Dr. Akhileshwar Jha is one of the renowned and experienced urology consultants in the Delhi-NCR region. He has more than 45 years of clinical experience. Dr. Jha is currently practicing at Columbia Asia Hospitals, Gurugram. He was previously associated with Umkal Hospital, Gurugram, VPS Rockland Hospital, National Health Service, United Kingdom, and King Fahd Central Hospital - Tertiary Care, Gizan, Saudi Arabia. Dr. Jha completed his MBBS from Prince of Wales Medical College, Patna, India in 1972. He completed his MS in General Surgery from Prince of Wales Medical College, Patna, India in 1976. He was awarded a fellowship from the Royal College of Surgeons (Edinburg), Scotland, the UK in 1981. In the year 2006, he has undergone Advanced training in KTP Greenlight Laser Training and Certification from Kings College, London, UK.
Dr. Jha is one of the top-rated urology surgeons because of his extensive experience in performing various surgeries to cure complex urological disorders. His area of expertise includes endourologic, laparoscopic procedures, and surgeries for cancer-related to urinary tract including kidney and bladder. He has a special interest in performing Laser prostatectomy and upper and lower tract reconstruction surgeries. He is one of those surgeons who are always keen to abreast himself with the latest medical technology especially in the urology arena.
The prostate is a gland in the male reproductive system, which makes fluid that forms an essential part of the semen. Prostate cancer starts when cells of the prostate glands begin to grow abnormally
Prostate cancer is one of the leading cancers in men above the age of 60. In most of the cases, it is slow growing and may even go undetected and do not cause any problem. However, in some cases, it could be aggressive and cancer cells can spread to other parts of the body (metastatic prostate cancer)
Prostate cancer is a very slow growing disease and starts with tiny alterations in the shape and size of the prostate gland cells. The prostate cancer risk increases with age and it is rarely observed before the age of 40. That is the main reason why many men die of old age, without ever knowing that they had prostate cancer.
There is no direct prostate cancer causes. However, there are some factors that can increase the risk of prostate cancer, including the following:
Usually, prostate cancer means the cancer of prostate gland cells called prostatic intraepithelial neoplasia (PIN). Almost all the prostate cancers are adenocarcinomas, but there are some other types of prostate cancer as well, including the following:
Based on how abnormal the patterns of cancer cells look, prostate cancers are classified as:
There are no warning signs of prostate cancer. The symptoms of metastatic prostate cancer usually appear first in the region that the cancer cells have invaded.
After cancer causes the prostate gland to swell, the following signs of prostate cancer may be experienced:
In prostate cancer stages, the following symptoms may also be there:
The prostate gland is present below the urinary bladder in men. It surrounds the urethra and produces fluid that helps in the movement of the semen. Prostatectomy is a surgery that involves total or partial removal of the prostate gland. It is commonly performed as a part of treatment for prostate cancer.
Radical prostatectomy: This surgery involves the removal of the entire prostate gland along with the surrounding lymph nodes. The surgical techniques used to conduct radical prostatectomy include the following:
Open simple prostatectomy: This surgical procedure involves removal of just the affected part of the prostate gland and is recommended for men with the cancerous prostate gland or benign prostatic hyperplasia (BPH).
Cancer in Bladder can be found to vary depending on the type of its origins. It can arise from the lining of the epithelium which is the inner lining of the urinary bladder or the urothelium. Rare forms of cancer are not of epithelial origins like the sarcoma or lymphoma. Tumours in bladder is found to be the 9th leading type of cancer in United States as per a survey conducted in 2012 with 430,000 new cases and mortality of 165000 deaths annually.
The first and foremost question to ask is where is your bladder located? The sac like muscular urinary bladder is located in the pelvis region above the pelvic bone. It is connected to the kidneys through the two ureters that transfer the urine from the kidney to the bladder for storage. An abnormal growth of cells in the inner lining causes a tumour requiring diagnosis and then followed by a turbt surgery.
In most cases the tumour cannot be assessed in the primary stages. There are hardly any notable evidences found when the patient is harbouring a primary tumour.
The next stage is designated as Oa and categorized as a non invasive type papillary cancer.
In the stage next of the stage 0 or the carcinoma in situ the inner lining of the bladder is affected and is still considered non invasive.
In stage I the cancer has spread into the lining of the bladder further but has not affected the muscular wall of the bladder.
While in Stage II the inside part gets affected including the muscles of the bladder making it now invasive.
And when the cancer has spread enough in muscles and the tissues around the bladder like the reproductive organs it is considered to be in stage III.
And in the final or stage IV the cancer will spread to the lymph nodes affecting the organs around it as well.
The causes of tumour in bladder are not always very clear and well defined but it has been linked with smoking, chemical exposure and radiation or a parasitic infection. The abnormal cells undergo some mutation that allows them to multiply in a non orderly fashion and goes beyond control and they do not die thus giving rise to the tumour.
A person suffering from a tumour will experience mild sensation of burning and discomfort in the times of urination for quite a few days. The force of the urinary stream may also undergo significant changes which can be observed for a week to a fortnight. Usually there could be none of the symptoms and in certain cases all symptoms even if experienced may not lead to the conclusion that it is a bladder cancer. There can be blood or clots of blood in the urine along with a tendency of urinating too frequently. Tendency of urinating at night may be felt more but there can be general problems in urine passing. Associated along with this the patient can experience pain on either side of the body.
This procedure aims at removing bladder tumours at an early stage by inserting a scope through the urethra leading to the bladder. In the TURBT procedure bladder cancer can be detected by the urologist and potentially allow the urologist to treat various other kinds of bladder related disorders. But 75% of the cancer of bladders that are detected are superficial in nature causing growth only on the surface of the walls of the bladder and does not get very deep. So this facilitates the surgeon to have the tumour removed at the bladder wall level causing no damage to the deeper layers of the organ. The information that is collected while executing the procedure will help the surgeons to decide the type of the abnormality of the tumour and the extent of the tumour. This later allows the urologist surgeons to decide whether further treatments will be required or not.
Some of the other treatment alternatives for TURBT are being worked upon while some of them have tremendous side effects
Blue light fluorescent cystoscopy : Enhanced tumour visualization is possible and detection of tumour chances are increased by almost 20 to 25% with this method where an ultraviolet blue light is used. A dye is injected an hour prior to the procedure.
Adjuvant bladder cancer therapy: TURBT is not suitable for many who have high chances of suffering a recurrence within 12 months from the treatment. In this case adjuvant therapy is recommended. It includes intravesicle chemotherapy. Chemotherapy for bladder cancer includes giving medication to curb the abnormal growth of cells. But it also has its sets of side effects like experiencing irritation in bladder and loss of hair, nails and feeling debilitated for a very long period of time.
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