Prostate cancer - life during and after treatment
The prostate is located below the bladder, surrounding the initial part of the urethra in men. Malignant tumour is the third most common malignancy among men, with nearly 5,000 new cases diagnosed in 2019, every 10th newly discovered tumour originates from the prostate. The risk increases with age, with the majority of patients diagnosed over the age of 60 years. Thanks to modern therapies (surgery, radiotherapy, hormone therapy and chemotherapy), it is now more common for patients to die with their prostate tumour rather than because of it. Since it has become an almost “chronic” disease, it is extremely important to maintain and improve the quality of life of these men.
Symptoms of prostate cancer
The first symptom of the disease may be difficulty urinating caused by prostate enlargement, with frequent urination at night. Often asymptomatic, it is detected on the basis of complex screening tests (blood test for PSA and rectal physical examination). Pelvic MRI and CT of the chest, abdomen and pelvis are required as imaging tests to assess the exact extent of the disease. Bone isotope test can be applied to check bone involvement, and PSMA-PET/CT using isotopes can be used for the most accurate detection of small metastases.
Blood PSA, as mentioned above, provides information about the disease, by tracking its changes both during the therapy and during the follow-up process to provide information about the activity and extent of the disease.
Treatment of prostate cancer
For localized disease (that does not metastasize to distant organs such as the lungs or bone), one of the bases of therapy is the removal of the prostate, known as a nerve-sparing radical prostatectomy. In this case, the prostate is removed by sparing the nearby nerves (which are responsible for erection and sexual function), so that impotence following conventional surgeries is less common. Since, in such cases, a part of the urethra is also removed, difficulty in holding urine, urinary incontinence often develop.
Another procedure with a similar recovery rate in terms of results is radiation therapy. Using modern equipment, a skilled radiotherapist can precisely outline the area to be irradiated, so that the radiation beam reaches almost only the area of the prostate affected by the tumour. Side effects are minimized, which are the most commonly urinary complaints (frequent, burning urination) and diarrhea due to urinary tract and rectal inflammation.
In terms of medication, almost all patients encounter hormone therapy during their illness. This is based on the fact that testosterone, which is produced mainly in the testes, but also in the prostate and adrenal glands, stimulates prostate tumour cells to divide and grow. If testosterone is deprived from the body, the growth of malignant cells is slowed down and stopped. This is the basic therapy for prostate cancer (to be honest, since testosterone is produced in the testicles, the base treatment to this day is bilateral castration). The hormone preparations are administered in the form of injections given under the skin, which must be repeated every 1 or 3 months, depending on the dose packaging. Testosterone levels are reduced by these products, so their side effects also originate from this. Decreased libido, loss of muscle mass and deterioreation of the memory are the most common. During the hormone therapy, a proper diet and regular exercise, especially weight-bearing exercises, are recommended.
There are various options to maintain and improve libido, and psychological support is also useful in these cases. To preserve cognitive functions, various activities such as chess, reading, crossword puzzles are recommended.
- az egyik első olyan új betegtámogató rendelés, amely a külföldi példák nyomán elérhető Magyarországon,
- amely az állami ellátásban korlátozottan érhető el,
- amelynek célja az onkológiai betegek életminőségének javítása a lehetőségekhez képest legmagasabb szintre,
- valamint célja az esetleges visszaesés vagy a betegség tovább terjedésének megelőzése.
Dr. Martin Tamás
Intézetünk klinika onkológusa pesti járóbeteg rendelőnk Onkorehabilitációs Központjában tumoros betegek komplex rehabilitációját, utógondozását, valamint rákprevenciót végez. A többi között felméri a betegség kiújulási áttétképződési esélyeit és javaslatot tesz ezek kiszűrésére, megelőzésére.