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Prostate Cancer: Causes & Treatment Options
Causes of Prostate Cancer

- Age: Prostate cancer risk goes up as men get older and are much more common after the age of 50 years.
- Race: US African-American men are more likely to get prostate cancer than other men.
- Family History: Men with some close family member who has had prostate cancer are more likely to get affected by it themselves.
- Genetics: Some inherited genes seem to raise risk of prostate cancer.
- Diet: Men who eat a lot of red meat or high-fat dairy product seem to have greater chances of developing prostate cancer.
- Medication: Some studies say there might be a link between daily use of anti-inflammatory medicines and prostate cancer.
- Obesity: Some studies have found that obese men have greater chance of suffering from advanced prostate cancer and dying because of it.
- Sexually Transmitted Disease: Men who have had gonorrhea have higher chance of developing prostate cancer.
Prostate Cancer Treatment
- Surveillance: Carefully observing growth of prostate tumor as they are slow growing and monitored through regular PSA blood levels.
- Brachytherapy: Radioactive seeds are implanted in prostate gland & which deliver high radiation doses to the tumor while reducing radiation exposure to the surrounding healthy tissue.
- Conformal Radiotherapy: This option allows the treatment team to plan radiotherapy treatment area very precisely in 3D dimensions - width, height and depth.
- Intensity Modulated Radiotherapy: Intensity of radiation can be changed during treatment to spare adjoining normal tissue. It is a type of conformal radiotherapy which shapes radiation beam to closely approximate shape of the tumor.
- Surgery: Surgery is the most common choice for prostate cancer treatment if it has not spread outside the prostate gland. The most common type of surgery is radical prostatectomy in which the surgeon removes the entire prostate gland.
ALSO READ: Robotic Prostate Surgery
Evolution of Neck and Back Surgery
The primary purpose of neck or back surgery is to correct an anatomical lesion in individuals who fail to show enhancement with conservative, that is, non – surgical treatment. Surgery isn’t an option for those patients whose anatomical lesion accounting for their pain cannot be identified. Surgery is useful only if there is a need to change the patients’ anatomy. Like for example, to remove disc herniation. There is no particular reason to consider an exploratory surgery to look for a source of pain. An unsuccessful conservative treatment is itself a sign for surgery. A noticeable anatomic lesion is also necessary.
Evolution in Spine Surgery
Present – day spine surgery has made major developments in both spinal implants and technique over the past couple of decades, but even until today the most remarkable progress in spine surgery has been better pre – operative imaging techniques, which have been greatly improved the ability of the surgeons to spot accurately and correct an anatomic lesion as a source of pain.
Definitely, MRI scan (Magnetic Resonance Imaging) has transformed back surgery. It is the most frequent and the best test to recognize an anatomical lesion responsible for the patient’s problem. The most vital factor in the resolution of the success in spine surgery is proper pre – operative diagnosis. Without an appropriate pre – operative diagnosis, even the most technically successful operations have a little chance for a successful result.
Though spine surgery is done by either neurosurgeons or orthopedic surgeons, it is more and more becoming a field unto itself. Many surgeons are doing extra specialized training in the field after their residency training. Given the precision needed for these more demanding surgical techniques, many neurosurgeons or orthopedic surgeons with fellowship training are choosing to concentrate more of their practice on spine surgery. Some trust that the increased level of special training and concentration on the spine have donated to enhancements in surgical techniques, which in turn have led to overall better success rates and minimized morbidity with many types of spine surgeries. For example, the reduced post – operative discomfort.
Objective of Spine Surgery
Spine surgery is generally an elective undertaking, which means that it is observed as a possible approach to increase a patient’s ability to function and reduce pain. Anyhow, just because spine surgery is elective doesn’t mean that it is not covered by insurance. Elective surgery may be medically necessary. ‘Elective’ means that the surgery of spine is seldom an absolute necessity. Only in exceptional instances, like for patients who have a progressive neurological loss of function or sudden start of bladder or bowel incontinence, is spinal surgery is actually mandatory on an emergency basis.
Spine surgery can basically achieve three tasks:
- Decompress the spinal cord or a nerve root.
- Stabilize a painful or an unstable segment with spinal fusion surgery.
- Reduce a distortion (for e.g. scoliosis surgery in the thoracic spine).
Spine surgery isn’t done for exploration. The source of a patient’s pain isn’t readily apparent with exploring and opening the spine. The pre – operative evaluation and imaging results are what identifies the problem and guide the diagram of the procedure.
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Spinal Fusion or Artificial Disc Replacement: Which Option Is Better For You?
- Spinal Fusion
- Artificial Disc Replacement (ADR or Total Disc Replacement or TDR)
Lumbar Spinal Fusion
Normal approach to treat pain and/or disability from lumbar degenerative disc disease is spinal fusion. This surgery involves making a direct bony connection between the vertebrae surrounding the painful discs; by stopping motion of the painful discs & which can give the patient relief from pain. There are plenty of options available with spinal fusion, each one having its own advantages and disadvantages. Surgical methods include fusion approached from the front, back or both. Spinal instrumentation in the form of pedicle screws and/or intervertebral cages provide internal structural help while bones fuse, and bone graft can either be harvested or one of a number of synthetic bone graft surrogate or extenders can be used from the patient themselves.
Lumbar Artificial Disc Replacement
With artificial disc replacement, pain relief is brought by removal of the painful disc and motion is maintained by using a prosthetic implant made of metal, without or with a plastic bearing surface. This is somewhat more similar in theory to the artificial hip, knee and the shoulder joints that the Orthopaedic surgeons have been using it for more than 35 years to maintain the range of motion and to get relief from the pain of arthritic extremity joints. But there is a significant difference that only one of the three joints is present at each vertebral level is being replaced, whereas in a knee or hip joint the total joint is replaced.
Fusion Surgery is Most Prevalent
By far till now, fusion surgery is still the most prevalent surgery, and patients should be aware that most of them won’t be eligible for disk replacement as it can treat only limited types of disc pathology. Some are considered same for certain types of artificial disc replacement and fusion. Like, for example, an anterior approach is used for both artificial disc replacement and for an anterior lumbar interbody fusion, which means that risks and potential complications are similar for both the surgeries. Well, for most of the part, there are unique considerations for every type of surgery, and the patients are well advised to get as much educated as possible when considering these two surgeries and analyze their options thoroughly with their treating or consulting physicians.
Determining the Right Treatment for Back Pain
Prior to, considering any type of surgery, patients with chronic low back pain should remember that not all pain are treatable by surgery. The collapse of non-operative treatment doesn’t mean that surgery is necessary to be the next step. Estimation with X-rays and MRI scan may be enough for the surgeon to give an opinion, but other tests including provocative discography and CT scan may be required to determine if surgery is suitable and if both artificial disc replacement and spinal fusion are options.












