Prostate cancer is a malignant transformation of the cells in the prostate gland.
The prostate gland is a small organ which only men have. It is the size of a walnut if normal, but it is also frequently enlarged as men get older. It is a reproductive organ and is located deep in the pelvis surrounded by other organs – bladder, rectum, urethra, seminal vesicles.
Prostate cancer is usually a disease of older men, but it can also be found in men as young as in their 40’s. This is usually the case if there is a family history and genetic predisposition.
In Australia, prostate cancer is the most commonly diagnosed cancer in men and more than 3000 men die from it every year.
In the early stages the cancer can be completely asymptomatic. Some patients might have mild urinary symptoms, sometimes bleeding. More advanced disease can cause more significant symptoms, but these are frequently a sign that the cancer might have spread to other organs.
Prostate cancer can be diagnosed by performing a combination of tests:
- DRE (digital rectal examination) – The surgeon feels and assesses the surface of the gland by inserting their finger in the rectum
- PSA (Prostate Specific Antigen) – A molecule present in the blood, produced by normal and malignant prostate cells. No other organ in the body produces PSA. PSA is detected on a blood test.
- MRI (Magnetic Resonance Imaging) – A type of scan which in the last few years plays an important role in the diagnosis of prostate cancer. MRI is also used in the surveillance, staging, surgical planning and prediction of continence in patients with prostate cancer.
- Prostate Biopsy – involves collection of several needle samples from the different anatomical zones of the prostate. These samples are subsequently examined under the microscope by an experienced uropathologist to determine the presence or absence of prostate cancer. The biopsy can be performed through different approaches – transrectal or transperineal. There are benefits and downsides to each of those approaches and Dr Penkoff can discuss those with you in detail.
If prostate cancer had been diagnosed the next step is staging – to determine if the cancer is localised to the prostate gland, locally advanced or metastatic. This involves different types of scans depending on the individual circumstances.
Once a full work up has been done and all the information is available a management plan can be formulated. This can differ significantly from patient to patient depending on multiple factors – patient characteristics, tumour characteristics, stage of disease, surgeon expertise and patient preference.
For further information and comprehensive discussion of your case please get in touch to make an appointment with Dr Penkoff.