Monday, April 5, 2010

Pin down that prostate problem

Recently, a 75-year old retired Air Force officer contacted me. The Bengaluru-based gentleman said he had a “good ten years left in me”. But he had been harbouring prostate cancer for the last five years and had been advised to leave it alone since it was slow growing. Alarmed, I asked him to rush to Hyderabad for further investigations, only to discover that the cancer had spread to his bones and abdomen. Unfortunately, even today the most common myth about prostate cancer is that since it’s slow growing, it is relatively harmless. However, this is not true. Changes in attitude, lifestyle and advances in medical technology have revolutionised the ageing process and men are leading active lifestyles well into their nineties. The Air Force officer once had a prostate cancer that was curable but his doctor had the wrong attitude. The cancer could end his life “prematurely”. Prostate cancer is most common in middle-aged men. Early detection is possible by a blood test called PSA (prostate specific antigen). PSA is a protein released specifically by the prostate gland into the blood stream. Basically, whenever there is an abnormal activity in the prostate gland, be it enlargement, infection or cancer, the prostate weeps in the form of PSA into the blood stream. If the PSA in the blood rises above 4 ng/ml then a prostate biopsy is essential to confirm the diagnosis. Very rarely the cancer can present as a bump in the prostate and therefore the PSA testing has to be combined by examination of the gland by a urologist. In the early stages, prostate cancer is normally without symptoms. Therefore, conducting a regular blood test for PSA and examination by a urologist should be routine for all men over the age of 50. When the disease is advanced, prostate cancer can cause difficulty in urination, infection and blood in urine. Till recently doctors were reluctant to offer treatment because of the side effects the treatment can cause. Any treatment given can affect both potency and the muscles that control urination. Laparoscopic robotic surgery and sophistication in radiation technology have minimised the complications and side effects and there is no reason why patients should not undergo a treatment to cure the prostate cancer. Recently, a new technique called HIFU (high intensity focused ultrasound) has been introduced in India. This uses high intensity ultrasound waves to destroy the cancerous gland. Since it is a nonsurgical procedure and does not involve radiation it avoids the trauma of surgery and side effects, thereby preserving the quality of life. Since the procedure is least traumatic it can be used on patients with heart ailments, diabetes and blood pressure. In conclusion, prostate cancer can be detected early by a blood test and examination by an urologist. It is advisable that men after the age of 50 should have a yearly prostate check even if they have no complaints. If cancer is detected early, can be cured by non-radiation and non-surgical proceduress.

The writer is the CEO of
Dr Ramayya’s Urology
Nephrology Institute and Hospitals

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