Ludhiana: First person, from scalpel to scan, the evolution of prostate care

Ludhiana: While prostate diseases used to be treated almost exclusively with invasive surgery, they are now being managed with advanced imaging, robotic precision, and, in many cases, careful observation, rather than immediate treatment. Dr. Vivek Kataria, Assistant Civil Surgeon and Urology Specialist, speaks with Manav Mander about prostate diseases, which have become a major public health concern for men worldwide.
For decades, prostate diseases were treated with surgery. How has care changed in recent years?
We have entered a new era. Today, advanced imaging, robotic precision, and careful observation are often considered superior to immediate invasive surgery. This shift prioritizes early detection, accuracy, and quality of life. But it still largely depends on men seeking timely medical care.
Why is prostate health becoming such a major concern worldwide?
Even though the prostate is small, diseases of this gland can have a significant impact on quality of life. As people age and lifestyles become more sedentary, prostate diseases are steadily increasing worldwide. Awareness and early diagnosis are more important than ever.
What do the numbers tell us?
The burden is enormous. Benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate, affected more than 112 million men in 2021, more than double the rate in 1990. Prostate cancer is the second most common cancer in men worldwide, with 1.46 million new cases and approximately 397,000 deaths in 2022. While detection rates are higher in developed countries due to screening, cases are rising in developing regions as life expectancy improves.
What causes prostate diseases?
It’s a complex interaction of age, hormones, genetics, and lifestyle. Prostatitis is often caused by infection or chronic inflammation. BPH is linked to hormonal changes that occur with aging. Prostate cancer is caused by genetic mutations, hormonal influences, and lifestyle factors such as obesity, poor diet, and inactivity. A family history of prostate disease also significantly increases the risk.
What symptoms should men look for?
Unfortunately, many early signs are overlooked. Frequent urination, reduced urine flow, difficulty starting urination, or waking up at night to urinate are often dismissed as normal signs of aging. Pelvic discomfort, painful urination, and sexual dysfunction can be tolerated silently. In prostate cancer, there may be few or no symptoms in the early stages. Warning signs such as blood in the urine or semen, persistent back pain, or erectile problems should prompt medical attention.
How has treatment changed?
In the past, surgery was the default treatment for a diagnosis. Now, we rely on prostate-specific antigen (PSA) testing, digital rectal exams, and multi-parametric MRI scans for faster and more accurate diagnosis. Minimally invasive and robotic-assisted surgery has replaced open procedures, offering greater accuracy, less blood loss, shorter hospital stays, and better protection of urinary and sexual function. For low-risk prostate cancer, active surveillance—monitoring through regular tests and scans—is increasingly being used. This means delaying treatment until the disease has progressed.
Despite these advances, why are many men still suffering silently?
Social stigma plays a major role. Men often feel embarrassed to discuss their urinary or sexual health. Fear of cancer, concerns about masculinity, or prioritizing work and family over personal health can delay diagnosis. This silence further worsens outcomes.
What role does public awareness play?
Medical innovation alone is not enough. We need awareness campaigns to educate men and their families about symptoms, screening, and modern treatments. Workplace health initiatives, community programs, and responsible media coverage can normalize conversations about prostate health. Routine screening, especially for men over 50 or those with a family history of the disease, can save lives.
What is the biggest challenge ahead?
The biggest challenge ahead is bridging the gap between scientific progress and public awareness. Modern medicine has transformed prostate care, but these advancements only help if men take action early. Open dialogue, education, and accessible healthcare are key. With timely screening and informed access to treatment options, prostate diseases can be effectively managed, allowing men to live longer and healthier lives.