The key is being able to distinguish between the 'tigers' in prostate cancer from the 'pussy cats.
We need to quickly recognise and treat the dangerous, aggressive prostate cancers but equally ensure that we don't over treat men whose disease is slow-growing and not clinically significant.
The PSA test has been the traditional benchmark for assessing risk of prostate cancer. PSA stands for prostate specific antigen, a protein made by the prostate which naturally leaks into the bloodstream when the prostate is damaged.
A simple blood test can be taken to measure levels of PSA and a high reading indicates prostate cancer may be present. However a high reading can also be caused by non-cancerous conditions, such as an enlarged prostate, or BPH (Benign Prostatic Hyperplasia).
Many men fall into a 'borderline' category, with a reading that suggests a little higher risk than average but not a clear indication of prostate cancer. However, there are also some men with what are thought to be traditionally low levels of PSA who actually have potentially important disease.
Understanding an individual patient's risk of prostate cancer is about far more than PSA, What is important is considering all risk factors when deciding whether to go further and make a diagnosis.
The new PCA3 test is based on genetic technology and measures prostate cancer risk in a different way to the PSA.
Combining these two assessments together provides a clearer picture of risk of who may have potentially serious disease at a time when treatment may reduce the chance of dying from prostate cancer.
Improvements in ultrasound technology have also meant it is significantly easier to find the cancer when it is present.
"These changes mean specialist can offer a more accurate, individually based assessment of each patient's risk of prostate cancer.
Growing numbers of men are now placed on active monitoring - which is intense observation if there is doubt that treatment is necessary but there is a need to continuously assess the patients' risk."
For men who are diagnosed with prostate cancer, there have been a number of surgical advances which have significant benefits for patients.
Prostate surgery has traditionally been associated with a long recovery and major side-effects because the early, open prostatectomy, or removal of the prostate, caused irreparable damage to adjacent nerves controlling erections and continence.
A small number of UK surgeons developed laparoscopic techniques for this surgery, operating through five small incisions or 'ports' rather than the large cut across the whole of the abdomen used in open surgery.
Mr Alan Doherty has performed more than 600 laparoscopic prostatectomies - one of the largest caseloads in the UK - and explains the benefits.
"Laparoscopic surgery very significantly reduces blood loss, scarring and risk of infection which means patients make a much easier and swifter recovery, typically leaving hospital on day three after surgery, rather than day five or six."
Mr Doherty has also developed a nerve-sparing approach for patients with early stage prostate cancer. This is a highly specialist technique to safely remove the cancerous prostate without harming adjacent nerves.
The da Vinci Prostatectomy, known as robotic prostatectomy or computer-assisted surgery, is a different approach which also reduces the side-effects and complications of the prostatectomy. Men are able to return to work or leisure activities more quickly than with open surgery.
Like a laparoscopic prostatectomy, the operation takes place through six small incisions, which are around 1 cm or so. Four robotic arms, which are up to 7mm wide, are inserted through 4 of these ports, and the other two ports are used by an assistant.
The hand movements of the surgeon are translated in real time movements by the robotic arms. The system is designed to remove any hand tremor and ensure very precise movements.
Marc Laniado, who was a member of one of the first teams in the UK to introduce robotic prostate surgery, explains: "The robot provides a highly magnified view in three dimensions of the nerves and blood vessels surrounding the prostate which makes it easier to avoid causing damage and reliably perform a nerve sparing prostatectomy
"There is also extensive evidence to show that for early, organ-confined prostate cancer, da Vinci prostatectomy is as effective in terms of removing all cancer cells as open surgery."
"There are important improvements for patients in terms of both the diagnosis and treatment of prostate cancer," concludes Mr Laniado.
"This means we are better able to identify and treat aggressive cancer and equally avoid unnecessary treatment. For those who do need treatment, we are able to offer a wider range of options using approaches which reduce side-effects and improve the patient's experience of surgery and subsequent recovery."
Jenny Hudson is an experienced health journalist, whose articles are regularly published in national newspapers and magazines. For more information about Harley Street Urology Clinic who are experts at Prostate Cancer Treatments in the UK.
Article Source: http://EzineArticles.com/?expert=Jenny_Hudson
No comments:
Post a Comment