B.K.Kidney & GI Center

Hi All,

I am dr. Shrikant M.Badwe. I am urologist practicing for the last 38 years. Let me tell you something about prostate cancer, prostate cancer is the second leading cancer all over the world and in the large metropolitan cities in India like Delhi, Kolkata, trivandrum and 3rd leading cancer in Mumbai and Bangalore. The unique think about prostate cancer is that in early-stage most often there are no signs and symptoms whatsoever. It's only when the prostate cancer becomes advanced or it spreads the symptoms like blood in the urine or back pain, bone pain, hip pain or blood in the semen all these symptoms are seen.

So it is extremely important to look for prostate cancer with high index of suspicion and this is done by doing screening test beyond the age group of 50 and this screening should be done at regular intervals by urologist. Screening consist of doing a blood test which is known as prostate-specific antigen and a regular examination of the prostate gland by putting a finger in the rectum which is known as digital rectal examination.

Whenever there is a suspicion of the presence of prostate cancer, the urologist will advise you further appropriate test like a CT scan or MRI or one more advanced PSMA scan; However, the fact remains that diagnosis of real prostate is confirmed by doing a biopsy through ultrasound guidance.

There are multimodal, that is various ways of treating prostate cancer depending upon the stage of prostate cancer. It needs to be emphasized that early diagnosis in early-stage prostate cancer can be completely cured by surgery or radiation therapy. However, in disease which is advanced or spread, various treatment modalities which are available which gives rewarding results and significant relief to the patients who are suffering from advanced disease. Now let me talk to you some common myths about prostate cancer and what are the actual facts about prostate cancer.

One of the myths is that prostate cancer is an uncommon disease, a rare disease in India and it is a disease of only affluent countries like USA or European countries, the fact is this is completely wrong, in fact, it is the second leading cancer as I said before in all over the world and even in Indian cities like Delhi, Calcutta, Pune and also in Bangalore and Mumbai.

Another myth is prostate is a disease of elderly people or older men, again not true. Majority of the patients, that is 65% are of the age of 65 or more however in 30% of the cases this cancer occurs before the age of 65 years and also in men with a family history of prostate cancer, the risk doubles and cancer can occur in a much earlier age.

One myth is that CA prostate is very non-aggressive, extremely slow-growing disease and patient of CA prostate die with the disease and never dies because of the disease, again it is a myth the fact is it isn't true. Many prostate cancer patients die prematurely, early and in our country one must remember that 75% of the patients are diagnosed late with metastatic disease or advanced disease and they suffer enormously, quality of life is often extremely poor and they require a specialized high-end treatment which is available and cares, which gives them good relief and rewarding relief.

Another myth is that once you do PSA and if the PSA test is high that means it is CA prostate, not at all true, high PSA can be due to just benign that is non-cancerous grossly enlarged prostate gland or infection in the prostate gland and sometimes infection of the urinary tract, UTI that also can give rise in PSA.

Your urologist will consider these various facts and judicially advise you and decide the further test, so once the PSA test is done, even if it is high you must see the urologist and plan further. Many people feel that once doctors tell you to do a biopsy of the prostate cancer, it will spread cancer. This also is absolutely untrue there is no risk at all, in fact, the transrectal sonography guided biopsy is mandatory for the diagnosis of prostate cancer and also for planning the treatment of prostate cancer.

Nowadays everybody feels that with the advent of robotic and laparoscopic surgery the results are much better and it is necessary to undergo this kind of expensive operation, that is a myth. Actually speaking, in many studies in the literature it had been proved completely, that open surgery, that is regular open surgery, laparoscopic surgery and robotic surgery all are equally effective if they are done in experts hand, inexperienced hands and by following the strict principles of cancer surgery.

Friends, I think that few of the myth I have explained to you and this will help you in seeing your urologist early at regular intervals and do your screening for prostate cancer.

Thank you.
 

Hello!

I am Dr. Shrikant M Badwe. I am a urologist. I have my own setup for urinary disease in Mumbai. I am also attached to various major hospitals, Mumbai. Now let's talk about what are the newest advances in treatment of urinary stone disease i.e. urolithiasis. One must remember there are a lot of advancements happening in every field. Now the stones can be formed anywhere in the kidney. This disease was treated totally in a different way in the past and now we have latest technologies. Previously we used to make a big cut in the body to remove the stones. Nowadays we enter the kidney through a pinhole. Small incision is made through which a wire can be passed. We remove the stone completely. This is known as PCNL. Now it also has changed a lot. Initially, the size of the hole was not that small but now it is becoming smaller and smaller.

A new technique with which we can make a very small hole or incision to fragment the stone and remove it. There are stones which carry urine from the kidney to the bladder which is known as ureter, those can be treated by special instruments. Previously, we used to go with large telescope inside the kidney and its size was 14 mm and now we are using the instrument of 4 mm. With such an instrument it is not that easy to burst the stone. So, we require laser for fragmentation. And we remove the stones with small incisions only. If the stones are right higher up from the kidney, sometimes these instruments cannot go to that level and sometimes these stones can move into the kidney. For this, we have flexible scope. It can enter right inside the kidney. It can reach anywhere in the kidney. With this we also have to pass a fiber which is a laser fiber. There are lots of advantages and disadvantages of laser. It is extremely fast. It never causes any damage to the surrounding delicate structure. Any hardest stone can also be fragmented with that.

Mechanical blasting of the stone causes lots of injuries. All these can be prevented if we use holmium laser. The procedure can be done very fast and patient can also be discharged from 48-72 hours. Stones in the bladder are easy to treat. We go inside through urinary passage inside the bladder and fragment the stone. Small stones can be passed out of the system. Now, these stones also require some interventions. Like patient is getting continues pain and it is disturbing his day to day life than one goes in and treat it. Second thing, if patient is getting fever then it means that patient's kidney is getting infected. So, we have to treat it early. And if both the kidney starts getting damaged, then one kidney needs to be treated early to treat the stone. So, patient who requires treatment early are pilots, air-hostess, sailor or somebody is having exams, marriage in near future because they cannot take the leaves for long. Treatment of stones in the urinary system should be done with lot of thoughtfulness and holistic thinking of the patient's stone or the type of stones. It should be offered with honesty and with ethical approach. So, if you want to have treatment of this kind of stones, you can contact me through lybrate.com.

Thank You.