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PROSTATE SURGERY
Prostate cancer is a disease in which cancer develops in the prostate, a gland in the male reproductive system. Prostate cancer may not cause any signs or symptoms, especially in the early stages. Symptoms are more likely to appear as the cancer grows. If you have any of these symptoms, don't ignore them. See your doctor. You may need to have some tests to help find out what is causing them. Most enlargements of the prostate are not cancer Prostate cancer may cause following symptoms as it grows:
  • Need to urinate often, especially at night.
  • Difficulty in starting or stopping the urine flow.
  • Dribbling after you finish urinating.
  • Frequent urination, especially at night.
  • Blood or pus in the urine.
  • A sense of incompletely emptying the bladder.
  • Pain while urinating.
  • Pain with ejaculation.
  • Hip and lower back pain that does not go away over time.
  • Pain in the lower part of your pelvis.
  • Unintended weight loss and/or loss of appetite.

Diagnosis

When a man has symptoms of prostate cancer, or a screening test indicates an increased risk for cancer, more invasive evaluation is offered. To confirm the diagnosis, your doctor will arrange special tests. These tests may also be used to "stage" and "grade" the cancer. You may have one or more of the following tests.

Blood Tests
Your blood may be tested for a substance called prostate-specific antigen (PSA). If you have an enlarged prostate, the amount of PSA in your blood may be slightly higher than normal. Prostate cancer usually causes even higher levels of PSA in the blood than an enlarged prostate does. If your PSA level is higher than expected for your age, more tests will be done to find out whether this is because of prostate cancer or another prostate problem.

Imaging studies
Imaging studies allow tissues, organs and bones to be looked at in more detail. Using x-rays, ultrasounds, CT scans, MRIs or bone scans, your healthcare team can get a picture of the size of the tumour and see if it has spread.

Biopsy
The only test which can fully confirm the diagnosis of prostate cancer is a biopsy, the removal of small pieces of the prostate for microscopic examination. However, prior to a biopsy, several other tools may be used to gather more information about the prostate and the urinary tract. Cystoscopy shows the urinary tract from inside the bladder, using a thin, flexible camera tube inserted down the urethra. Transrectal ultrasonography creates a picture of the prostate using sound waves from a probe in the rectum.

Treatment for Prostate Cancer

Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, chemotherapy, cryosurgery, hormonal therapy, or some combination. Which option is best depends on the stage of the disease, the Gleason score, and the PSA level. Other important factors are the man's age, his general health, and his feelings about potential treatments and their possible side effects. Because all treatments can have significant side effects, such as erectile dysfunction and urinary incontinence, treatment discussions often focus on balancing the goals of therapy with the risks of lifestyle alterations. The selection of treatment options may be a complex decision involving many factors. For example, radical prostatectomy after primary radiation failure is a very technically challenging surgery and may not be an option. This may enter into the treatment decision.

Surgery
Surgical removal of the prostate, or prostatectomy, is a common treatment either for early stage prostate cancer,or for cancer which has failed to respond to radiation therapy. The most common type is radical retropubic prostatectomy, when the surgeon removes the prostate through an abdominal incision. Another type is radical perineal prostatectomy, when the surgeon removes the prostate through an incision in the perineum, the skin between the scrotum and anus. Radical prostatectomy can also be performed laparoscopically, through a series of small (1cm) incisions in the abdomen, with or without the assistance of a surgical robot. A decision to have surgery depends on the stage and grade of the cancer, your general health and your PSA level. During the operation, the entire prostate will be removed. This is called a prostatectomy. Some nearby tissue may also be affected by the surgery. Surgery is done under general anesthetic and you may stay in the hospital for several days after the surgery.

Radiation Therapy
Radiation therapy, also known as radiotherapy, is often used to treat all stages of prostate cancer, or when surgery fails. Two different kinds of radiation therapy are used in prostate cancer treatment: external beam radiation therapy and brachytherapy. In radiation therapy, a large machine is used to carefully aim a beam of radiation at the prostate. The radiation damages the cells in the path of the beam – normal cells as well as cancer cells. In brachytherapy, or internal radiation therapy, radioactive beads or seeds are placed directly into or near the prostate.

Hormonal Therapy
Hormonal therapy is a treatment that removes or blocks hormones and stops cancer cells from growing. Hormonal therapy uses medications or surgery to block prostate cancer cells from getting dihydrotestosterone (DHT), a hormone produced in the prostate and required for the growth and spread of most prostate cancer cells. Hormonal therapy is usually used when cancer has spread from the prostate. It may also be given to certain men undergoing radiation therapy or surgery to help prevent return of their cancer.

Chemotherapy
Chemotherapy drugs interfere with the ability of cancer cells to grow and spread, but they also damage healthy cells. Chemotherapy is not used to treat cancer of the prostate in the early stages of the disease.

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