Prostate cancer at a glance
ANJIRA ASSAVANONDA
Prostate cancer is a disease which develops in the prostate, a gland in the male reproductive system. It ranks 9th among the cancers in Thai men, with the number of sufferers likely to increase each year, especially with men aged older than 45 and urban dwellers.
Globally, prostate cancer is the second most common cause of cancer deaths and . According to statistics, one in six men encounter suffer from prostrate cancer at any stage of lives.
What are the causes?
The causes of prostate cancer are not specifically identified, but it is found that people whose family members have had the disease have a 30 per cent chance of suffering from it. If immediate family members have suffered from it, chances will double.
Besides family history, the living environment, modern lifestyle, diets, drinking and smoking, lack of physical exercise, as well as diseases such as diabetes and obesity are all risk factors.
How can prostate cancer be detected?
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| Dr Viroon Donavanik |
Most men will not experience any symptoms at an early stage. And, even if there are symptoms, it can often be confused with prostate gland's disease.
When discovered, the cancer is likely to be fully developed. The only way to early detection is with a blood test for prostatic specific antigen (PSA).
If the PSA level doubles or significantly increases in a year, that signals some irregularities, and you may need to have your tissue examined.
Symptoms that might indicate the presence of prostate cancer
- A need to urinate frequently, especially at night.
- Difficulty starting urination or holding back urine.
- Weak or interrupted flow of urine.
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| Implant radiation seeds. |
- Painful or burning sensation while urinating.
- Difficulty in getting an erection.
- Painful ejaculation.
- Blood in urine or semen.
- Frequent pain or stiffness in the lower back, hips or upper thighs.
Treatment
Treatment in-cludes prostate surgery, chemotherapy, hormone replacement and combinative therapies.
Besides all those treatments, "brachytherapy" or implant radiation is being introduced as the most effective method to cure the cancer.
Dr Viroon Donavanik, radiation oncologist specialising in brachytherapy at Piyavate hospital said the treatment is a new choice for prostate cancer patients.
"If used for patients with early signs of cancer, the recovery chance is 90 to 95 per cent. And you can be sure the cancer will not return in 10 years," said Dr Viroon.
The advantage of brachytherapy is that it doesn't involve surgery and so is less painful, and has reduced side effects.
According to Dr Viroon, if patients remain strong and the cancer does not spread outside the prostate gland, it is possible for the disease to be completely cured. But if patients aged above 85, suffer from poor health, the least aggressive treatment would be best for them.
More about brachytherapy
Brachytherapy or implant radiation, is a procedure in which radioactive material is placed directly into or near the cancer cells. The radiation is sealed in needles or seeds.
According to Dr Viroon, three types of material are normally used for brachytherapy - Iodine-125, Palladium-103 and Cesium-131. The most popular material used in Thailand is iodine.
The quantity of implant radiation given for each patient is between 20 to 40 seeds, depending on the prostate size.
The Grid programme is also used to assess the accurate quantity and position to plant the radiation seeds.
The cost of brachytherapy in Thailand is averagely more than 200,000 baht per case.
Complications after therapy
Ninety per cent of the patients treated with iodine will suffer from no complications in the first two weeks.
However, up to 10 per cent may experience an interrupted flow of urine in the first 12 hours, because of a bloodclot during the implantation.
After two weeks, the iodine will give out the radiation, which can result in the swollen prostate, urinary frequency, urgency, nocturia, burning and dysuria.
These symptoms will peak in the first month after treatment, and gradually level off. In three to four months, patients should be back to normal.
"There could be some cases in which what we planted does not turn out to be what we wanted. In that case, we'd opt for supplemented external radiation but that is low possibility," said Dr Viroon.
Health advice
- Drink less and do not smoke.
- Eat less fat and red meat,and more fish.
- Avoid being overweight.
- Males who do not have family history of prostate cancer should have a blood test at the age of 50. Those whose family members have had prostate cancer should have a blood test at 40, and in case of aggressive cancer, they should get tested at 35.
- Males who experience some urinary tract symptoms such as dysuria, urinary frequency at night, painful urination, blood in the urine, tiredness, loss of appetite, as well as pain in the back and bones should go for a doctor for urgent diagnosis.
To consult Dr Viroon Donavanik, email
medical.org@piyavate.net, or call 02-625-6500. The doctor is based in the US, but visits Thailand every three to four months.
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