Prostate cancer is the cancer of prostate gland. The cells of prostate glands divide abnormally leading to the formation of a tumor. This causes hindrance in the normal urinary function and various other symptoms are experienced by the patient. People above the age of 40 are at risk for developing this disease and the risk increase significantly after the age of 65 years. Prostate cancer is not common in the people below the age of 40 years. The prostate gland is present in the abdominal region just beside the urinary tract. The function of this gland is to provide protection and nutrition to the sperms and the secretion of prostate forms the part of semen.
The screening of prostate cancer is done through the PSA (Prostate Specific Antigen) Testing, however reduction of death due to prostate cancer through the screening is controversial as the test does not provide a conclusive result. PSA is secreted in higher concentration by the malignant prostate cells and the high level of this antigen in the blood may indicate the presence of cancer. However, the concentration of PSA may also increase in Benign Prostate Hyperplasia and Prostatitis. In some cases, the level of PSA is not increased even in the presence of cancer.
Various hospitals in South Africa are capable of successfully treating, managing or during prostate cancer. Some are Multispeciality hospitals with a separate department of urology while some hospitals such as The Urology Hospital are exclusively dedicated to urological disorders. As a leader for medical facilities in the African continent, the country has access to the latest technology and experienced doctors. Every year, thousands of patients from developed and developing countries such as Europe, USA, and Africa visits South Africa for medical treatment.
Evidence-based treatment is one of the USP of South Africa when it comes to Prostate cancer treatment. All the treatment available for prostate cancer is performed in South Africa such as Radiotherapy, Surgery, and Brachytherapy. The best treatment strategy depends upon the condition of the patient.
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:
Treatment for prostate cancer can be divided into early stage and advanced stage. Your doctor will choose the best suitable treatment for you, depending on the stage and classification of prostate cancer, your age, and overall health status. Although, your feelings, expected lifespan, and your opinion will play a major role in choosing the right kind of treatment.
The most common treatment options for prostate cancer include the following:
Watchful waiting or active surveillance
No immediate treatment is carried out, but the patient is followed up at regular intervals to see the progression of the disease. This method is used in elderly patients with short life expectancy and in case of an early disease.
The main type of prostate surgery is called radical prostatectomy. In this, cancerous tissues are removed by a surgical operation. A long cut in the abdomen is needed in this surgery, depending on the extent and stage of cancer.
However, a keyhole surgery for prostate cancer using a laparoscope or robot is also available. These treatments have good success rates but may result in certain long-term side effects such as sexual dysfunction, narrowing of the urethra, and urinary incontinence.
High-intensity beams are used in this treatment to destroy the cancer cells in the prostate. Radiotherapy can be administered via needles implanted into the prostate, under ultrasound guidance or as an external beam. Radiotherapy can be used after surgery if the resection of cancer tissue has not been completed.
There are two types of radiotherapy for prostate cancer:
In this, the radiation beams are shaped so that the region where they overlap is as close to the same shape as the organ that requires treatment. It minimizes healthy tissue exposure to radiation.
In this, the beams with variable intensity are used. It is an advanced form of conformal radiotherapy. It is usually delivered with the help of a computer-controlled linear accelerator.
Hormone therapy involves the use of medications that suppress testosterone levels. They are used as primary treatment and in advanced cases or Stage 4 prostate cancer.
Chemotherapy is a kind of advance drug treatment in which strong medications are used to kill the cancer cells and prevent it from spreading. It is used when the prostate cancer is not controlled by hormonal treatment. Chemotherapy is selected only for treatment of Stage 4 prostate cancer and when the patient can cope with it.
This treatment uses extremely cold temperatures to freeze and destroy cancer tissues in the prostate. Cryotherapy is the best option for treating recurrent prostate cancer, especially if initial radiation therapy did not kill enough cancer cells. The surgeon inserts an ultra-thin metal probe or needle into the prostate gland, from which a freezing liquid, such as liquid nitrogen or more commonly, argon gas, is infused into the prostate gland.
Some treatments such as radiofrequency and high intensity focused ultrasound (HIFU) are used to treat early prostate cancer or when the patient is not fit for a major surgery.
Prostate cancer is the malignancy of the prostate cells. The oncogene in these cells becomes dominant over the tumor suppressor gene leading to uncontrolled growth. The exact cause of this cancer is not known, however, research on a various patient suffering from prostate cancer reveals that certain factors increase the risk of cancer:
a) Age: Risk of prostate cancer increase with age. The risk increases after 40 years of age and people over the age of 65 years have high risk.
b) Race: Statistics shows that the risk of developing prostate cancer is increased in individuals of a certain race. African American men are at higher risk as compared to Caucasian or Hispanic men.
c) Diet: Diet also plays an important role in developing prostate cancer. Dust rush in animal fat and red meat increases risk. Further, obesity is another factor to be looked upon as obesity is also linked to prostate cancer.
d) Testosterone level: Increase in testosterone level increases the risk of prostate cancer. High level of testosterone increases the growth of the prostate gland.
e) Lifestyle: People who excessively drink or smoke are at a higher risk of developing cancer.
f) Prostatic intraepithelial neoplasia: Presence of Prostatic intraepithelial neoplasia, an abnormal condition of the prostate gland, raises the risk of this cancer.
g) Family History: People whose close relatives i.e. father, brother or son had diagnosed with cancer, are at increased risk.
h) Genomic changes: Mutation in genes such as BRCA 1 and BRCA 2 increases the risk of prostate cancer.
i) Prostate diseases: The risk of prostate cancer is also increased due to the presence of underlying diseases such as Benign Prostate Hyperplasia or Prostatitis.
The average cost of prostate cancer treatment in South Africa is significantly lower as compared to the US and many other countries. This is the reason that many patients visit South Africa for the treatment of prostate cancer, especially through robotic surgery. The average cost of robotic surgery in South Africa is approximately $10000 however, it may vary depending upon the city, hospital or the doctor performing the surgery. Also, the cost of treatment depends upon the age and the speed of recovery.
Surgeries for prostate cancer are performed with high success rates in South Africa, thanks to the extensively experienced urologists and modern technologies along with highly trained support staff that works tirelessly before, during and post-surgery. Following are the various surgeries available for prostate cancer in South Africa:
1) Robotic-Assisted Surgery: Robotic-assisted surgery has changed the way of performing the prostatectomy. Through this technique, surgeons can perform complex prostatectomy with ease and precision.
2) Open Prostatectomy: This surgery is performed manually by the surgeon. This surgery is generally conducted to remove the areas, other than the prostate gland, in which cancer has spread such as lymph nodes.
3) Laparoscopic Surgery: Laparoscopic surgery is the part of a minimally invasive procedure. A small incision is made on the abdomen to insert the instruments along with the tube with a camera at the end to assist the removal of the prostate gland.
Recovery from prostate surgery depends upon various factors. These factors include age, response to post-surgical treatment, level of immunity and complications due to surgery. With the high-tech techniques used in South Africa, the sexual activity takes just 3-4 months after surgery, while previously it requires almost a year or more and that too with only 50% activity. Vital nerves are prevented from damage leading to less recovery period. Further, the recovery period with modern technology is less due to a minimally invasive procedure, reduced blood loss and fewer complications. The hospital day is reduced to 3 days from 6 days in the past leading to lesser treatment cost. Urinary process in robotic-assisted surgery requires less time to get normal. The catheter used for urination would remove after 2-3 weeks of surgery. Pain, swelling, and constipation are treated with the medications. The patient may be able to walk and eat a normal diet within 24 hours to 48 hours after surgery. The complete recovery may take about 4 weeks.
Various hospitals in South Africa are well equipped to treat patients suffering from prostate cancer. These hospitals are situated in major cities of South Africa such as Johannesburg, Port Elizabeth, and Cape Town. Following are the top hospitals:
1) Netcare Chris Barnard Memorial Hospital, Cape Town
2) Waterfall City Hospital, Madrand
3) The Urology Hospital, Pretoria
4) UCT Private Academic Hospital, Cape Town
5) Ahmed Kathrada Private Hospital, Johannesburg
6) Netcare Greenacres Hospital, Port Elizabeth
There are a number of sought after Prostate Cancer Surgeons in South Africa. Some of the most prominent ones are listed below:
1) Dr. Greg Boustead, Netcare Chris Barnard Memorial Hospital, Cape Town
2) Dr. Lance Coetzee, The Urology Hospital, Pretoria
3) Dr. Howlett Justin, UCT Private Academic Hospital, Cape Town
4) Dr. Stephen M. Eppel, Netcare Christiaan Barnard Memorial Hospital, Cape Town
5) Dr. Ahsan Ahmad, Ahmed Kathrada Private Hospital, Johannesburg
6) Dr. Van Heerden, The Urology Hospital, Pretoria
7) Dr. Johannes Brummer, Netcare Greenacres Hospital, Port Elizabeth
8) Dr. Johan Coetzee, Netcare Greenacres Hospital, Port Elizabeth
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