Prostate cancer in its early stages is usually not accompanied by any noticeable symptoms. As the cancer grows, however, it begins to put more pressure on the urethra, and will then begin to cause a variety of symptoms especially affecting the lower urinary tract. For example, more frequent urination (especially at night); pain or burning sensation while urinating; urinary retention (an inability to fully empty the bladder); difficulty in starting, maintaining, or stopping the urine stream; straining to urinate, etc. If left untreated, patients will have greater difficulty and more frequent urination, to the point that they may urinate blood.

If you have the symptoms of prostate cancer, the doctor will perform a physical examination and additional tests to confirm the diagnosis as follows:
 

• Digital Rectal Examination (DRE) – As part of a physical examination, your doctor inserts a gloved and lubricated finger into your rectum and feels toward the front of your body in order to check the size, shape and flexibility of the prostate.

• Prostate Specific Antigen (PSA) Blood Test – PSA will be at an elevated level in patients with prostate cancer.

• Magnetic resonance imaging (MRI)

• Transrectal Ultrasound ( TRUS) – This test uses sound waves, in which the doctor will insert an ultrasound probe (a machine that uses sound waves to build a picture of the inside of your body) into your rectum toward the position of the prostate. A small needle is then used to take 12 core samples from 12 biopsy sites. These samples will then be sent to a lab for a pathology examination.

• MRI/Ultrasound Fusion Biopsy – This is the use of three-dimensional imaging technology coupled with ultrasound guidance in real-time, which allows doctors to see both the details and position of the cancerous tumor in the prostate much more clearly. This means they are then able to guide the biopsy needles precisely to the lesion they want to sample as opposed to random biopsy sampling.

The stages of the cancer are determined by the location of the cancer cells, what parts of the body the cancer has spread to, and abnormal functioning of bodily organs. Knowledge of the stage of the cancer is important to treatment, as it helps the doctor with determining the most appropriate treatment.
 

Prostate cancer is divided into 4 stages:
 

Stage 1 – This is the beginning stage. Cancer is found in the prostate only and cancer cells have not yet spread.

Stage 2 – The tumor has grown slightly larger, and is found in more than one-half of one lobe of the prostate or in both lobes, but has not spread beyond the prostate.

Stage 3 – Cancer cells have spread and broken through the outer layer of the prostate gland and may have spread into the seminal vesicles (tubes that carry semen).

Stage 4 – Cancer cells have spread (metastasized) outside the prostate to other tissues, commonly including the bones and lymph nodes.

Treatment options for prostate cancer are determined by location, size, stage of cancer, physical and mental condition of the patient, as well as the quality of life of the patient after treatment. Currently, treatment options include the following:

• Surgery , which is divided into 2 main methods:

1. Laparoscopic Radical Prostatectomy – This type of surgery has been developed from traditional open abdominal surgery. With this method, the doctor inserts a tiny camera called a laparoscope and other special instruments through 5 tiny incisions in the abdomen below the navel, and performs the surgery via the images viewed on a monitor. The results of this type of surgery include less pain for patients, faster recovery, fewer side effects, and better treatment results than those associated with open abdominal surgery.

 

2. Robotic–assisted da Vinci Surgery or Da Vinci Prostatectomy) – This procedure involves the use of robotic arms which are controlled by the surgeon. It not only has the advantages of less pain and faster recovery time as is the case with laparoscopic surgery, but it also increases the chances of patients being able to control urinary incontinence post-surgery and minimizes the risks of erectile dysfunction.

• Radiation Therapy – This includes both brachytherapy (internal radiation) and external beam radiation. The type of radiation therapy used depends on whether the level of the prostate cancer is low-risk, intermediate-risk, or high-risk.

• Chemotherapy – Improved treatment results are currently being seen with chemotherapy. At the same time, doctors also have methods for relieving and minimizing adverse reactions that are side effects of the drugs.

• Hormone Therapy – This is often used as an additional treatment after surgery or in cases where the cancer is in a metastatic stage. With this treatment, the physician will try to reduce or stop the body from producing the male hormone testosterone through medication – if medication is not successful, surgical options would need to be considered.