Prostate Cancer Treatment

Prostate Cancer Treatment

Prostate cancer occurs when normal prostate cells begin to grow uncontrollably. In many cases, prostate cancer is slow-growing and does not spread beyond the prostate gland before diagnosis. Early treatment of prostate cancer with expert Dr. Enmar Mohamed Habib, Professor of Urology and Pediatric Urology at Cairo University and Fellow of McGill University, Canada, stops or slows its spread, thanks to his extensive experience of more than 20 years.
 

Symptoms of prostate cancer:

Prostate cancer occurs in the outer layer of the prostate gland; therefore, in its early stages, there may be no symptoms. When symptoms do appear, they may be urinary symptoms similar to those of benign prostatic hyperplasia (BPH), which occurs in the inner lobes of the prostate, those surrounding the urethra. These symptoms include:
•  Frequent urge to urinate.
•  Painful, burning, difficult, or weak urine stream with urination.
•  Hematuria.
•  Pain during ejaculation.
•  Pain in the lower back, upper thighs, or lower pelvic area.
•  Loss of appetite and consequently weight loss.
•  Bone pain.

Prostate cancer diagnosis:

1-  Blood tests:

The PSA blood test measures a protein in the blood called a prostate-specific antigen (PSA). Prostate cells naturally produce PSA, but cancerous cells produce higher levels. The PSA test is used to stage cancer, plan treatment, and monitor its success. In addition, Dr. Enmar Mohamed Habib may test your blood testosterone levels.
The PSA test is not used alone to diagnose the condition; rather, it is combined with a clinical examination performed by Dr. Enmar Mohamed Habib to gain a more accurate idea of prostate health.

2-  Clinical examination:

A clinical examination is a physical examination used to help your doctor detect changes in your prostate. During this test, the doctor checks for any abnormal shape, consistency, lump, or thickness of the gland. This test is also used to detect and stage cancer or track treatment success.
A clinical exam is safe and easy, but it cannot detect early-stage cancer alone. It is often performed with a PSA test to detect prostate cancer early before it spreads.

3-  Prostate ultrasound:

A prostate ultrasound uses sound waves to produce images of the prostate gland, which helps diagnose symptoms such as difficulty urinating or elevated PSA levels.

4-  Prostate biopsy:

If screening tests show a problem in the prostate, a prostate biopsy may be performed to make an accurate diagnosis by searching for cancer cells within the samples. 

Latest methods of treating prostate cancer:

1- Radical prostatectomy:

The main surgical procedure to treat prostate cancer is radical prostatectomy. In this procedure, Dr. Enmar Mohamed Habib removes the entire prostate gland along with some surrounding tissue, including the seminal vesicles. Sometimes, nearby lymph nodes are also removed if there is a chance the cancer has spread to them (based on PSA levels, prostate biopsy results, and other factors).
•  Laparoscopic prostatectomy:
Laparoscopic surgery is performed through several small incisions in the abdomen, rather than one large incision. Dr. Enmar Mohamed Habib inserts a laparoscope, a long, thin tube with a light and a tiny video camera at the end, through one of the incisions to view inside the body. Long, thin surgical instruments are inserted through the other incisions to perform the procedure.
In laparoscopic radical prostatectomy, Dr. Enmar Mohamed Habib guides the long instruments directly into the abdomen.
•  Robotic prostatectomy:
Robot-assisted laparoscopic radical prostatectomy is performed using a robotic system. Dr. Enmar Mohamed Habib sits at a control panel in the operating room and maneuvers robotic arms, which precisely hold surgical instruments through several small incisions, usually in the patient's abdomen. The robot helps the surgeon move the instruments more precisely than if held by hands.

Laparoscopic or robotic prostatectomy vs. traditional surgery:

Laparoscopic or robotic prostatectomy has become the most common procedure for prostate cancer due to several short-term advantages compared to open surgery:
• Less blood loss during the procedure.
• Less postoperative pain.
• Shorter hospital stay.
• Faster recovery time.
• Shorter catheter duration.
• Lower risk of some rare side effects.
The long-term outcomes of laparoscopic, robotic, and open prostatectomy are nearly the same regarding side effects that concern many men, such as erectile dysfunction and urinary incontinence.
Regardless of the method chosen, the most important factor for surgical success is the surgeon's experience and skill. That’s why it’s crucial to choose an experienced surgeon you trust and feel comfortable with, like Dr. Enmar Mohamed Habib, the best adult and pediatric urology professor in Egypt and the Arab world.

Side effects of radical prostatectomy:

•  Urinary incontinence (inability to control urination):
Urinary incontinence is most common after prostate surgery. Urine may leak when coughing, laughing, sneezing, or exercising. It is usually caused by problems in the valve (bladder sphincter) that keeps urine in the bladder. Prostate cancer treatments can damage this valve or the nerves that control it. Older men are more likely to experience urinary issues.
After prostate cancer surgery, bladder control usually improves slowly over several weeks or months. The more experienced the surgeon, the fewer incontinence problems you will experience; therefore, we recommend choosing the best urologist, Dr. Enmar Mohammed Habib.
•  Erectile dysfunction (problems getting or maintaining an erection):
An erection is controlled by two small bundles of nerves that run along either side of the prostate. Dr. Enmar Mohamed Habib is careful not to injure these nerves during prostatectomy. However, if the cancer is growing within or near the nerves, the surgeon will need to remove them.
• If both nerve bundles are removed, you will not have spontaneous erections, though you may be able to with assistive methods.
• If nerves on one side are removed, you may still have erections, but with a reduced chance.
• If no nerves are removed, you may regain normal erections after surgery.
Your ability to achieve erections after surgery depends on your age, erectile function before surgery, and whether the nerves were preserved. The younger you are, the less likely you are to be seriously affected.

2- Radiotherapy:

Radiation therapy involves the use of radiation to kill cancer cells. This treatment is an option for prostate cancer that has not spread outside the prostate. Radiation therapy can also be used to slow the progression of metastatic prostate cancer and relieve symptoms. Sessions are typically short, five days a week, for 4 to 8 weeks. There are two types of radiation therapy:
• External Radiation Therapy: A machine outside the body directs radiation at the cancer cells.
• Internal Radiation Therapy (Brachytherapy): A high radiation dose is delivered inside the prostate gland to reduce damage to other tissues. It is known as internal radiation, where treatment is delivered inside or near the cancer to destroy cancerous tissue.

Short-term effects of radiation therapy include:

•  Discomfort.
•  Diarrhea.
•  Pubic hair loss.
•  Fatigue.
•  Bladder inflammation, which can cause pain when urinating and frequent urination.
Long-term side effects of radiation therapy include erectile dysfunction (impotence).

3- Hormonal therapy:

Hormones regulate cell growth in the prostate. In particular, prostate cancer requires testosterone to grow. Therefore, hormonal therapy aims to stop testosterone production or prevent the body from using it. Hormonal therapy is often used in conjunction with radiation therapy. For example, you may receive hormonal therapy before radiation therapy to increase the chance of treatment success, or after radiation therapy to reduce the risk of cancer recurrence.
Hormonal therapy does not cure prostate cancer on its own, but it can slow the progression of advanced cancer and relieve symptoms.
The main side effects of hormonal therapy include reduced libido and erectile dysfunction due to its effects on testosterone. These side effects usually disappear when treatment stops.

Consult Dr. Enmar Mohamed Habib, Professor of Urology and Pediatric Urology at Cairo University and Fellow of McGill University, Canada, about the treatment options for your cancer type and stage. He will explain the risks and benefits of each treatment method and help you choose the best one to eliminate the cancer cells with the best results and minimal side effects.