In 2030, the worldwide burden of prostate cancer is expected to rise to 1.7 million new cases and 4,99,000 new deaths simply due to population growth and ageing as prostate cancer has become a major health problem in industrialized world during the last decades of the 21st century, contributing to 3/4th of the registered cases across the globe. Prostate cancer is the second most common cancer in the world and the sixth leading cause of cancer death among men globally.
Prostate cancer is the most common cancer in elderly men above the age of 65 to 70 years old and approximately four lakh males die from the disease every year due to prostate cancer. It is estimated that one in four to five males above the age of 70 develop prostate cancer, so the incidence is always on the rise however, with greater detection method greater awareness, the early stage diseases are detected more commonly as compared to late stage diseases.
Hence, the mortality rate in prostate cancer is very less with an almost 98% 10-year survival. Longer life expectancy in males has led to an increased incidence of prostate cancer in the community.
In an interview with HT Lifestyle, Dr TB Yuvaraja, Head Robotic Surgery and Consultant Surgical Uro Oncology at Kokilaben Dhirubhai Ambani Hospital in Mumbai, said, “In the past, it was thought that prostate cancer prevalence in India was far lower than in western countries but with the increasing migration of rural people to urban areas, changing lifestyles, increasing awareness, and easy access to medical facilities, more cases of prostate cancer are being diagnosed, and it is becoming increasingly apparent that our prostate cancer rate is not too far behind western countries.”
He added, “In recent years, indication for genetic testing in prostate cancer have expanded from patients with a family history of prostate cancer to those with advanced castration-resistant disease, and even to early prostate cancer patients for determination of the appropriateness of active surveillance. Inherited genetic mutation can significantly increase the risk for prostate cancer, may be associated with aggressive disease and poorer outcomes, and can have hereditary cancer implications for men and their families. Germline genetic testing is strongly recommended for patients with advanced/metastatic Prostate cancer, particularly given the impact on targeted therapy selection.”
The health expert asserted, “Our ultimate goal is to prevent men from developing prostate cancer in the first place. In recent decades, metastatic prostate cancer has undergone significant improvements in terms of treatment. It’s certainly an encouraging time for prostate cancer with all the new therapeutic options that are emerging. Nevertheless, if the present trends continue, this disease can become a far greater public health problem.”
Early Detection Signs:
According to Dr Preetam Kumar Jain, Senior Consultant Oncologist and Hematologist at Masina Hospital in Mumbai, screening is the process of detecting cancer in people before they develop symptoms. He suggested, “Screening can help detect cancers at an earlier stage, when they are more likely to be treatable. If in case the discovery of prostate cancer is because of screening, it can be that it can be an earlier stage which in turn may be more treatable. However, note that there still may be issues revolving around screening process even if it might appear to imply that Prostate Cancer screening is always beneficial. Thus, it is unclear of whether the benefits of the screening process outweigh the risks for most men.”
Bringing her expertise to the same, Dr Santoshi Nagaonkar, Director Urology, Director Urological Oncology and Director of Robotic Surgery at Sir HN Reliance Foundation Hospital in Mumbai, said, “The most frequent form of cancer among men is prostate cancer. As people get older, this cancer occurs more frequently. Stages 1 and 2 are theoretically curable at this point, however Stages 3 and 4 are advanced (non-curative). The PSA blood test is used to diagnose this cancer. The same blood test is used to check on individuals who have already received treatment.”
He insisted, “It goes without saying that the PSA blood test, a visit to the urologist, and any additional radiological scans on the doctor’s advice would be included in the follow-up assessment together with the PSA blood test. Prostate cancer in its Initial stages, may not show much symptoms.” As per him, the early signs of prostate cancer can include the following:
1. An inability to urinate.
2. A slow, irregular urine flow
Causes:
Dr Preetam Kumar Jain explained, “Prostate cancers are very common after the age of 70 due to major hormonal changes in the body. The emergence of Dihydrotestosterone in the body is a very strong precursor to much development of prostate cancer. The elderly age, patients who have prostate cancer nowadays are also more prone to get detected early due to increase a greater incidence of benign hypertrophy or prostate which later gets detected as cancer as well as screening and other methods that are being used. Due to this, in some of the rates or results are much better, with majority of the people surviving for long periods of time.”
Dr Santoshi Nagaonkar said, “In the post-Covid period, several patients experienced delayed diagnosis, which led to the presentation of multiple individuals with advanced disease. Additionally, those who were undergoing any type of treatment, including radiation, hormone, or chemotherapy, had their medical care delayed since Covid patients were given precedence. Shorter PSA doubling times (sub 3 months) indicated an aggressive form of the disease and required more regular PSA testing in cancer patients.”
Prevention Tips:
Dr Preetam Kumar Jain highlighted, “There is no assured way to avoid prostate cancer. Many risk factors, including age, race, and family history, are uncontrollable. However, there are some things you can do to reduce your risk of prostate cancer. Avoiding cancer risk factors may aid in the prevention of certain cancers. Obesity, lifestyle choices like smoking, excessive alcohol consumption and not exercising are all probable risk factors. Increasing protective factors like quitting smoking and exercising may also aid in the prevention of some cancers.”
He added, “There is no definitely method to reduce the risk of prostate cancer. Certain risk factors are irreversible such as age, personal history, family history and genetic susceptibility. However, there are studies that reversible risk factors when controlled can help in reducing the risk of prostate cancers.” Some of them are as follows:
1. Healthy lifestyle
2. Regular exercise, like 20 minutes a day, 5 days a week
3. Avoid Obesity
4. Maintain Body mass index
5. Diets rich in fruits and vegetables
6. Diets rich in antioxidants
7. Diets decrease in high dairy products and calcium content
8. Avoid diet containing red and processed meats..
9. Some studies say that drugs that inhibit 5 alpha reductase inhibitors and aspirin ,may reduce the reduce the risk of prostate cancer and it’s mortality.. However, they are not FDA recommended as of now.
10. Identifying early symptoms of prostate related problem can make you alert. Symptoms like frequent micturition, incomplete voiding of urine, nocturia, could be possible signs of prostate related problems
11. If you have a family history of prostate cancer, then the subsequent generation members are at a risk of prostate cancer, atleast a decade Earlier. Knowing this genetic susceptibility, you may have to remain alert as your age advances.
12. New genetic studies are in the pipeline for better understanding of the prostate cancer. Mutation analysis like BRCA and HRR testing are now being recommended in patient with prostate cancer.
Dr Santoshi Nagaonkar highlighted, “Prostate cancer progresses among all malignancies comparatively more slowly. Therefore, periodic PSA evaluation is part of the usual evaluation that is performed with a three-month interval for patients who have finished their treatment (surgical removal) or patients undergoing any type of treatment (hormone or chemotherapy).”
Sharing his expert advice, he suggested the following prevention tips –
1. Keep an Ideal Weight: Obesity can increase the aggressiveness of prostate cancer. In general, shedding pounds and keeping them off as you age can help reduce your chance of cancer and a host of other illnesses.
2. Consistent Exercise: In addition to supporting you in achieving a healthy weight, exercise can help battle some of the harmful health impacts of a sedentary lifestyle, reduce inflammation, and boost immune function.
