Prostate Cancer Screening: What You Need to Know?

Prostate cancer is a common type of cancer affecting the male population, particularly those above the age of 50. It has a higher chance of getting completely treated when detected early. The 5-year survival rate in case of prostate cancer is about 64% in India. A study revealed that patients who underwent surgery for prostate cancer had a 15-year survival rate of over 91%. These findings highlight the actual importance of awareness and prevention of prostate cancer through regular screening and timely diagnosis.

Regular screenings of the prostate gland can help detect prostate cancer early. Males above the age of 50 are encouraged to discuss the pros & cons of prostate cancer screening with a qualified oncologist. Before screening is performed, the oncologists may review the patient’s risk factors. Prostate cancer screening tests may demonstrate the need for further investigation through additional testing.

When is Screening for Prostate Cancer Necessary?

Most prostate cancers are slow-growing, which provides enough time to be diagnosed before the cancer has proliferated beyond the prostate. However, prostate cancer screening may be beneficial for people with certain risk factors.

Screening of the prostate gland for the presence of cancerous tumours or growths can be extremely beneficial in developing treatment plans to prevent its growth or spread. Since most prostate cancers grow slowly, watchful waiting may be recommended by oncologists.

Nevertheless, it is advisable to consider starting screening for prostate cancer if there is one or more of the following risk factors:

• Aged over 50 years
• Family history of prostate cancer
• Certain genetic factors like having Lynch syndrome and inheriting specific mutated genes associated with breast cancer
• Obesity may be a factor in causing more aggressive prostate cancer than people who are not obese

While the above risk factors can increase the likelihood of developing prostate cancer, they are not definitive. Having these risk factors doesn’t cause prostate cancer, most definitely, but it may put emphasis on taking regular screening tests.

Prostate Cancer Screening: What Are They?

• Digital Rectal Examination (DRE): It is the primary screening exam performed by an oncologist, which involves inserting a lubricated & gloved finger inside the rectum to reach and examine the prostate gland. The prostate gland is situated adjacent to the rectum. If the oncologist discovers any abnormalities in texture, shape, or size, they may prompt further examination and evaluation.
• Prostate-Specific Antigen (PSA) test: This is a blood test exclusively required for obtaining a qualitative assessment of a protein specific to the prostate gland known as Protein-Specific Antigen (PSA). A marked elevation of the PSA levels in the blood may be indicative of prostate cancer. Elevation in PSA levels may also occur due to benign conditions like prostatitis and benign prostatic hyperplasia, which may also prompt a deeper investigation of the prostate gland. 

Identifying Prostate Cancer

Some patients may not require a definitive diagnosis if the cancer is in its early stages. However, significant abnormality during screening tests may prompt further examination to confirm the presence of cancer. These tests may help in the process of confirming a cancer diagnosis.

• A transrectal ultrasound scan to obtain visuals of the prostate gland
• An MRI scan in addition to an ultrasound or to assist in a biopsy
• A biopsy of the prostate gland by retrieving a sample of tissue from the gland and analysing it in a laboratory to determine the presence of cancerous cells

Cancer Staging

Upon finding cancerous cells in the prostate gland, oncologists may need to determine the level of aggressiveness through a laboratory examination of the tissue sample from the prostate gland. This is essential to understand whether prostate cancer requires treatment. Based on its findings, oncologists may also devise a treatment plan for each patient.

• Gleason Score

The Gleason score provides an idea of abnormality in the cancer cells. The higher the score, the greater the abnormality. This helps understand the grade of cancer and how aggressive it is.

• Staging Prostate Cancer

Cancer staging helps understand how far the cancer has spread.

Management & Treatment of Prostate Cancer

How prostate cancer would be treated may depend upon a number of factors, including the overall health condition of the concerned patient, their ability to tolerate different modes of cancer treatment, and how far the cancer has spread. A team of oncologists, along with radiologists, urologists, and other medical specialists, work together to devise a customised treatment plan for each patient.

If the cancer is in its early stages, doctors might recommend active surveillance to monitor the condition instead of applying any treatment if the cancer is progressing slowly. Screening tests, imaging scans, and biopsies may be employed on a regular basis. Doctors may focus on managing symptoms rather than eliminating the tumour.

Surgery

If the cancer is found to be more pervasive or the prostate gland has become diseased but hasn’t spread yet, a radical prostatectomy may help remove the prostate gland along with a portion of the surrounding tissues and a few lymph nodes to ensure no cancerous cells are left. This procedure may be accomplished in different ways, such as open surgery, laparoscopic surgery, or robot-assisted laparoscopic surgery.

Additional Treatments

Other cancer treatment modalities may offer preventive measures to control the spread of cancer as well as for symptom relief. These measures may include:

• Radiation Therapy

This treatment involves using radiation to destroy cancerous cells or prevent them from growing. Radiation therapy for early-stage prostate cancer may be provided by:

• External radiation therapy: This involves using a machine to deliver radiation from the outside. It is often performed under computer guidance to target a specific area and minimise the risk of irradiation to healthy tissues.
• Internal radiation therapy: Also known as Brachytherapy, this method involves implanting radioactive seeds near the prostate through imaging guidance.
• Chemotherapy

Chemotherapy is a common cancer treatment using special chemotherapy drugs to help stop the growth of cancer cells.

• Hormone Therapy

This method involves blocking or reducing specific androgens which have been identified to help spread cancerous cells.

• Immunotherapy

In immunotherapy, the body’s own immune system is empowered to help fight cancer. This is achieved by using specific substances created in a laboratory to boost or restore the body’s natural defence mechanism against cancer.

• Targeted therapy

Targeted therapy involves using drugs or other substances that identify and destroy specific cancer cells around the body.

Advanced Prostate Cancer Screening at Apollo Hospitals, Karnataka

Cancer screening is the most important step of prostate gland cancer identification and treatment. At Apollo Hospitals, Karnataka, we are dedicated to providing comprehensive, patient-centric healthcare and treatment for cancer in patients of all age groups. Our medical team of widely recognised and extensively experienced medical and surgical oncologists advocate regular screening of the prostate gland for early diagnosis and treatment of prostate cancer and regularly engage in patient education focusing on the importance of cancer screening.

We offer the most advanced therapies backed by cutting-edge technology to target and treat various forms and stages of cancer with a high rate of success to provide a better quality of life to our patients.