Doctors suggest how increasing life expectancy in India may increase the burden of the disease

 Of the 7.6 million deaths due to cancer worldwide, one-sixth are caused by prostate cancer which is also today the second most frequently diagnosed cancer type after lung cancer.

 

A disease whose risk increases proportionately with age, prostate cancer is growing in incidence as life expectancy increases. According to Dr Ganesh Bakshi of Tata Memorial Hospital, 70 % of all prostate cancers are diagnosed in men over the age of 65.  It is still unclear why this increase with age occurs for prostate cancer but studies suggest that after 70, most men have some form of prostate cancer, though there may be no outward symptoms.

 

The prostate is an exocrine gland (secretions end up outside the body) of the male reproductive system, and exists directly under the bladder. Roughly the size of a walnut, it is through the prostate that the urethra – the tube carrying urine and semen out of the body – goes through. Besides producing a fluid that forms part of the semen and protects the sperm, the prostate gland also plays a role in urine control.

 

Traditionally, the incidence of prostate cancer has been the highest in the United States and Europe and lower in countries of South and East Asia. However, with increase in life expectancy, adoption of newer lifestyles and screening using prostate specific antigen (PSA), the incidence of prostate cancer is on the rise in low and middle income countries like India as well.

 

In India, where life expectancy increased from 61.97 in 2001 to 65.48 in 2011, prostate cancer incidence is growing by 1% every year. However, not many people are aware of this problem and its treatment to prevent it from turning fatal. We need to up the ante against the disease by spreading awareness about prostate cancer, its risks and ways to curtail it.

 

Dr Shikant Badwe of BK Kidney Hospital says, Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.

Before we discuss the prevention and treatment options, here is a quick look at some key facts about Prostate Cancer.

·      ·        One new case occurs every 2.5 minutes and a man dies from prostate cancer every 17 minutes.
·       A nonsmoking man is more likely to get prostate cancer than lung, bronchus, colon, rectal, bladder, lymphoma, melanoma, oral and kidney cancers combined.
·       Because prostate cancer is a relatively slow-growing cancer, the 5-year survival rate for prostate cancer diagnosed at all stages is 98%. The relative 10-year survival rate is            84% and the 15-year survival rate is 56%.

In the West, where a number of celebrities and high profile people have spoken publicly about the disease, awareness has steadily risen. Hollywood stalwarts Robert De Niro and Michael Douglas have undergone treatment for prostate cancer, so has South Africa’s iconic former President Nelson Mandela and former US Secretary of State Colin Powell.

Age, genetic predispositions and diet all seem to have a direct correlation with the risk of prostate cancer. Some studies have also indicated that men with sexually transmitted diseases too have a higher chance of getting afflicted with prostate cancer.

However, in India the awareness about the disease remains low. It is important to note that there are no warning signs of early prostate cancer. Once a tumor causes the prostate gland to swell, or once cancer spreads beyond the prostate, the following symptoms may happen:

§  A frequent need to urinate, especially at night

§  A weak or interrupted urinary stream

§  Blood in urine or semen

Hence, it becomes important to immediately visit a doctor if any of these symptoms are observed.  The good part is that prostate cancer is a relatively slow-growing cancer, and the survival rate is hence high.

The treatments include surgery (prostatectomy), radiotherapy, hormonal therapy using androgen-depriving drugs, depending upon the stage and level of the cancer.