Prostate cancer: Cancer discovery, monitoring and treatment

PROSTATE CANCER

Prostate cancer is a disease that develops from initially normal prostate cells that transform and multiply uncontrollably, until they form a mass called a malignant tumor.

The majority of prostate cancers are adenocarcinomas (90%); they develop from the cells that make up the lining tissue of the prostate (epithelial cells).

DISCOVERY OF PROSTATE CANCER

Most often, the discovery of prostate cancer follows a PSA measurement and/or an abnormality in the consistency of the prostate during a digital rectal examination. The diagnosis can also follow a surgical treatment of a prostate adenoma. More rarely, when the cancer is advanced, it sometimes causes symptoms that lead one to suspect its presence, such as an infection of the urinary tract, the presence of blood in the urine or in the semen, urine retention, pain in the the lower back or in the bones.

To establish the diagnosis, your doctor questions you and then performs a clinical examination including a digital rectal examination. He prescribes a PSA blood test. When these various examinations reinforce the suspicion of cancer, your urologist may suggest that you perform a prostate biopsy under local anesthesia. Finally, an imaging assessment is sometimes performed.

MONITORING AND TREATMENT

The choice of care strategy is adapted to your personal case. It depends on the characteristics of the cancer you have: where it is located, its histological type, i.e. the type of cells involved, its stage, i.e. its degree of extension, and its grade, i.e. its degree of aggressiveness. These characteristics are determined through examinations of the diagnostic work-up. Your situation is discussed during a multidisciplinary consultation meeting (RCP) which brings together at least three doctors from different medical specialties (urologist, medical oncologist, radiation oncologist, pathologist, etc).

Several types of treatment can be offered depending on the results of the various examinations carried out during the diagnostic assessment: surgery, external radiotherapy, brachytherapy, hormone therapy, active monitoring.

National Cancer Institute. Prostate cancers: key points [Internet]. E-cancer.fr. [cited 2022 Nov 2]. Available from: https://www.e-cancer.fr/Patients-et-proches/Les-cancers/Cancer-de-la-prostate/Points-cles