostate cancer and injected back into the body. It's an option for treating advanced prostate cancer that no longer responds to hormone therapy.

Drugs

During this type of treatment, drugs are prescribed that help the immune system identify cancer cells and attack them. This is also an option for treating advanced prostate cancers that no longer respond to hormone therapy.

Book Appointment

If you have any questions or doubts about any Carcinoma Prostate treatment or any other treatment available at Aashray Urology Institute, book a consultation with Dr. Ashit Shah and he will expertly guide you on the same.
Book Appointment
Dr. Ashit Shah

Dr. Ashit Shah

Meet the doctor

Dr. Ashit Shah

MB, MS, DNB(Urology), DLU(France)

Dr. Ashit Shah

Dr. Ashit Shah

Dr. Ashit Shah is a senior consultant Urologist heading Aashray Urology Institute. After completing his M.B.B.S. and M.S. in General Surgery, he was awarded Diplomate of National Board (D.N.B.) in Genito-Urinary Surgery by the National Board of Examinations, New Delhi. He earned his Diplomate in Laparoscopic Urology from Louis Pasteur University, Strasbourg, France in the year 2006. Dr. Shah has a special interest in Endo-Urology, especially Urolithiasis i.e. Urinary Stone Disease. Having spent more than 27 years in the profession of Urology, he has experience of over 75,000 urological consultations and more than 15,000 surgeries. Being counted amongst the torch bearers of ethical and transparent medical practice in the city of Vadodara, he was conferred ‘Inspiring Urologist Award’ for the year 2019 by The Economic Times.

Insurance Partners

To see the complete list of our insurance partners, click here.
cigna logo
aegon life logo
cigna logo
apollo-munich logo
edelweiss
hdfc-life
max-health-insurance
bharti -logo
future-general
liberty-general
tokio-iffco-tokio-general-insurance
Heritage Health(TPA) Pvt.Ltd.