

Prostate cancer is defined as the growth and development of abnormal cells in the male prostate gland, which is a small muscular reproductive gland in the male. It is the most common cancer in men all over the world. Most men are often unaware of this disease due to the lack of less prominent symptoms, which leads to the spread of cancer in other parts of the body (advanced stage). Early detection and appropriate treatments can help to overcome prostate cancer effectively.
What are the Stages of Prostate Cancer?
Prostate cancer can be categorized into three stages based on the TNM system, which is given below:
- Tumour (T) stage
- Node (N) stage
- Metastasis (M) stage
Among the above stages, the M stage is the advanced stage of prostate cancer in which the cancer has started to spread to different parts of the body.
What are the Symptoms of Prostate Cancer?
Prostate cancer does not show any prominent symptoms in its early stage. However, when the disease progresses and spreads to the prostate gland, the patient may experience some common symptoms, which are given below:
- Urinary problems: Prostate cancer leads to the enlargement of the prostate gland, which affects the urethra and leads to urinary problems.
- Blood in Urine or Semen: You may see blood in the urine or sperm which may indicate prostate cancer.
- Erectile Dysfunction: Nerves and blood vessels can impact around the area and are responsible for erectile dysfunction.
- Pain and Discomfort: Advanced prostate cancer can lead to pain in the pelvic area, lower back, hips, or upper thighs. This discomfort may be persistent and progressively worsen over time.
- Bone Pain: Prostate cancer can spread to bones in the advanced stage, which leads to bone pain, particularly in the spine, hips, and pelvis.
How to Diagnose Prostate Cancer?
- Prostate-specific antigen (PSA) test
- Digital rectal exam (DRE)
- Computed tomography scan (CT Scan)
- Magnetic resonance imaging (MRI)
- Biopsy
How to treat prostate cancer?
- Surgery (Radical Prostatectomy)
- Chemotherapy
- Radiation therapy
- Immunotherapy
- Targeted therapy
- Hormonal therapy (Androgen deprivation therapy)
Androgen Deprivation Therapy:
Androgen Deprivation Therapy is the primary and first line treatment in advanced stages when the disease has spread beyond the prostate gland. Androgens are essential for the production of testosterone, which acts as a fuel for the growth of cancerous prostate cells. This therapy aims to block the action of this androgen. It shuts down the action of testosterone, thereby eradicating tumor cells. It is the gold standard and often the first-line treatment for advanced prostate cancer. Surgical and medicinal castration, as well as conventional ADT, lower androgen production. However, nonsteroidal ADT blocks the androgen receptor directly, offering a treatment for prostate cancer. The effectiveness of these nonsteroidal ADTs is achieved without lowering the amount of synthetic androgens.
Calutide 50mg tablets containing bicalutamide have been used widely for many years. It can also be used in combination with surgical castration of androgen deprivation therapy or LHRH therapy. Other anti-androgen medications for prostate cancer therapy are nilutamide, flutamide, enzalutamide, apalutamide etc.
Radiation therapy:
The widely used radiation therapy for prostate cancer is external beam radiation therapy. It is used for localized prostate cancer, particularly in those with the illness at low to intermediate risk. In cases like advanced metastatic prostate cancer, where the cancer has started to spread from the prostate gland, it is applied to control the symptoms, ease out the pain, and improve the quality of life in patients.
Usually, for advanced cases, radiation therapy will only help limit the spread and metastasis but not treat or cure the tumor itself. Sometimes, it can also be used as a last option for cancer that has returned after the first treatment or to lower the chance of cancer recurrence.
Radiation therapy stops cancer cells from proliferating and dividing by causing damage to their DNA. Because ADT can increase the radiation sensitivity of prostate cancer cells, radiation therapy may be more successful when paired with it. Various patients are given personalized treatment based on the assessment of Gleason score, PSA levels, tumor stage, and metastasis presence.
Conclusion
The effective use of combinational therapy that include the radiation therapy to shrink the tumors and androgen deprivation therapy to eradicate the cancer cells will yeild a better outcome compared to monotherapy. There are further research and trials undergoing which will unlock new potential treatment plans for better patient outcomes.





