Prostate cancer is the second most common cancer diagnosis in men worldwide. In Bulgaria, prostate cancer is also the second most common and accounts for 17% of all malignancies.
What is prostate cancer?
Prostate cancer begins with abnormal growth of cells in the prostate gland. The cancer cells grow and divide at a rapid rate, forming a tumor. Over time, they can spread to other tissues and organs- metastasizing.
What causes prostate cancer to develop?
The specific causes of prostate cancer are not yet fully understood. Advancing age is considered a major risk factor, as most cases are detected after the age of 50. Genetic predisposition and obesity are also associated with a higher risk. Family history is also relevant. The risk of developing prostate cancer increases 7-fold in people who have family members with the disease. In addition, if a mother has had breast cancer, then there is a higher risk of her son developing prostate cancer. This occurs in BRCA mutation carriers. People who have first-line family members diagnosed with prostate cancer or breast cancer with BRCA mutations should begin regular screenings and tests of PSA– prostate-specific antigen at the age of 40, while those without a family history can start at 45.
How does prostate cancer develop and what are the first symptoms?
While benign prostatic hyperplasia (BPH) causes difficulty urinating and other complaints, prostate cancer is a more insidious disease as it often develops in the peripheral zone of the prostate. Very often it may not show any symptoms before it reaches an advanced stage. For this reason, annual medical checkups are crucial for early diagnosis and successful treatment.
How is the disease diagnosed?
Diagnosis for prostate cancer usually includes:
- PSA (prostate-specific antigen) - testing to measure the level of protein produced by the prostate;
- Uroflowmetry - a study to assess the strength and intensity of the jet;
- Ultrasound diagnostics to check the size and anatomy of the prostate;
- Digital rectal examination (rectal tumescence) is performed by manual palpation to examine the shape, size and surface of the prostate gland;
- Prostate biopsy for laboratory analysis of a prostate tissue sample performed in case of suspicion of a malignant process after the previous examinations.
In case the pathological results confirm the presence of prostate cancer, further tests are carried out to assess whether and to what extent the cancer has spread to other parts of the body. These may include magnetic resonance imaging (MRI), computed tomography (CT), PET scan with gallium 68 or bone scintigraphy.
What are the stages of prostate cancer?
Once the diagnosis is confirmed, staging is performed to assess how far the disease has spread and how much it has progressed. Staging in prostate cancer is key to treatment planning and patient prognosis. Generally, in stages 1 and 2, the spread of the tumor is limited to the prostate gland. In stage 3, the tumor has advanced outside the prostate, usually to the seminal vesicles, which is called locally advanced prostate cancer. When in stage 4, the disease has spread to adjacent lymph nodes or to distant organs. In some cases, the disease can also cause metastasis to the bone.
How is prostate cancer treated?
Prostate cancer treatment is planned individually, depending on the type, size and aggressiveness of the tumor, as well as the patient's age, preferences and general health. The treatment process may include one or more of the following options:
- Active surveillance. The vast majority of prostate cancer patients will never need any treatment.
- Nano Knife Therapy- The Nano Knife procedure uses short, low-energy electrical pulses to destroy cancer cells.
- Surgery. This is the most effective treatment option when the cancer is confined to the prostate gland. Surgery for prostate cancer usually involves removal of the prostate gland, which is called a radical prostatectomy. It can be performed as open or laparoscopic surgery.
- Radiation treatment (radiotherapy). It can be used to cure localized prostate cancer, as well as to shrink the tumor or as palliative therapy in patients with locally advanced or metastatic cancer.
- Focal therapies (HIFU, Cryotherapy). These are non-invasive techniques used to destroy cancer cells by heating or freezing, respectively. They are usually applied to treat very small tumors localized in the prostate gland while the surrounding tissues remain unaffected.
- Drug treatment. There are various options here, including hormone therapy to reduce the production of the male hormone testosterone, which stimulates the growth of cancer cells; chemotherapy taken orally or by injection; immunotherapy or targeted (targeted) therapy are also appropriate for some patients.
- Therapy Lutetium-177 PSMA. This is an innovative treatment option from the field of nuclear medicine. It is suitable for patients with advanced prostate cancer , when other treatment options have been exhausted.
What is the prognosis for prostate cancer?
With proper treatment, the prognosis for prostate cancer patients is generally positive, thanks to modern diagnostic capabilities and successful treatment methods. Comprehensive medical care, where all treatment options are considered, planned and provided in one place, is essential to the quality of the treatment process and patient satisfaction.
What should patients interested in prostate cancer treatment abroad do?
"Medical Carragee offers prostate cancer patients the most advanced and innovative treatment at some of the best cancer centers in the world. All patients who contact us receive a free consultation with some of the best specialists in prostate cancer treatment. This way they can find out if they are on the right track in their treatment or if there are other more effective and advanced treatment methods in their case.
