Usually, prostate cancer, during early stage, doesn’t show any sign and symptoms. It is often detected through a DRE or PSA test, a process known as screening. If DRE or a PSA test is indicating that prostate cancer might be present, then more testing and monitoring is done to diagnose the cancer. If is often the later stages when prostate cancer starts showing signs and symptoms. These signs and symptoms may include, as suggested by the robotic surgeon in India:
• Blood present in the urine • Frequent urination • Interrupted or weak flow of urine, or needing to strain so as to empty your bladder • Frequent urge to urinate at night • Blood in seminal fluid • Pain or discomfort while sitting, it is caused due to enlarged prostate • Burning sensation or pain while urinating (it is less common compared to other symptoms) • Onset of ED or erectile dysfunction There are cases where men with the prostate cancer may not experience any of the above stated signs and symptoms and may not feel any changes. The best doctor for prostate cancer treatment in Delhi suggests that similar signs and symptoms may be caused by other non-cancerous conditions of prostate, like benign prostate hyperplasia or enlarged prostate. It is also possible that the signs and symptoms are being cause due to some other medical condition altogether, that is not even cancer. Some of the urinary symptoms may also be caused due to infections of the bladder. Anyhow, if you experience any such signs and symptoms, you must speak to your doctor as soon as possible.
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Bladder cancer starts when the healthy cells that are present in the urinary bladder lining changes and starts growing out of control and forms a tumor. There are many risk factors that contribute to development of a bladder cancer. Risk factors are anything that can increase one’s chance or risks of developing bladder cancer. Yes, a risk factor often influences development of the cancer, most don’t really cause cancer directly. There are cases where a person has many risk factors and still doesn’t develop the cancer, while there are others who have no risk factors and still develop a cancer, in which case they need to get bladder cancer treatment in Delhi. Here are some risk factors that influences the risk of one developing a bladder cancer: • Age - As a person gets older the chances of them getting diagnosed with a bladder cancer gets higher as well. More than 70 percent of the people who are diagnosed with the bladder cancer are people whose age is more than 65 years. • Tobacco use - Cigarette smoking is known to be the most common of risk factors contributing to development of bladder cancer, although smoking pipes and cigars also does raise the risks of developing a bladder cancer. • Gender - Men are more likely to develop a bladder cancer by 3 – 4 times, as compared to women. At the same time, men are less likely to die from a bladder cancer as compared to men, suggest the best doctor for kidney transplant in Delhi. • Chemicals - Certain chemicals used in rubber, leather, textile, print and paint industries; some naturally-occurring chemicals; as well as chemicals known as aromatic amines are known to increase risks of bladder cancer. Usually, people with early-stage prostate cancer experience no signs or symptoms of prostate cancer. Prostate cancer is usually diagnosed through DRE or a PSA test, it is a process known as screening. If a DRE or a PSA test is indicating of presence of prostate cancer, further testing and monitoring is required to diagnose the cancer. When people with prostate cancer do begin to experience signs and symptoms of prostate cancer, it is often diagnosed at a later stage. The signs and symptoms of prostate cancer are as follows:
• Frequent urination • Frequent urge to urinate at night • New onset of ED or Erectile Dysfunction • Need to put strain in order to empty your urinary bladder or an interrupted or weak flow of urine • Blood present in the urine • Pain or discomfort when sitting, that is caused by enlargement of prostate • Blood present in seminal fluid • Burning or pain while urinating, it is a much less common symptom Sometimes, people with prostate cancer don’t experience any of these symptoms. Similar symptoms are often caused by other non-cancerous conditions of prostate gland, such as enlarged prostate or BPH. Also, it could be cause by some other medical condition altogether, including kidney diseases or kidney failure. In such cases, one may even need a kidney transplant in Delhi. If you are experiencing any changes in your symptoms or new symptoms, you should consult your doctor. Your doctor will diagnose your problems. Talk with your doctor about options you have for prostate cancer treatment in Delhi. Making a change is daily diet can be tough for many people, but when it comes to your well-being and health, it becomes necessary. Prostate cancer is a very serious disease, and there are a few foods that should be avoided in order to prevent prostate cancer from developing. There are different categories of foods that can cause cancer and each have different reasons as to how it can cause the cancer. Here are a few categories of food, as suggested by the best surgeon for prostate cancer that must be avoided entirely or consumed in moderation: Milk Milk has a lot of amazing benefits, such as it helps with bone development. However, consumption of too much milk can be harmful for the health of the prostate. It contains natural growth hormones that can stimulate growth of mutated cells and precancerous, hormone-sensitive tumors. Processed and red meat Yes, it is one of favorite things on menu for many people, but if you really care about your prostate health, its best that you avoid eating processed as well as red meat. Studies suggest that having large quantities of processed and red meat can increase the risk of developing prostate cancer. Alcohol Research shows that people who are heavy drinkers are twice more likely to develop prostate cancer, when compare to people who drink in moderation. Alcohol consumption is one of the primary causes of kidney diseases and cancer as well, for which one would have to visit the kidney cancer treatment specialist Delhi. Urology deals with an unhealthy urinary tract and reproductive tract in both men as well as women. The specialists who treat conditions of the urinary tract and reproductive tract are known as urologist. They might be general practitioners or specialist of a part of the urinary and reproductive system. Urologists are well trained to diagnose, perform surgery and treat issues such as kidney stones, kidney transplant and prostate cancer. There are a number of urologists in Delhi who have been successfully practicing urology and helping patients from throughout the country and world. When To Approach An Urologist? Best urologist in Delhi should be approached when you experience the following symptoms:
What is the process of treatment for urological issues?
Urological issues can be treated according to the diagnosis done. If the problem is caused by infectious bacteria, medicines and anti-septic supplications are sufficient. For more serious problems such as kidney stones or prostate cancer surgery can be suggested. Prostate cancer specialist in Delhi and urological surgeons perform imaging tests to determine the process of treatment. What are Kidney tumors? Kidney tumors are a diverse group of tumors which can range from simple benign lesions like Oncocytoma which are harmless to frankly malignant lesions like Renal cell carcinoma which may be life threatening. The benign tumors grow very slowly and rarely is life threatening unlike the malignant tumors, which grow rapidly, and is life threatening. What are the types of Kidney tumors? There are multiple types of kidney tumors. The most common type among adults being Renal cell carcinoma (Adenocarcinoma), which constitutes almost 90-95% cases, followed by Transitional cell carcinoma. Other rare tumors are Oncocytoma, angiomyolipoma, squamous cell carcinoma, sarcoma, etc. Where do they arise? Kidney consists of many parts like kidney cells, blood vessels, urine collecting system and tumors may arise from any of the various parts. The most common type of tumors arising from the kidney cells is the renal cell carcinoma (RCC). However another commonly occurring cancers are Transitional cell carcinoma (TCC) arising from urine collecting system. Other types may arise form blood vessels, fat or soft tissue etc. What are the signs & symptoms? Most of the kidney tumors in todays era are asymptomatic (i.e. have no symptoms) as they are mostly detected by chance on Ultrasound, CT scan or MRI done for some other unrelated reasons, so much so that these tumors are also known as the Radiologist/Doctor’s tumors. The most common symptoms usually are flank pain, blood in urine or in later stages abdominal mass. Sometimes they can present with fever, weight loss, or generalized weakness. When the disease has spread beyond the kidneys, patients can develop lower limb swelling, backache, headache, cough etc. Those who develop TCC of kidneys might present with blood in urine as the first and the only symptom with or without other non-specific symptoms like generalized weakness, fever. Know more about Uro Onco Surgeon in Delhi Who are likely to develop these tumors? Most of the kidney cancers, mainly RCC develop sporadically i.e. without any family history of such tumors. However around 10-15% of tumors can be familial which occur due to some genetic alterations which are transmitted in families. People who have high blood pressure, or who consume tobacco or those who are too fat, are at increased risk of developing these tumors. People who suffer from stone disease or are undergoing chronic dialysis for renal failure are also at increased risk of developing these tumors. How can it be diagnosed? As mentioned previously most of these tumors in today’s era are incidentally detected on imaging such as ultrasound or CT scan performed for some or the other reasons. Apart from CT scan or MRI, Chest x ray and certain blood tests which include Complete blood counts, Kidney function, Liver function tests, urine tests are done. Those having any abnormality in liver function tests or complaining of bony pains undergo bone scan to detect spread of tumors to bone. There is no role of FDG-PET scan in diagnosis of these tumors, however they are sometimes used for detection of recurrences. What is the treatment for Kidney cancers? Treatment is largely dependent upon the type of kidney tumor as well the stage of the tumor (extent of disease spread). For the most common variety “RCC”, if the opposite uninvolved kidney is normal, and there are no comorbidities like high blood pressure or Diabetes or any preexisting kidney disease, complete removal of the tumor-bearing kidney is the standard treatment, which is known, in medical terminology as Radical Nephrectomy. However in patients who have a single kidney (either by birth or due to previous surgery) or in patients with Diabetes or high blood pressure or chronic kidney disease, or in patients with tumor in both the kidneys, only tumor along with rim of normal tissue is removed, with preservation of normal kidney, known as Partial nephrectomy. Now a day, partial nephrectomy has become a standard of care if tumour is around 5-6 cm in a kidney. These tumors are removes with 1 cm margins of normal kidney tissue and kidney is repaired and saved. Advantage is preservation of kidney function, which is very important for our life. Certain patients with kidney tumors have a portion of tumor entering big vessels (renal vein &/or Inferior vena cava), which open, into heart. This group constitutes approximately 10% and requires expert care and management at a tertiary center. For patients whose tumors have progressed beyond the kidneys into other distant sites like, lung, liver, bones, brain etc. and if they are fit enough to undergo the surgery, radical nephrectomy (in this situation called as “ Cytoreductive nephrectomy ”) is performed. The other metastatic sites can also be removed surgically if feasible. Treatment of TCC of kidneys is however different from that of RCC. In this the kidneys along with the ureter (tubular structure which transmits urine from kidney to urinary bladder) and 1 cm bladder cuff has to be removed in high-grade lesions, whereas for low-grade tumors, simple endoscopic fulguration and BCG instillations suffice. Consult Kidney Cancer Treatment Specialist Delhi What are the medi cines given once the kidney is removed in Metastatic disease? Once these patients have recovered from the surgery, a special type of anticancer medicines is started known as TKI’s (Tyrosine Kinase inhibitors) e.g. sunitinib, sorafenib, pazopanib etc. Currently newer immunotherapeutic medicines are also available both as injectable and as oral medicines, e.g. Temisirolimus, Everolimus, Nivolumab, Cabozanitinib etc. These medicines are known to shrink the metastatic tumor deposits and prolong disease progression but they do not cure the disease. Is there any treatment if patient is not fit to undergo surgery? In certain elderly patients with small peripherally located tumors who are not surgically fit, newer technologies which involve killing the tumor cells either by heat e.g. Radiofrequency ablation (RFA), Microwave therapy or by cooling e.g. cryoablation are available at selected centers and can be dealt with safely, however due to its limited availability, high cost, poor reproducibility and unavailability of expertise, and the psychological fear of leaving behind the tumor in the body, these modality are not routinely used at least in India. What are the different approaches of kidney surgery? Surgery for kidney cancers is performed by large open incisions, laparoscopically or robotically. Open surgeries are mainly performed in cases with large tumors more than 12 cm size or invading adjacent organs or associated with clot in big blood vessels or if doing partial Nephrectomy in patients with a single kidney. Gradually open surgeries are becoming historic as with the advancements in instrumentation, technology and expertise, laparoscopy has overshadowed open surgery, the main advantages being its minimally invasive nature, key hole surgery, less pain, faster recovery and discharge from hospital and fewer complications. Now a day most of the kidney surgery is done laparoscopically. Going one step ahead, Robotics has further revolutionized the management of kidney cancers, mainly in performing Partial nephrectomies because of its precision and efficient suturing advantages apart from the usual advantages of laparoscopy. Now a day most of partial nephrectomies are done robotically with excellent outcome. Its only disadvantage is its cost, which is 1.25 lakhs extra. Know more about Prostate Cancer Treatment in Delhi Is there a role of Radiotherapy or chemotherapy in kidney cancers? There is a very limited role of Radiotherapy in the treatment of RCC as these tumors are resistant to radiotherapy. Radiotherapy may however be used as a palliation (symptomatic relief) to decrease severe bony pains or refractory bleeding from urine collecting system. As far as chemotherapy is concerned, certain subtypes of RCC, like collecting duct tumors, Bellini duct tumore and sarcomatoid differentiation, have been shown to have a some beneficial effect, however is still investigational. Chemotherapy also has a role in TCC of kidney after nephrectomy has been done. On the other hand chemotherapy has good response in the treatment of childhood Wilms tumors. For patients with Severe bony pains arising due to metastasis to bones from kidney tumors, local radiotherapy can be given as a palliation. How is the follow up done after surgery? Usually after surgery patients are discharged around 3-4 days later and called for OPD visit around 1 week from discharge. Initially they are followed up at 3 months, then 6 months and then annually thereafter at least till 5 yrs., and preferably lifelong at increasing intervals. Tumors can recur even years later, but usually recur within first 2 years. During these visits they undergo a detailed clinical history and physical examination along with blood tests, chest x rays and contrast CT scan or MRI of abdomen and some other tests if required. Whereas follow up after surgery for TCC of kidney is slightly different in that apart from the tests mentioned above, urine cytology (to look for cancer cells,) & cystoscopy (endoscopy of urinary bladder) also needs to be performed at regular intervals to detect recurrences early. What is the survival rate of kidney cancers? Survival rate of patients with kidney tumors is stage dependent. For RCC, which are localized to the kidneys, the 5-year survival rate is greater than 90%, however for tumors, which have spread beyond the kidneys to surrounding fat, the survival is around 60%. Survival decreases further to 10-20% as the spread occurs to lymph nodes or distant sites. Survival for TCC of kidney is much poorer than RCC and ranges from 50-60%. Survival rates for other varieties of kidney tumor are worse than above. Can it be prevented? In todays era of stressful life, leading a healthy lifestyle and avoiding the risk factors mentioned above, does not guarantee against developing a kidney cancer. So these tumors are not 100% preventable, but leading a healthy lifestyle is in general beneficial for an individual and as a whole reduces the chances of other infections and cancers. Moreover certain tumors are hereditary and cannot be prevented at present. So regular health check ups and early detection is the key to successful treatment and good long-term outcomes. 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What is the prostate? The prostate is a gland which lies just below the urinary bladder in men. It provides fluid to help in male reproductive functions. The prostate gland surrounds a tube, called the urethra through which urine exits the penis. A problem affecting the prostate gland can affect how you urinate and may affect your sexual function. What is prostate cancer? Prostate cancer is the commonest cancer in men. Globally, around 1.1 Million men are diagnosed with prostate cancer and more than 300,000 die of prostate cancer in a year. Prostate cancer is less common in men below the age of 50 years. The average age for diagnosis is 70 to 74 years. The risk is greater for men who have a family history of prostate cancer and in African men. Prostate cancer is more common in developed, western countries, suggesting that there may be a link with lifestyle factors such as diet. Prostate cancer can grow very slowly or very quickly. Slow-growing cancers are common and may not cause symptoms or shorten life. Click here to know about Kidney Transplant in Delhi What are the Symptoms of Prostate Cancer? Many men with prostate cancer have no symptoms related to their cancer. For those that do have symptoms, they could include any of the following:
The PSA test is a blood test that measures the level of prostate specific antigen (PSA) in your blood. PSA is a protein made by the prostate gland. It is released into the bloodstream, depending on your age and the health of your prostate. A raised level may mean you have prostate cancer. About two out of three men (67%) with a raised PSA will not have prostate cancer. The higher the levels of PSA, the more likely it is to be a sign of cancer. The PSA test can also miss cancer. Other conditions which are not cancerous (for example, benign enlargement of the prostate, prostatitis, and urinary infection) can cause higher PSA levels in the blood. The PSA test is often done to detect cancer in men who have problems passing urine. It is also used to help in the treatment of men who are known to have prostate cancer. It can detect early prostate cancer before it causes symptoms or there is any abnormality of the prostate. When you have a PSA test, you should not have:
PSA testing combined with DRE helps identify prostate cancers at their earliest stages. Visit now for Robotic Surgery Cancer Multi-parametric Magnetic Resonance Imaging (mpMRI) This is a type of MRI scan in which three pulse sequences are used, with the results combined and analysed together. An mpMRI cannot diagnose prostate cancer, however if cancer is suspected, your doctor may recommend this test to identify which areas of the prostate may be abnormal. This may reduce the need for a biopsy. PET scans These specialised scans are much more sensitive and specific in detecting recurrent or metastatic cancers. The prostate specific membrane antigen (PSMA) PET scan is the most commonly used. Bone scan This scan can show whether the cancer has spread to your bones. It can be used for later comparison if needed. A small amount of radioactive material (technetium) is injected into a vein. After 1–2 hours, you will have a body scan. This scan is painless. How is prostate cancer treated ? The treatment of prostate cancer depends upon many factors. The type of cancer, whether or not the cancer has spread (metastasized), a patient’s age, general health status, and prior prostate treatments the patient may have undergone. There are three standard therapies for men with organ-confined prostate cancer : Deferred treatment (active surveillance/watchful waiting) Surgery Radiation Therapy. Active Surveillance Active surveillance may be recommended only if a cancer is not causing any symptoms and is expected to grow very slowly. The cancer is regularly and carefully monitored with PSA, clinical evaluation and intermittent prostate biopsies to ensure that the cancer is not becoming more aggressive. If progression of the cancer is evident, active treatment can be started. This approach is sometimes suited for older men or those who have other serious health problems. Because some prostate cancers spread very slowly, older men who have the disease may never require treatment. Other men choose active surveillance because they feel the side effects of treatment outweigh the benefits. Watchful waiting Watchful waiting (WW) is also known as deferred or symptom-guided treatment. It refers to conservative management, until the development of local or systemic progression with (imminent) disease-related complaints. Patients are then treated according to their symptoms, in order to maintain quality of life. In contrast to Active surveillance, no specific tests or markers are used to actively monitor disease. It is used for elderly patients with a short life span. Surgery Surgical treatment of prostate cancer involves removing the entire prostate as well as the seminal vesicles (small glands near the prostate), with or without the removal of lymph nodes - a procedure called radical prostatectomy. Radical prostatectomy – can be done by various approaches. 1. Open radical prostatectomy – entails an incision on the lower half of the abdomen and removal of the prostate. Although it is the oldest procedure, it entails a longer hospital stay, bigger wounds and greater chances of infection. 2. Laparoscopic Radical Prostatectomy – is done by making small holes in the anterior abdomen. It is a technically challenging operation requiring advanced laparoscopy skills by the surgeon. The hospital stay is shorter, the recovery of the patient is faster and the chances of infection are lesser. 3. Robotic assisted laparoscopic prostatectomy/Robotic radical prostatectomy The three goals of surgery, in order of importance, are cancer control, preservation of urinary control, and preservation of sexual function. Great skill and experience in the selection of surgical candidates and operative technique are necessary to achieve all three. With the advent of robotic surgery, improvements have been made in the surgical technique. RARP is now the most preferred and most advocated surgical technique for Radical prostatectomy. Click here for Uro Onco Surgeon in Delhi What happens during the procedure ?
Are there any side-effects?
Most procedures have possible side-effects. But, although the complications listed below are well-recognised, most patients do not suffer any problems.
Common (greater than 1 in 10) - Temporary difficulties with urinary control. - Impairment of erections even if the nerves can be preserved (20 to 50% of men with good pre-operative sexual function). - Inability to ejaculate or father children because the structures which produce seminal fluid have been removed (occurs in all patients). - Discovery that cancer cells have already spread outside the prostate, needing further treatment. Occasional (between 1 in 10 and 1 in 50) - Scarring at the bladder exit resulting in weakening of the urinary stream and needing further surgery (2 to 5%). - Severe urinary incontinence (temporary or permanent) needing pads or further surgery (2 to 5%). - Blood loss needing transfusion or repeat surgery. - Further treatment at a later date, including radiotherapy or hormone treatment. - Lymph fluid collection in the pelvis if lymph node sampling is performed. - Some degree of mild constipation can occur; we will give you medication for this but, if you have a history of piles, you need to be especially careful to avoid constipation. - Apparent shortening of the penis. - Development of a hernia related to the site of the port insertion. - Development of a hernia in the groin area at least 6 months after the operation. Rare (less than 1 in 50) - Anaesthetic or cardiovascular problems possibly requiring intensive care admission (including chest infection, pulmonary embolus, stroke, deep vein thrombosis, heart attack and death). - Pain, infection or hernia at incision sites. - Rectal injury needing a temporary colostomy. Radiation Therapy Radiation therapy is either a non-invasive, or minimally invasive treatment for prostate cancer that uses x-rays or gamma-rays to eradicate prostate cancer cells. Prostate cancer treatments have several forms of radiation therapy that may be recommended. Each patient receives a customized treatment plan depending on the nature of the cancer, the patient’s unique symptoms and overall health. Click here for Bladder Cancer Treatment in Delhi Prognosis Prognosis means the expected outcome of a disease. Generally, prognosis is better when prostate cancer is diagnosed while it is early stage, and at a lower grade. You will need to discuss your prognosis with your doctor. However, it is not possible for any doctor to predict the exact course of the cancer. Test results, the extent of the spread of the cancer, and factors such as your age, level of fitness, medical and family history are important in assessing your prognosis. These factors will also help your doctor advise you on the best management or treatment options and tell you what to expect. Prostate cancer often grows slowly and even the more aggressive prostate cancers tend to grow more slowly than other types of cancer. Compared with other cancers, prostate cancer has one of the highest five-year survival rates. For many men, the prostate cancer grows so slowly that it never needs treatment. Many men live with prostate cancer for many years without any symptoms and without it spreading. Chronic kidney disease (CKD) are conditions that negatively affects the ability of kidneys to function properly. It damages your kidney and reduces its ability to do the jobs it is meant to do in order to keep the body healthy and functioning properly. One of the primary function of the kidneys is to eliminate waste out of the body. And in case of chronic kidney diseases, too much waste that accumulates in the blood can make one feel sick. Some other complications that may develop along with this includes anemia, high blood pressure, nerve damage, poor nutritional health, and weak bones. Also, CKD increases the chances of heart and blood vessel diseases. If the CKD reaches an extreme state even the Best Kidney Doctor in Delhi might find it difficult to treat, even with the help of Robotic Surgery Cancer. Here are some general facts about Chronic Kidney Disease.
Open surgery is a type of surgery that has been traditionally used over the decades. It involves large incisions into the body that are made using a scalpel. Then the surgeon used the surgical instruments to conduct the operation. Open surgery is often compared to modern types of minimally invasive surgeries such as laparoscopic surgery. Laparoscopic surgery is being used by some of the Best Kidney Specialist in Delhi and also by many prostate cancer. It involves making minor incisions as small as 0.5 cm to 1.5 cm to conduct the surgery. Laparoscopic surgery might seem to be the best way to perform operations, however, there are still many cases that requires open surgery.
Although some surgeries are still done using the tradition method of open incision, the number of operations performed using laparoscopic surgery is far greater. A Prostate Cancer Specialist in Delhi might mean a very small incision and it can also mean no incision at all, depending upon the technique of surgery being used. It also causes less pain than open surgery, which means that less medication is needed to manage pain. Nowadays, more and more surgeons are opting for laparoscopic surgery over open surgery whenever possible, owing to its advantages over the other. Laparoscopic surgery provides much lower risks of infection, equally successful outcomes, and also needs shorter time for recovery. Sometimes, a surgery starts out as a laparoscopic surgery with minor incisions, and converts into an open surgery when the surgeon feels a need for greater flexibility. |
AuthorDr. Anant Kumar, Robotic Surgeon in India, has 32years of practice in urology & kidney transplantation and is presently the Chairman of Uro-Oncology, Robotic & Kidney Transplantation Max Hospital Complex at Saket New Delhi & Max Hospital Vaishali.www.roboticsurgeonindia.com/ |