Recently we lost a renowned musician Rashid Khan to Prostate cancer at a very young age of 55 years. Survival rates are actually better compared to other cancers as it spreads slowly in the body. If prostate cancer is diagnosed early, the survival rates are better. It is a challenge only if spread to other distant organs. Generally believed to be a cancer affecting elderly males beyond the age of 60 years, the incidence of prostate cancer in younger men is worryingly increasing. Importantly, younger the age, more aggressive is the cancer and tends to present with advanced stages and variant or rare histologies. In clinical practice, men between the ages of 45-60 are being regularly diagnosed with prostate cancer. One of the reasons may be linked to changing lifestyles and more consumption of saturated fats. Another may also be increased testing and awareness. The patients are usually diagnosed with PSA screening blood tests or during evaluation for other symptoms or urinary symptoms.
Prostate cancer ranks among the prevalent forms of cancer. Numerous prostate cancers progress slowly and remain localized within the prostate gland, often posing minimal risk. However, certain variations of prostate cancer exhibit aggressive growth patterns and have the potential to metastasise rapidly. The age of onset for prostate cancer is lowering, with younger men now being diagnosed with a more aggressive form of the cancer. Possible reasons for this trend include lifestyle factors, genetics, and increased availability of the PSA test. In India, the death rate of prostate cancer is high compared to the US.
Early detection of prostate cancer, while it remains localised within the prostate gland, significantly enhances treatment success rates. This underscores the importance of timely screening and diagnosis for effective management. Some of the factors that increase the risk of Prostate cancer are Old age, family history, obesity and lifestyle. People with older age have a higher risk of Prostate cancer compared to the young. A family history of genes or blood relatives diagnosed or people who are obese are at high risk of getting it.
A prostate biopsy is done to confirm the presence, type, and aggressiveness of the cancer. Staging is done with an MRI scan or Pet CT scan. The stage determines the form of treatment offered. The most common type of prostate cancer is adenocarcinoma, which can be completely cured in more than 95 percent of patients.
The treatment is usually surgery using an open, laparoscopic, or robotic approach. Or radiation to the prostate. If there is an unusual pathological type or advanced stages, more types of treatments need to be added, including chemotherapy, androgen deprivation or hormone therapy, bone-strengthening agents, etc. In advanced stages, the chance of cure remains low, and the control of the cancer takes precedence. This is why early diagnosis is vital.
The most important way to diagnose cancer early is to do a simple blood test called a prostate-specific antigen (PSA) blood test. It is advised to undergo the test once a year, from the age of 50 years. If there is a family history of prostate cancer, it is wise to start testing from 45 years of age.
Though a frightening prospect, prostate cancer is often very slow-growing, and cure rates are extremely high with the right treatment and timely intervention. Public awareness is vital to the fight against prostate cancer.
(The author, Dr. Vishruth K Raj, is a Consultant Urologist and Uro-oncologist, at Aster RV Hospital.)
