Comprehensive Urology is among the nation’s premier experts in the treatment of prostate cancer, which affects nearly 3 million American men. While it’s not uncommon for men with prostate cancer to show none of the regular symptoms (which can include blood in the urine, difficulty urinating, pain in the pelvis or back while urinating, and chronic fatigue), it’s extremely important to get a prostate cancer screening, especially if you have a family history of the disease. Early screenings are one of the main reasons that this disease is so treatable and current survival rates are so high.
However, the fact that this disease is so common – along with the fact that your chances of surviving it are often very high – has not always been the case. Let’s take a brief look at prostate cancer over the last century and a half and see how diagnoses and treatment have changed over time.
The Rise of Prostate Cancer
The rate of prostate cancer has exploded since the mid-1800s, despite the fact that diagnosis and treatment have evolved and improved drastically. So, why the proliferation of cases? There are several reasons:
- Medicine has not always been able to distinguish between prostate issues and other types of urinary obstruction problems
- Incidence of prostate cancer increases once a man reaches the age of 50. As human life expectancy has increased, so have the number of cases
- Dietary and/or environmental causes. Men in western countries have far higher rates of prostate cancer than men in Asian countries. This is highlighted further by the fact that the cancer rates increase after these Asian men immigrate to western countries
The Early Years of Treating Cancer of the Prostate
The first known case of prostate cancer was discovered in 1853, when Dr. J. Adams of The London Hospital recorded what was, at the time, a very rare type of cancer. As such, the disease was poorly understood and treatments varied. In fact, the first treatments of prostate cancer were surgeries intended to relieve urinary obstruction. In the 1890s, a surgical procedure called orchiectomy (removal of the testes) was implemented, though it was met with limited success.
It wasn’t until 1904 that radical perineal prostatectomy (removal of the entire prostate) was first performed, done so by Hugh H. Young of Johns Hopkins Hospital. The treatment remained basically unchanged for approximately 80 years, yet it wasn’t as common as you would think for one simple reason: nearly all patients were left impotent.
Radiation therapy was also first used in the early 1900s. Doctors inserted needles with radium into the prostate itself to reduce tumor growth, but it was very difficult for surgeons to perform and for patients to endure.
Even as recently as the mid-1900s, diagnoses of cancer of the prostate were typically made in men over 70-years-old. By that age, most patients had advanced stages of metastasis (spread) and were usually dead within 1-2 years.
Treatment in the Mid-20th Century
In the 1940s, androgen ablation therapy, which is effective and useful even today, was discovered. Essentially castration by chemical means, the procedure was effective in treating not only metastatic cancer but also other types of cancer that depend on the action of male hormones to grow, as this therapy blocks the production of male sex hormones.
Discovered by Charles Huggins (who won the 1966 Nobel Prize as a result), this treatment was advocated by many physicians because it reduced the size of the prostate gland, decreased pain, and increased appetite and weight gain.
Although there were drawbacks to androgen ablation therapy – lower testosterone levels, increased risk of blood clots, and cardiovascular problems – it led to the discovery of alternative approaches.
Radical retropubic prostatectomy was developed in 1945 by Terence Millin in London. This total removal of the prostate gland was further developed by Patrick Walsh in early 1980s and “nerve-sparing” approach allowed better preservation of erectile function as well as urinary continence for men after surgery. This technique is still utilized daily in open prostate surgeries across the world.
Treatment in the Late 1900s
The decade of the 1980s was an important one in terms of prostatic cancer treatment. In 1983, an approach called radical retropubic prostatectomy that had been utilized in the past for some decades, was further developed and especially “nerve sparing” modification was added by Patrick Walsh. It involved removing the prostate gland, yet because of recent advances in the control of bleeding, it helped patients avoid the damage that the surgery had, until that point, wrought on erectile function and sexual potency.
With development of minimally invasive surgery (laparoscopy) it was adapted for prostate removal as well. Advent of the daVinci® robotic-assisted surgical system and later its widespread popularity (less bleeding, shorter hospital stay, less post-operative pain, and improved suturing of urethra to the bladder neck after removal of the diseased prostate gland) has resulted in robotic prostatectomy to become the most popular prostate cancer surgery in the United States.
About the same time, a technique using ultrasound guidance made brachytherapy (the placement of radioactive pods in the prostate) easier and more effective. Today, brachytherapy is a common, successful method of addressing localized cancer.
Also around this time, prostate-specific antigen (PSA) was discovered to be an effective serum marker for the disease. This led to FDA approval of PSA screenings, which have helped saved countless lives. Learn more about prostate-specific antigen screening at WebMD.com.
Today’s Treatment Options
Nowadays, the typical prostate cancer patient is not the same as he once was, as a man in his 60s who is diagnosed with this disease is usually found to have a localized, not metastatic, form of cancer. This makes it more likely that a man can survive the disease and maintain his quality of life.
Effective treatments available at Comprehensive Urology in Los Angeles today include:
- Robotic prostatectomy
- Radiation treatment
- Active surveillance
- HIFU (High Intensity Focused Ultrasound) ablation
- MRI Fusion therapies (eventually combined with HIFU)
Learn More By Contacting Comprehensive Urology
As good as current prostate cancer treatment methods are, the future looks even brighter. To learn more about prostate cancer treatments and diagnoses, contact Comprehensive Urology in Los Angeles today.