Prostate cancer “prostate”
The prostate gland – musculo-glandular organ male reproductive system. From his state of health depend not only sexual performance, but also the normal life of a representative of a strong half of mankind. Therefore, the prostate gland or prostate is also called “the second man’s heart.” Below we will try to detail and clear talk about prostate cancer (prostate).
The prostate gland is represented by several types of cells, but the ability to fatal malignancy have a greater degree of
secretory cells (glandular) epithelium. Cancer, “born” from the glandular cells (glandulotsitov) is called adenocarcinoma. There are other types of cancer developing in the prostate, for example, sarcoma, small cell and urothelial (transitional cell) carcinoma, but they are much rarer adenocarcinoma, so our article will be devoted primarily to her.
Some types of prostate cancer grow and spread in the body fast enough, but it is rather an exception to the rule. There are cases when at the opening of a patient who died from very different diseases, prostate cancer is detected, of which neither the patient nor the doctor did not even know.
The average age of survival in prostate cancer
Prostate cancer is the second highest frequency of occurrence after skin cancer in men. It develops, as a rule, in old age. About two-thirds of cases of cancer of the prostate are persons older than 65 years and the average age of patients with the disease is 67 years. After lung cancer, prostate cancer is the most deadly cancers has ever known to mankind.
However, paradoxically, in spite of the seriousness of the cancer pathology, the majority of men who have prostate cancer are diagnosed ultimately survive. For example, in the US more than 2.5 million patients who have ever been diagnosed with prostate cancer still remain in good health. As for specific numbers, the 5-year survival rate for prostate cancer, as well as 10-year-old, is close to 100%. It was only in the later stages of the disease, when the tumor has spread to distant lymph nodes, bone, and other organs, the 5-year survival rate is 28%.
Causes of prostate cancer in men
To date, scientists still do not have the appropriate level of understanding of the causes of prostate cancer, but the risk factors that can under certain conditions lead to the formation of malignant tumors are not a mystery:
- Age. Prostate cancer is almost does not occur in men younger than 40. However, it is worth noting the half-century anniversary, as the risk of developing the disease begins to increase sharply;
- Race and nationality. For unknown reasons until the end of prostate cancer is more common in African Americans than among representatives of other races. This oncological disease is more common among North Americans, residents of north-western Europe, Australia and the Caribbean;
- Family history. Prostate cancer can occur in families, which gave scientists suggesting its hereditary nature. We present even this figure is that the presence of the father or brother of prostate cancer increases the risk of disease by half;
- The “bad” genes. This risk factor is directly related to the previous one. The scientists were able to detect a number of inherited genetic changes that increase the likelihood to meet with the described cancer in their unwitting owner;
- Diet. We can not say that this is such a determining cause of prostate cancer, however, it is also regarded by scholars as one of the catalysts of tumor development. For example, men who eat a lot of red meat or high-fat foods with little or no fruits and vegetables have great chances to get prostate cancer;
- Obesity. Some studies suggest that obese men tend to be more aggressive forms of prostate cancer, and that they are more likely to die from the disease than those with normal weight;
- Inflammation of the prostate ( prostatitis ). The prostate tumor tissues often show signs of inflammation. The origins of the link between prostatitis and malignant degeneration of the tissues are not fully understood, but studies in this field are quite active, and;
- Diseases, sexually transmitted diseases . The influence of this factor is associated mainly with the called same gonorrhea or chlamydia inflammation of the prostate;
- Vasectomy (ligation of the spermatic cord). Yes, it is a harmless procedure for male sterilization, particularly if it is made before the age of 35 years, is associated with a small increased risk of prostate cancer.
Symptoms and signs of prostate cancer
Early signs of prostate cancer is very difficult to see, as the disease develops almost asymptomatic. In more advanced stages of the disease can cause urinary disorders: a weak and interrupted urine flow, frequent urination, especially at night. However, these symptoms are not specific: they are more frequently associated with benign prostate disease, such as adenoma.
With the progression of prostate cancer in the urine can appear traces of blood (hematuria) or have serious problems with erection. Prostate cancer is usually Launched metastasizes to bone, entails that the pain in the hip, spine, ribs, etc. The tumor, spread to the spine often compresses the spinal nerves, causing weakness and numbness of limbs, and sometimes – urinary contents of the bowel and bladder.
Diagnosis of Prostate Cancer
Diagnosis of prostate cancer includes a survey and medical examination (including digital rectal examination), as well as a number of laboratory and instrumental studies.
Laboratory tests to confirm the diagnosis, “prostate cancer”, as well as the establishment phase of the disease include:
- A blood test for prostate specific antigen (PSA). Used mainly asymptomatic for diagnosing prostate cancer in the early stages of its course. He is a marker for yield of tumor beyond the prostate: in this case, the PSA level increases. Normal PSA in the blood is from 2 to 6.5 ng / ml depending on age:
- 40-49 – 2.5 ng / ml;
- 50-59 – 3.5 ng / ml;
- 60-69 – 4.5 ng / ml;
- 70-79 years – 6.5 ng / ml.
- Tolstoigolnuyu biopsy.
Of course, in cases of suspected prostate cancer is still a lot of laboratory tests, including detailed analyzes of blood and urine biochemistry, etc., but specific diagnostic methods should be considered as the first two.
Modern oncology has by far the broadest possibilities in terms of prostate cancer diagnosis instrumental methods that enables diagnosis with the highest degree of reliability. The doctor receives a comprehensive information tool via the following research:
- transrectal ultrasound (TRUS);
- bone scintigraphy;
- CT scan;
- Magnetic resonance imaging;
- scanning with monoclonal antibodies
Prostate Cancer Stages
After laboratory research doctor makes a final diagnosis and determine the stage of prostate cancer.
Stage I – the minimum size of the tumor, it is not even visible on ultrasound and is not detectable. Determine Prostate cancer is possible only by the level of prostate-specific antigen (PSA). A person does not feel any signs of disease.
Stage II – The tumor grows, but does not extend beyond the boundaries of the prostate. It is visible on ultrasound and palpable on digital examination. It appears the first sign of the disease – dysuria: intermittent weak stream, frequent urge to go to the bathroom especially at night.
Stage III – the cancer is outside the prostate borders and affects the neighboring organs: the seminal vesicles, bladder and rectum. But while metastases have not yet penetrated to distant organs. On stage 3 prostate cancer is a violation of potency, there is pain in the lower back and pubic hair. When urinating severe burning, and in the urine appear traces of blood.
Stage IV – the cancer increases. Metastases penetrate into distant organs: bone, liver, lungs and lymph nodes.
On stage 4 prostate cancer a person has a severe weakness, breakdown due to severe intoxication. When urination and defecation causing severe pain. Due to the impossibility of self-voiding, it is necessary to install a catheter.
Methods of treatment of prostate cancer
In the treatment of prostate cancer in one way or another by these doctors can be involved as oncourologist, radiation oncologist and a medical oncologist. Depending on all the surrounding circumstances (age of the patient, presence of diseases occurring in parallel, stage and aggressiveness of cancer, overall health, the expected side effects) can be selected one or more ways to treat prostate cancer.
Surgery – a method of first choice in the treatment of prostate cancer. The main method of surgery in this disease is radical prostatectomy, providing for the complete removal of the prostate gland and some of the adjacent tissues. This operation can be carried out in various ways: it can be retrolobkovaya (incision is made in the abdomen) or perineal (incision is made between the anus and the scrotum) prostatectomy.
Less invasive way to remove the tumor is the laparoscopic surgery. This is a high-tech version of the surgery, which uses special equipment that allows to produce all manipulations through smaller incisions. When laparoscopic radical prostatectomy surgeon makes several small incisions, through which are special long instruments used to remove the cancer. One of the tools has on its end a small video camera that allows the doctor to see inside the abdominal cavity.
The new word in the treatment of cancer – the robot-assisted laparoscopic prostatectomy, when all manipulations performed “by hand” Da Vinci robotic system, and the surgeon is located behind the panel and controls the process. This method, like the previous one, has a number of advantages for the patient in front of the traditional prostatectomy: less trauma and blood loss, faster recovery. To implant surgery robotic system requires greater precision during all manipulation and better maneuverability.
As in the case of benign prostatic hyperplasia, transurethral resection of the prostate can be used for cancer of the prostate (TURP). This operation is justified in the later stages of prostate cancer to partially eliminate the problems with urination. Therapeutic function this kind of surgery can not be held. TURP essence consists in removing the inner portion of the prostate surrounding the urethra. skin incisions in this case not required since all manipulations produced a special device – retroskopom, administered through the penis into the urethra. Upon reaching the destination on the diseased tissue affected by electricity or a laser to remove or vaporize it. All the procedure takes no more than one hour.
Radiation therapy for prostate cancer can be used as a “solo”, if the tumor has not yet moved beyond the prostate, and in combination with hormone therapy if the cancer came out and hit the surrounding tissue. Another field of activity for radiotherapy – “cleaning” of the body from the traces of cancer cells after surgery. Sometimes, when treatment is no longer possible, radiotherapy is used as part of a palliative treatment to reduce tumor size and mitigation of the clinical picture.
Two basic methods of radiation therapy can be used in prostate cancer: external irradiation (EBRT) and brachytherapy (internal irradiation). As part of EBRT light beam that focuses on the prostate, is emitted by an external device. The following types of methods:
- 3D-conformal radiotherapy;
- radiotherapy with modulated intensity (IMRT);
- conformal proton radiotherapy.
As for brachytherapy for prostate cancer, its essence is the use of tiny radioactive pellets about the size of a grain of rice. These “grains” are placed directly into the prostate. Brachytherapy is used only in the early stages of prostate cancer in a relatively non-aggressive tumors.
Cryosurgery (sometimes called cryotherapy or cryoablation) is used in the early stages of cancer and is the impact on the tumor ultralow temperatures. Here’s how it works: through the skin (between the scrotum and anus) introduced several hollow probes that TRUS directed by the surgeon into the prostate. Then through these probes served very cold gas, so that the ice balls are formed, completely destroy the gland with the tumor. To protect from the urethra through the catheter to freeze throughout the procedure served warm saline.
The goal of hormone therapy for prostate cancer is to reduce the level of male sex hormones – androgens, or preventing their penetration into the prostate. What is it for? Androgens stimulate the growth of prostate cells, thus depriving prostate androgen possible contact often causes a decrease in tumor size or slowing its growth.
To combat prostate cancer hormono therapy are used the following types:
- Orchiectomy (surgical castration);
- Use analogues releasing factor luteinizing hormone (chemical castration) or the antagonists. These drugs (Lupron, Eligard, Zoladex, Trelstar in the first case and the second Firmagon) reduce the amount of testosterone produced by the testicles;
- The use of anti-androgens (Euleksin, Casodex, Nilandron).
Chemotherapy for prostate cancer involves oral or injection course administration anticancer drugs that are entering the systemic circulation, act on the whole body, which is effective if the tumor has metastasized. In the early stages of prostate cancer chemotherapy is usually used.
In the prostate cancer chemotherapeutic drugs are not used more than once, then the other drug is administered. Pharmacological nomenclature includes docetaxel, mitoxantrone, estramustine, Doxorubicin, Paclitaxel, Carboplatin, Vinblastine, Etoposide.
Sipuleytsel-T (Provenzh) – the so-called cancer vaccine. Unlike conventional vaccines, that stimulate the immune system to fight against infectious diseases, the vaccine incites immune cells to fight the tumor cells. Immunotherapy is used in the advanced stages of prostate cancer when the patient no longer responds to hormone therapy. These vaccines – piece goods, they are created individually for a specific patient and are not produced in large quantities.
For most men struggle with prostate cancer eventually ends with the complete cure. However, life after cancer is full of strict restrictions. Nothing can be done: this is the harsh reality. A proper diet, enough rest, exercise therapy – all this should be an integral part of human life, beat cancer.
Read About: Cervical Cancer
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