What Is
Prostate Cancer?
The prostate is a small gland located below the bladder and
surrounding part of the urethra. Prostate Cancer develops when abnormal
prostate cells grow uncontrollably.
The disease does not behave identically in every patient.
Some tumours remain confined to the prostate for years, while others can extend
beyond the gland or spread to lymph nodes, bones, or other organs.
This difference in tumour behaviour is why treatment must be
individualized rather than based on the diagnosis alone.
What Causes
Prostate Cancer?
There is no single cause responsible for every case. Risk
can be influenced by several factors, including:
- Increasing
age.
- Family
history of prostate cancer.
- Certain
inherited genetic changes.
- Ethnic
background.
- Other
individual health and lifestyle factors.
Having a risk factor does not mean that a man will
necessarily develop the disease.
Symptoms of
Prostate Cancer
Early prostate cancer may cause no noticeable symptoms.
This is one reason evaluation and appropriate testing can be important for men
at increased risk.
When symptoms occur, they may include:
- Difficulty
starting urination.
- Weak
or interrupted urine flow.
- Frequent
urination.
- Increased
nighttime urination.
- Blood
in the urine or semen.
- Erectile
difficulties.
- Pain
in the back, hips, or pelvis in advanced disease.
These symptoms can also occur with non-cancerous prostate
conditions, including BPH. Therefore, symptoms alone cannot establish a
diagnosis.
How Is
Prostate Cancer Diagnosed?
Evaluation may involve several steps rather than a single
test.
Depending on the individual case, the urologist may
recommend:
- Medical
and family history.
- Physical
examination.
- Digital
rectal examination.
- PSA
blood testing.
- Prostate
imaging, including multiparametric MRI when appropriate.
- Prostate
biopsy.
- Additional
imaging for staging when indicated.
The results are combined to determine whether cancer is
present and, if so, how aggressive and extensive it appears to be.
What Is the
PSA Test?
PSA (prostate-specific antigen) is a substance produced by prostate cells and measured
through a blood test.
An elevated PSA does not automatically mean prostate cancer.
PSA can also increase because of benign prostate enlargement, inflammation,
infection, or other prostate-related conditions.
For this reason, PSA results need to be interpreted together
with the patient's age, examination findings, medical history, imaging, and
other clinical information.
What Is a
Prostate Biopsy?
A prostate biopsy involves obtaining small tissue samples
from the prostate so that a pathologist can examine them under a microscope.
The biopsy can confirm whether cancer cells are present and
provides information about the tumour's grade. This information is important
when determining the most appropriate treatment strategy.
Understanding
Prostate Cancer Stages
Staging describes how far the cancer has progressed.
It broadly considers whether the tumour:
- Is
confined to the prostate.
- Has
extended outside the prostate.
- Has
reached nearby lymph nodes.
- Has
spread to distant organs.
Localized prostate cancer is contained within the prostate,
while locally advanced disease extends beyond it. Metastatic disease has spread
to distant sites.
The stage, tumour grade, PSA level, and other findings help
the medical team determine the patient's risk category and treatment options.
Prostate
Cancer Treatment Options
There is no single treatment that is appropriate for every
patient.
Depending on the disease characteristics, options may
include:
- Active
surveillance.
- Radical
prostatectomy.
- Radiation
therapy.
- Hormone
therapy.
- Chemotherapy.
- Other
systemic or specialized treatments.
- Treatment
combinations for higher-risk or advanced disease.
Active surveillance can be appropriate for selected patients
with localized cancer, allowing treatment to be deferred while the disease is
closely monitored.
Advanced prostate cancer may require systemic treatment
rather than surgery alone.
Radical
Prostatectomy
Radical Prostatectomy
is a surgical procedure in which the entire prostate gland and seminal vesicles
are removed. Pelvic lymph-node removal may also be performed when clinically
appropriate.
The goal of surgery in appropriately selected patients is to
remove the cancer with curative intent while preserving important surrounding
structures whenever oncologically safe.
Radical prostatectomy may be considered particularly for
healthy patients with cancer that is confined to the prostate or selected cases
of locally advanced disease.
Robotic-Assisted
Prostate Cancer Surgery
Robotic-assisted radical prostatectomy is a minimally invasive approach in which the surgeon
operates through several small abdominal incisions using specialized robotic
instruments and a high-definition three-dimensional camera.
The robotic system does not independently perform the
operation. The surgeon controls the instruments throughout the procedure.
Potential advantages of the minimally invasive approach
include small incisions and a potentially shorter recovery compared with
traditional open surgery. The exact benefits depend on the patient's condition
and the surgical team's experience.
Nerve-Sparing
Prostatectomy
In selected patients, the surgeon may perform nerve-sparing
surgery to preserve the nerves responsible for erectile function.
However, nerve preservation is not always possible. If the
tumour is very close to or involves these structures, removing the cancer
safely may require sacrificing part or all of the neurovascular bundle.
The priority remains complete and oncologically appropriate
cancer removal.
Preparation
Before Prostate Cancer Surgery
Before surgery, the patient undergoes a detailed evaluation
that may include:
- Review
of biopsy and pathology results.
- PSA
assessment.
- Cancer
staging.
- MRI
or other imaging when required.
- Blood
tests.
- Cardiovascular
assessment when indicated.
- Anesthesia
evaluation.
- Review
of medications.
- Discussion
of urinary and sexual function before treatment.
The surgical plan is then tailored according to tumour
characteristics and the patient's general health.
Recovery
After Prostatectomy
Recovery varies between patients and depends on the surgical
technique and individual health.
After surgery, patients are generally given instructions
regarding:
- Catheter
care.
- Wound
care.
- Physical
activity.
- Fluid
intake.
- Medication.
- Pelvic-floor
rehabilitation.
- Follow-up
PSA testing.
Urinary control often improves progressively during
recovery, while sexual-function recovery can take considerably longer and
varies between individuals.
Possible
Side Effects of Prostate Cancer Surgery
As with any major operation, radical prostatectomy has
potential risks.
Important possible side effects include:
- Urinary
incontinence.
- Erectile
dysfunction.
- Changes
in ejaculation and fertility.
- Bleeding.
- Infection.
- Blood
clots.
- Injury
to surrounding structures.
Nerve-sparing techniques may help preserve erectile function
in appropriately selected patients, but they cannot guarantee that normal
erections will be maintained.
Follow-Up
After Prostate Cancer Treatment
Follow-up is an essential part of prostate cancer care.
After radical prostatectomy, PSA monitoring is
commonly used to evaluate the response to treatment and detect possible
biochemical recurrence.
Depending on the pathology and PSA results, additional
treatment such as radiation or systemic therapy may sometimes be considered.
The follow-up schedule is individualized according to the
patient's cancer characteristics and treatment history.
A Message to
Our Patients
A diagnosis of Prostate Cancer does not automatically
mean that every patient needs surgery. Modern prostate cancer care offers
several treatment strategies, and the most appropriate choice depends on the
cancer's stage and grade, PSA level, overall health, life expectancy, and
individual priorities.
For patients who are suitable candidates for surgical
treatment, radical prostatectomy—including robotic-assisted techniques—can
provide an important treatment option for localized prostate cancer. Our
urology team provides comprehensive assessment, staging, surgical planning, and
postoperative follow-up with the goal of achieving effective cancer control
while paying close attention to urinary and sexual function.
Frequently
Asked Questions
Is prostate cancer always
aggressive?
No. Prostate cancer can range from slow-growing disease that
can be monitored to more aggressive tumours requiring active treatment.
Does every patient with prostate
cancer need surgery?
No. Depending on the cancer's risk category and the
patient's circumstances, active surveillance, radiation therapy, surgery,
hormone therapy, or combinations of treatments may be appropriate.
What is radical prostatectomy?
It is an operation to remove the prostate gland and seminal
vesicles. Pelvic lymph nodes may also be removed when indicated
What is robotic prostatectomy?
It is a minimally invasive form of radical prostatectomy in
which the surgeon controls specialized instruments through small abdominal
incisions.
Can prostate cancer surgery cause
erectile dysfunction?
Yes. Erectile dysfunction is a recognized possible side
effect. When medically appropriate, nerve-sparing surgery may help preserve
erectile function, but recovery varies considerably between patients
Can urinary incontinence occur after surgery?
Yes. Temporary or persistent urinary leakage can occur after
radical prostatectomy. Urinary control often improves during recovery, and
pelvic-floor rehabilitation may be part of postoperative care.
Is prostate cancer curable?
When prostate cancer is localized, treatment can be
performed with curative intent, and several effective treatment approaches are
available. The appropriate option depends on the individual cancer
characteristics.