Non Surgical Treatment of Prostate
Cancer In New Delhi, India
Dr Vijayant Govinda Gupta is a Urologist in New Delhi, India. He is a specialist in the diagnosis and treatment of Prostate Cancer. He surgically manages prostate cancer. Read further for more information on Prostate Cancer Treatment in New Delhi, India. We will also discuss TRUS guided prostate biopsy in this article.
Dr VG Gupta authored this article. He is a full member of the European Association of Urology and Urological Society of India. He is an ex member of the American Urological Association. All information is current as on publication date. Prostate cancer is a worrisome diagnosis. Prostate cancer symptoms are non specific and make the diagnosis more difficult. Prostate biopsy is the only way to definitively diagnose the condition. In this article we discuss prostate cancer treatment and biopsy.
What Is Prostate Cancer?
Prostate is an apple shaped sex organ, situated between the bladder and the urine pipe. Prostate is a sex organ, it produces fluid throughout life that makes a mans semen white and liquid. But, with age this gland can develop prostate cancer in it. Prostate cancer is a cancer of age. With increasing age, the chances of a man developing cancer of prostate increases. It is one of those rare cancers that has found to have no defined risk factors. Till today, no proof of any predisposing factor has been found. Still avoiding smoking, moderate alcohol intake, preventing sexually transmitted diseases, eating a balanced diet and maintaining a healthy weight are good for general health, but whether these steps will prevent prostate cancer are debatable.
What Is a Digital Rectal Exam for Detecting Prostate Cancer?
The prostate can be felt by the doctor when he puts his finger through your anus (ass-hole), where he can feel its size, shape and areas of hardness that are suggestive of cancer. This is called a digital rectal examination or a DRE.
Symptoms of Prostate Cancer
Prostate cancer is a thief. It will slowly creep on an it will rarely produce symptoms. In India, where routine health checkups are rare, Indian patients present late for treatment. Usually when symptoms are full blown. Prostate cancer symptoms are –
- Urinary complaints – Frequency (going again and again), Urgency (Have to go feeling) Nocturia (getting up at night to urinate more than once or twice) Poor stream (Thin stream of urine/less pressure) Itermittency (stop start of flow).
- Hematuria – Blood in urine – bleeding is usually less, mixed with urine, may pass a few clots or pieces, usually bleeding occurs once or twice.
- Bowel alteration – Difficulty in passing stools, constipation
- New onset bony pain – Pain in back, hips, lower legs that is present all through the day
The difficult part is that most prostate cancer patients will never have symptoms and will actually get a diagnosis during workup for other diseases.
Is Prostate Cancer Treatable?
A lot of myths abound regarding prostate cancer. One thing I wish to stress in the beginning, prostate cancer is completely treatable. In New Delhi India the full treatment options for prostate cancer management are available. Even in advanced prostate cancer, several newer treatments exist and patients can hope to live long healthy lives if managed correctly. Diagnosing and treating prostate cancer lies squarely in the domain of a urologist. He is the leader of the multi disciplinary team which includes an oncologist, radiation oncologist and a pathologist.
Prostate cancer is a long term disease with patients living for many decades with their disease. During this period patients would require management of their urine, sexual problems, complications of treatment and bleeding in urine. A urologist is trained to manage all these problems. Also as members of prestigious associations, a urologist is the most updated person to manage your care. Diagnosis of prostate cancer is based on the following modalities-
- Digital Rectal Examination
- Prostate Biopsy
- MRI
- Serum PSA – a blood test that helps in diagnosis
Trus Guided Prostate Biopsy In New Delhi India
The only way to definitively treat prostate cancer is to do a prostate biopsy first.
Prostate biopsy is usually done under local anaesthesia. It is usually painless. The most you would feel is a small sting when the needle is fired. It is a day care procedure, and the patient can usually go home the same day after a few hours. The patient is made to lie down on his side with knees touching the belly and asked to relax. Liberal jelly is placed in the back passage and a probe is passed through.
This step is completely painless. Then the doctor proceeds to administer local anesthesia and after this the procedure becomes very comfortable. Using a needle under trans rectal ultrasound guidance the urologist takes 12 cores or 12 samples from the entire prostate. The biopsy is then processed by a pathologist and the report is back after 2 days. There are usually no complications. Minor bleeding, fever, pain may occur in some patients. But, they are easily managed. The prostate biopsy report will contain the following essential information
- Number of cores positive for cancer
- Gleason score – it varies from 6 to 10 and indicates aggressiveness of the cancer
- Supplementary information like perineural invasion and lymphovascular invasion etc
Some times, your biopsy may come out negative, but other clinical isgns such as serum PSA may remain elevated. In these circumstances you would require more advanced prostate biopsy techniques. These include MRI fusion prostate biopsy or may require close observation.
Prostate Biopsy Cost In Delhi
Prostate Biopsy Cost by TRUS guided ultrasound in New Delhi India is 35000 INR in Local Anesthesia (600 USD) or 50000 INR in General Anesthesia (1000 USD)
Why Is Prostate Cancer on The Rise In India?
Prostate cancer is a rising problem in urban populations, especially in Indian cities like Delhi and Gurgaon. These cities are seeing a rapid increase in population. And with it, its residents are having to face this dreaded problem. Prostate cancer is eminently treatable. If caught early, it is completely curable and long term survival is the norm. But, prostate cancer is also an enigma of treatment paradigm. It requires very very careful and nuanced workup by a qualified urologist with significant experience in diagnosis of prostate cancer.
The Treatment Options for Prostate Cancer In New Delhi India
- Curative Surgery – Radical Prostatectomy
- Non Curative Surgery (Palliative) – DJ stenting / TUR Channeling / Orchidectomy
- Radiation therapy
- Medical Therapy – Hormonal Therapy
- Immunotherapy
Non Surgical Treatment Options For Prostate Cancer
If your prostate cancer has spread beyond your gland, and spread to your nodes or bones, then unfortunately you are not a candidate for surgery. Prostate cancer growth is driven by the male hormone – testosterone. This hormone is produced in your testis (balls, nuts). So, if we remove the testis, then the hormone production dies, and the cancer comes in control. The procedure to remove the male testis is called an orchidectomy and it is a simple painless daycare procedure where you can go home the same day. If you wish for cosmesis, a artificial testis can be placed in the same sitting.
There exists other prostate cancer treatments and therapies which may provide benefit in patients not willing or ineligible for conventional gold standard treatments.
Radiotherapy After TUR Channeling
If you choose radiotherapy, be aware that you should get IMRT and 3D RT. In this the radiotherapy is focused only on the prostate and prevent long term problems. But radiotherapy can make your follow up difficult, makes biopsy impossible and makes detection of residual cancer difficult. It will also not cure you, and make curative surgery very very difficult.
HIFU – High Frequency Ultrasound
A new modality, with limited results, it may be of benefit in some patients. But, you require careful evaluation by a urologist before proceeding to this modality. If you are eligible for HIFU, you are most likely to be benefited by radical prostatectomy.
