The prostate gland is a muscular-glandular organ of the reproductive system of men. His health depend not only sexual performance, but also the normal life of representative of a strong half of mankind. So the prostate gland or prostate is also called the “second men’s heart.” Below we will try in detail and clearly tell about the prostate gland (prostate).
The content of the article
Men over 50 years should be screened annually for prostate the Prostate is represented by several types of cells, but fatal ability to have malignancy largely her cell secretory (glandular) epithelium. Cancer, “born” of glandular cells (granulozitov) 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 quickly, but this is the exception rather the rule. There are cases when the autopsy of a patient who died from quite other disease is detected prostate cancer, of which neither the patient nor his attending physician knew nothing.
The average age, the survival rate for prostate cancer
Prostate cancer ranks second in frequency after skin cancer in men. It develops usually in the elderly. Approximately two thirds of cases of cancer of the prostate gland are those over 65 years, and the average age of a patient with the disease is 67 years old. After lung cancer prostate cancer is the most deadly cancer ever known to mankind.
However, paradoxically, despite the seriousness of this cancer, most men who have diagnosed prostate cancer, ultimately survive. For example, in the United States more than 2.5 million patients who have ever been diagnosed with cancer of the prostate still remain in good health. As for specific figures, the 5-year survival rate for prostate cancer, as well as a 10-year, close to 100%. And only in the later stages of the disease when the tumor has spread to distant lymph nodes, bones and other organs, the 5-year survival rate is 28%.
The causes of prostate cancer in men
To date, scientists still do not possess the necessary level of understanding of the causes of prostate cancer, but risk factors, is able under certain conditions to lead to the formation of malignant tumors, are not a mystery:
- Age. Prostate cancer almost never occurs in men under the age of 40. But it is worth it to celebrate the fiftieth anniversary, as the risk of developing this disease begins to increase sharply;
- Race and nationality. For some strange reason prostate cancer is more common in African Americans than among representatives of other races. This cancer increasingly common among North Americans, residents of North-Western Europe, Australia and the Caribbean Islands;
- Family history. Prostate cancer can occur in members of the same family that gave scientists the basis to assume his hereditary nature. Is even such a figure that a father or brother prostate cancer increases the risk of morbidity doubled;
- “Bad” genes. This risk factor is directly linked to the previous one. Scientists were able to detect a number of inherited genetic changes that increase the probability to get acquainted with the described cancer in their unwitting owner;
- Diet. Not to say that it was the determining cause of prostate cancer, however, she is also regarded by scientists as one of the catalysts for the development of the tumor. So, men who eat lots of red meat or foods high in fat, few vegetable and fruits, have great chances to get the prostate cancer;
- Obesity. Some studies have confirmed that fat men tend to more aggressive forms of prostate cancer, and that they are more likely to die from the disease than patients with normal weight;
- Inflammation of the prostate gland (prostatitis). In the tumor tissues of the prostate often show signs of inflammation. The origins of the link between prostatitis and malignant degeneration of the tissue is not completely clear, but research in this area is ongoing and quite active;
- Diseases, sexually transmitted. The impact of this factor is associated mainly with the same caused by gonorrhoea or chlamydia inflammation of the prostate;
- Vasectomy (ligation of the spermatic cord). Yes, this harmless procedure of male sterilization, especially 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 to notice very difficult, as the disease is almost asymptomatic. In advanced stages the disease can cause disorders of urination: weak and intermittent urine stream, frequent urination, especially at night. But these symptoms are not specific: they are associated more often with benign diseases of the prostate, e.g., BPH.
With the progression of prostate cancer in the urine may be traces of blood (hematuria) or serious problems with erection. Launched prostate cancer usually metastasizes to the bones, which leads to pain in the hip, spine, ribs, etc. a Tumor that has spread to the spine often compresses the spinal nerves, causing weakness and numbness in the extremities, and sometimes incontinence of the intestinal contents and urinary bladder.
Diagnosis of prostate cancer
Diagnosis of prostate cancer includes a medical questioning and examination (including digital rectal examination), and a number of laboratory and instrumental studies.
Laboratory tests to confirm the diagnosis “prostate cancer”, and also establishing the stage of the disease include:
- A blood test for the prostate specific antigen (PSA). Used mainly for the diagnosis of asymptomatic prostate cancer in the early stages of its occurrence. He is the token release of tumor outside the gland in this case, the PSA level increases. The normal PSA in the blood is 2 to 6.5 ng/ml depending on age:
- 40-49 years 2.5 ng/ml;
- 50-59 years 3.5 ng/ml;
- 60-69 years, 4.5 ng/ml;
- Years 70-79 is 6.5 ng/ml.
- Core biopsy.
Of course, in cases of suspected prostate cancer is still a lot of laboratory tests, including detailed blood and urine tests, biochemistry, etc., but specific diagnostic methods should be considered as the first two.
Transrectal ultrasound Modern Oncology has by far the widest possibilities in the diagnosis of prostate cancer by instrumental methods, allowing to make the diagnosis with higher confidence. The physician receives information through the following instrumental examinations:
- transrectal ultrasound (TRUS);
- bone scintigraphy;
- computed tomography;
- magnetic resonance imaging;
- ProstaScint scan;
- scanning with monoclonal antibodies.
Stages of prostate cancer
After laboratory studies the doctor makes the final diagnosis and determines the stage of prostate cancer.
Stage I – a tumor of minimum size, it is not even visible with ultrasound and not detectable. Define prostate cancer is possible only on the level of prostate specific antigen (PSA). The person does not feel any signs of the disease.
Stage II – the tumor is growing, but not beyond the boundary of the prostate. It is visible by ultrasound and palpable during digital examination. Manifested the first sign of the disease – urination disorder: intermittent weak stream, frequent urge to go to toilet especially at night.
Stage III – cancer extends beyond the boundaries of the prostate and affects the adjacent organs: seminal vesicles, bladder and rectum. But while the metastases have not penetrate to distant organs.
Stage 3 prostate cancer occurs violation of potency, there is pain in lower back and pubis. Urination severe burning and appear in the urine traces of blood
Stage IV – malignant tumor increases. Metastases penetrate into distant organs: bone, liver, lungs and lymph nodes.
4 stage prostate cancer in humans, there is a strong weakness, a breakdown due to severe intoxication. Urination and defecation there is severe pain. Because of the impossibility of self-urination it is necessary to insert the catheter.
Stage of prostate cancer (diagram)Methods of treatment of prostate cancer
In the treatment of prostate cancer by one method or another may be involved are doctors, as oncourology, radiation oncologist and medical oncologist. Depending on all attendant circumstances (age of patient, presence of ongoing disease stage and aggressiveness of the cancer, overall health and expected side effects) can be selected one or several ways to treat prostate cancer
Surgery is the method of first choice in the treatment of prostate cancer. The main method of surgical intervention in this disease is radical prostatectomy, involving the complete removal of the prostate gland and some adjacent tissue. This operation can be performed in different ways: it can be retromarcia (with an incision lower abdominal) or perineal (incision made between the anus and scrotum) prostatectomy.
A less invasive method of tumor removal is laparoscopic surgery. This is a more high-tech variant of a surgical intervention, which uses special equipment that allows to make all operations through smaller incisions. In laparoscopic radical prostatectomy, the surgeon makes several small incisions, through which are special long instruments are used to remove the gland. One of the tools has on its end a small video camera which allows the doctor to see the abdominal cavity.
The new word in cancer treatment is robot-assisted laparoscopic prostatectomy, when all manipulations are made by hand robotic system Da Vinci, the surgeon is at the console and controls the process. This method, like the previous one, has a number of advantages for the patient over traditional prostatectomy: less trauma and blood loss, fast recovery. For the surgeon the introduction of robotic systems suggests greater accuracy when performing all handling and better maneuverability.
As with benign prostatic hyperplasia, prostate cancer can be used transurethral resection of the prostate (TURP). This operation is justified in the later stages of prostate cancer for partial elimination of the problems with urination. Therapeutic functions this type of surgery carries. The essence of TURP is to remove the inner part of the prostate surrounding the urethra. Incisions in this case are not required because all procedures are performed by a special device — retroscope, inserted through the penis into the urethra. Upon reaching the destination on the affected tissue affected by electricity or laser to remove or evaporate 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 reached outside the gland, or in combination with hormone therapy if the cancer came out and struck the surrounding tissue. Another field for radiation treatment — “cleaning” of the body from traces of cancer cells after surgery. Sometimes, when treatment is impossible, radiation therapy is used as part of a palliative treatment to reduce tumor size and alleviate the clinical picture.
Prostate cancer can be used two main ways of radiation therapy: external radiation (EBRT) and brachytherapy (internal radiation). Within the EBRT beam focused on the prostate, is emitted by any external device. There are the following varieties of this method:
- 3D conformal radiation therapy;
- radiation therapy with intensity modulated (IMRT);
- conformal proton radiation therapy.
As for the brachytherapy of prostate cancer, its essence is the use of tiny radioactive pellets the size of a grain of rice. These “seeds” are placed directly into the prostate. Brachytherapy is used only in the early stages of prostate cancer at a relatively nonaggressive tumors.
Cryosurgery (sometimes called cryotherapy or cryoablation) is used in the early stages of cancer and is in effect on the tumor low temperatures. This is how it happens: through the skin (between the scrotum and anus) introduced several hollow probes, which are under the control of TRUS sent by the surgeon to the prostate. Then using these probes served very cold gas, resulting in formation of ice balls, completely destroying the gland along with the tumor. To protect the urethra from freezing in there through the catheter for the entire procedure served warm saline solution.
The goal of hormone therapy in prostate cancer is to reduce the level of male sex hormones — androgens, or preventing their penetration into the prostate. What does it do? Androgens stimulate prostate cells to grow, therefore depriving the prostate of the ability to communicate with androgens often causes a decrease in the size of the tumor or slowing its growth.
To combat prostate cancer use the following types of hormone therapy:
- orchiectomy (surgical castration);
- the use of analogues releasing factor, luteinizing hormone (chemical castration) or its antagonists. These drugs (Lupron, Eligard, Zoladex, Trelstar in the first case and the second Firmagon) reduce the amount of testosterone produced by the testes;
- the use of antiandrogens (Eulexin, Casodex, Nilandron).
Chemotherapy for prostate cancer involves oral or injectable course introduction anti-cancer drugs which enter the systemic circulation, act on the whole body that effectively if the tumor has metastasized. In the early stages of prostate cancer chemotherapy is usually not used.
Prostate cancer chemotherapy drugs are not used more than once, then you assign a different drug. Pharmacological nomenclature includes Docetaxel, Mitoxantrone, Estramustine, Doxorubicin, Paclitaxel, Carboplatin, Vinblastine, and Etoposide.
Sipuleucel-T (Provenge) is a vaccine against cancer. Unlike traditional vaccines, which stimulate the immune system in the fight against infectious diseases, this vaccine incites immune cells to fight tumor cells. Immunotherapy is used for advanced stages of prostate cancer when the patient no longer responds to hormone therapy. These vaccines, one of a kind, they’re created individually for a specific patient and not available in large quantities.
For most men struggle with prostate cancer ultimately ends in complete recovery. However, life after cancer is full of strict limits. Nothing can be done: such is the harsh reality. Proper nutrition, enough rest, physical therapy should be an integral part of human life, beating cancer.