Dr.

Ehsanur Reza
Assistant professor, surgery
MMC
 What Is Prostate Cancer?

• Prostate cancer develops in a

man's prostate, the walnut-
sized gland just below the
bladder that produces some of
the fluid in semen.
• It's the most common cancer in
men afer skin cancer. 
• Prostate cancer ofen grows
very slowly and may not cause
signifcant harm. But some
types are more aggressive and
can spread quickly without
treatment.
 What are my chances of getting prostate cancer?

 2nd leading cause of

cancer death in
American men
 1 in 6 men will be
diagnosed with prostate
cancer in their lifetime
 If locally confned, 5-yr
survival rate is 100%
 In case of metastasis, 5- Chances of getting prostate cancer:
yr survival rate is 35% HIGH
Chances of Survival: High IF CAUGHT
EARLY
Where is this damned prostate , anyway?
Prostate is …
• A sex gland in men
• Size of a walnut
• Responsible for producing fluid
that sperm travels in
• Located in front of the rectum,
below the bladder
• Wraps around the urethra
 Sir Alec
Jerry Orbach GuinnessCharles
Roger
Moore Who gets
prostate
cancer?
John Kerry

Colin
Powell

Robert De Niro
 Symptoms of Prostate Cancer

Early Stages
CAN BE ASYMPTOMATIC

Aching pains in genitals, lower abdomen,

lower back
 Problems with sexual function
Painful, frequent, urgent urination
Slow urine stream and retention
Blood in the urine
 Advanced Stages

• Loss of energy
• Persistent swelling in
legs
• Pain in the back, spine,
rib or hip
• Hard growth on
prostate
• Enlarged lymph nodes
Risk Factors You Can't Control
Risk Factors You Can Control
But I’m in great
shape and don’t
feel sick
Do I really need my
prostate
examined?

If you’re over 50 HELL

YES!!
If you’re over 40 it
doesn’t hurt
(figuratively speaking)
 Can Prostate Cancer Be Found Early?

• 50 for average-risk men

who expect to live at least
10 more years.
• 45 for men at high risk. This
includes African-Americans
and those with a father,
brother, or son diagnosed
before age 65.
• 40 for men with more than
one frst-degree relative
diagnosed at an early age.
 
What kinds of
exams do I
have to take to
make sure I
NEVER die
from prostate
cancer?
Screening: DRE and PSA
Prostate Cancer Detection
Stage 1: Annual Digital Rectal Exam

Your doctor will insert a

gloved, lubricated finger into
your rectum
 He will try to feel for
enlargement, lumps and
tenderness of the prostate
Prostate Cancer Detection
Stage 1: Annual Digital Rectal Exam

Early detection
of prostate
cancer is
VITAL for
survival
 Prostate Cancer Detection
Stage 2: Prostate Specific Antigen (PSA)
Testing

Cell activity in the

prostate produces PSA
Higher than average
PSA levels in the
bloodstream is a sign of
abnormal cell
multiplication in the
prostate
 PSA Test Results

• A normal PSA level is considered to be under

4 nanograms per milliliter (ng/mL) of blood,
while a PSA above 10 suggests a high risk of
cancer. But there are many exceptions:
• Men can have prostate cancer with a PSA
less than 4.
• A prostate that is inflamed (prostatitis) or
enlarged (BPH) can boost PSA levels, yet
further testing may show no evidence of
cancer.
• Some BPH drugs can lower PSA levels,
despite the presence of prostate cancer,
called a false negative.
• If either a PSA or DRE test are abnormal,
your doctor will order other tests.
Prostate Cancer Detection
Stage 3:
Prostate Cancer Biopsy
 Biopsy and Gleason Score

• A pathologist looks for cell

abnormalities and "grades"
the tissue sample from 1 to
5. The sum of two Gleason
grades is the Gleason
score. These scores help
determine the chances of
the cancer spreading. They
range from  2, less
aggressive, to 10, a very
aggressive cancer.
Your
thoughts……..

So what 
happens if they 
find cancer? 
What are the 
stages?
What are 
treatment 
options? 
 Prostate cancer Staging

Stage I Stage II Stage III Stage IV

Locally advanced: Advanced:

Early stage: Locally
spread to seminal spread to
confined cancer
vesicles bladder, rectum,
spine
 Prostate Cancer Imaging
• Typical x-ray
appearance of
osteoblastic bone
metastases
 Prostate Cancer Imaging

• Some men may need additional

tests to see if the cancer has
spread beyond the prostate.
These can include ultrasound, a
CT scan, or an MRI scan (seen
here). A radionuclide bone scan
traces an injection of low-level
radioactive material to help
detect cancer that has spread
to the bone.
• In the MRI scan shown here,
the tumor is the green, kidney-
shaped mass in the center, next
to the prostate gland (in pink).
Prostate Cancer Survival Rates
Treatment: Watchful Waiting

For: Early stage, slow growing, localized

cancer
Procedure: Monitor growth regularly
 Treatment: Surgery
oFor: Stages I & II,
accelerated growth
oProcedure: Surgical
removal of the entire
prostate
oProcedure: ~ 3 hours,
invasive
Laparoscopic Radical
Prostatectomy

Less invasive, faster

recovery
Robotic surgery – prostate
cancer
Treatment: Radiation Therapy
 Prostate Brachytherapy
For: Stages I & II,
accelerated growth

Procedure: Templates
and ultrasound guidance
are used to place
radioactive
seeds/catheters into the
prostate to irradiate the
gland

Procedure: ~ 1 hours,
minimally invasive
 Treatment: Hormone Therapy

• Hormone therapy may shrink

or slow the growth of cancer,
but unless it is used with
another therapy it will not
eliminate the cancer. Drugs or
hormones block or stop the
production of testosterone
and other male hormones,
called androgens.
• Side effects can include hot
flashes, growth of breast
tissue, weight gain, and
impotence.
 Treatment: Chemotherapy

• Chemotherapy kills cancer

cells throughout the body,
including those outside the
prostate, so it is used to
treat more advanced
cancer and cancer that did
not respond to hormone
therapy.  Treatment is
usually intravenous and is
given in cycles lasting 3-6
months.
 Treatment: Cryotherapy

• Cryotherapy freezes and kills

cancerous cells within the
prostate (like the highly
magnifed cells shown here.)
It's less invasive than surgery,
with a shorter recovery time.
• Because the freezing
damages nerves, as many as
80% of men become
impotent afer cryosurgery.
There can be temporary pain
and burning sensations in
the bladder and bowel.
 Treatment: Prostate Cancer Vaccine

• This vaccine is designed to

treat, not prevent, prostate
cancer by spurring your body's
immune system to attack
prostate cancer cells. Immune
cells are removed from your
blood, activated to fght cancer,
and infused back into the
blood. Three cycles occur in one
month. It's used for advanced
prostate cancer that no longer
responds to hormone therapy.
Mild side effects can occur such
as fatigue, nausea, and fever.
Hope for Advanced Cancer
Coping With Erectile Dysfunction
 Food for Health
• A cancer-conscious diet may be the
best choice for survivors who want to
bolster their health and those hoping
to lower their risk. That means:
• Five or more fruits and veggies a day
• Whole grains instead of white flour
or white rice
• Limit high-fat meat
• Limit or eliminate processed meat
(hot dogs, cold cuts, bacon)
• Limit alcohol to 1-2 drinks per day (if
you drink)
• Foods high in folate may have some
action against prostate cancer (such
as spinach, orange juice, lentils).
Studies found mixed results on
lycopene, an antioxidant found in
tomatoes.
Foods for good prostate
Prostate Cancer Myths
Thank
You