• Prostate Cancer

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    Prostate cancer remains the second leading cause of cancer death in men worldwide, yet it is highly curable if discovered while still confined to the prostate gland.

    Dr. Ramani considers many factors when recommending the most appropriate treatment for prostate cancer. These factors include patient age, co-morbid conditions, grade of cancer, clinical stage of cancer & body habitus.


    What is Prostate Cancer?

    Prostate cancer, which develops from cells in the prostate gland, is the second most common cancer in men worldwide. The walnut-sized prostate gland, located between the pubic bone and rectum, wraps around the urethra, the tube that carries urine from the bladder.

    The American Cancer Society (ACS) estimates that 180,400 new cases of prostate cancer will be diagnosed in the United States each year, and that 31,900 people in the USA will die of prostate cancer this year. Although the number of cases of prostate cancer declined among white American men, the incidence of the disease in black men and the mortality rate among black men is more than twice that of white men, according to the ACS.

    The disease grows very slowly in most cases. In fact, 89 percent of patients diagnosed with prostate cancer have a five-year survival rate, and 63 percent live at least 10 years after the disease is found and treated.

    Eventually, the cancer may spread outside the prostate gland to other parts of the body. Since lymphatic vessels of the prostate lead to pelvic lymph nodes, cancer cells can spread out along these vessels, where they can reach lymph nodes and continue to grow.


    Symptoms

    Prostate cancer, by nature, is silent in its initial stages. Its symptoms don’t appear until later, when patients may notice a need to urinate frequently, particularly at night. Prostate cancer may also cause a difficulty or inability to urinate, a weak or interrupted flow of urine or painful and burning urination. Other symptoms may include painful ejaculation, blood in urine or semen, and frequent pain or stiffness in the lower back, hips or extremities.


    Causes

    Although genetics plays a strong role in development of Prostate Cancer, environmental agents have been thought to play a role. Patients with family history of Prostate Cancer are at a higher risk of developing Prostate Cancer than the average population.


    Diagnosis & Testing

    An annual PSA (Prostate Specific Antigen) test, which is a fairly routine blood test, combined with a digital rectal examination of the prostate gland by your urologist increases the chance of picking up prostate cancer earlier. Men with a strong family history of prostate cancer must start getting annual PSA’s done after the age of 40 whereas other men should start after the age of 50.


    Treatment

    Physicians tailor prostate cancer treatment plans to their patient’s needs, taking into account the type of cancer, the age of the individual, the degree to which the cancer has spread and the general health of the patient.


    Laparoscopic Radical Prostatectomy This minimally invasive procedure removes the prostate gland and is typically performed on qualifying prostate cancer patients. Unlike conventional surgery, a laparoscopic radical prostatectomy requires only five button-hole incisions. Through these incisions, a surgeon uses a laparoscope—a tiny camera—and surgical instruments to conduct the operation and remove the prostate.

    Advantages for the patients include:

    • Minimal Pain
    • Minimal Blood Loss
    • Overnight Hospital Stay
    • Minimal Risk of Infection
    • Catheter Required for Seven days as opposed to three weeks with Open Surgery
    • Return to work in two to three weeks
    • Excellent cancer outcomes.

    Incisions Two Weeks after
    Laparoscopic Radical Prostectomy

    Incisions One Year after
    Laparoscopic Radical Prostectomy


    Dr. Ramani has performed over 500 laparoscopic radical prostatectomies and is considered an International Expert on Minimally Invasive Surgery for prostate cancer.



    Open Radical Prostatectomy A surgical treatment for prostate cancer, the open radical prostatectomy procedure removes the entire prostate with an incision in the lower abdomen. With the advent of Laparoscopic Prostatectomy this is becoming rare and used only in select situations.
    Radiation Therapy Radiation Therapy uses high energy x-rays to kill cancer cells and shrink tumors. Radiation can be produced from a machine outside the body (external radiation) or by putting materials that produce radiation (radioisotopes) through thin plastic tubes into the area where the cancer cells are found (internal radiation).
    Hormone Therapy Hormone therapy is a prostate cancer treatment that alters the body's hormone balance to prevent certain cancers from growing. This may be accomplished with drugs that alter the way hormones work or with surgery that removes hormone-producing organs such as the testes. This treatment is typically reserved for patients who are not candidates for either curative surgery or have failed previous treatments.
    Chemotherapy Chemotherapy involves the use of drugs to kill cancer cells. Chemotherapy may be taken orally or injected into a vein. Chemotherapy is usually a systemic treatment, meaning the drugs enter the bloodstream, travel through the body and can kill cancer cells anywhere in the body, including the prostate.

    Prevention

    Regular screening is the key to catching prostate cancer in its early stages. The American Cancer Society and the American Urological Association recommend that all men 50 and older receive a PSA screening, annually. In some cases, however, younger men who run a higher risk of developing the disease (African American men and those who have a family history of prostate cancer) may be encouraged to be tested regularly beginning at age 40.