Prostate cancer ( prostate ) : causes, symptoms , diagnosis, treatment
Urology / / August 12, 2017
prostate cancer, prostatectomy prostate video
Prostate cancer: overview
Causes and prostate cancer risk factors
Symptoms of prostate cancer (prostate)
diseases with similar symptoms
Cancer Diagnosisprostate (prostate)
stages of prostate cancer (prostate)
treatment of prostate cancer (prostate)
Stage I. treatment options
Stage II.Treatment options
Stage III.Treatment options
Stage IV.Treatment options
forecast prostate cancer (prostate)
prevention of prostate cancer
Prostate cancer (prostate) - a malignant tumor that originates in the prostate gland.
Prostate (hereinafter everywhere - Prostate) - musculo-glandular organ that is part of the reproductive system and surrounds the urethra into the urinary system, male.It is located in the pelvis just below the bladder, and has the same size and shape as the chestnut.
main function of the prostate - fluid production as a part of semen.Prostate covered on all sides by the initial part of the urethra (the tube that c
prostate cancer, as well as any cancer progresses and if not treated in the early stages, can eventually spread through the blood and lymph to other organs.
Fortunately, prostate cancer usually has a slow growth compared to other cancers.Most older men observed the presence of microscopic prostate cancer, but often it grows so slowly that many men with prostate cancer, as they say, "die with him, but not from him."
Prostate provides the following functions:
- glandular cells produce a milky fluid.During sex, smooth muscles contract, and the liquid flows into the urethra.There it mixes with sperm and other fluids;
- contains the enzyme 5-alpha reductase, which converts testosterone into dihydrotestosterone - another male hormone, which has a great influence on the prostate.
prostate gland undergoes many changes during the life of the person.At birth the human prostate gland is about the size of a pea.She did not significantly increase until puberty, at which it begins to increase rapidly, reaching adult size and shape of a walnut (when a man reaches the age of 20).Iron as a whole remains unchanged, until the man reaches an average of 40 years.At this age, the majority of men in the process of cell division, the prostate begins to grow again.
Causes and risk factors of prostate cancer
- Age . Prostate cancer occurs almost exclusively in men older than 40 years and most often in men over 50 years.The average age at diagnosis is about 67 years.By age 70, about two thirds of men have at least microscopic evidence of their body in prostate cancer.But because of the extremely slow growth of prostate cancer are often older men with this diagnosis, dying, did not even know that they have prostate cancer.
- Family history and genetic factors. Heredity plays a role in some types of prostate cancer.Men with a family history of the disease have a higher risk of developing prostate cancer.Have one family member with prostate cancer doubles the risk of his own person, the presence of three members of the family with this diagnosis increases the risk by 11 times.Specific gene named «HPC1» ( «hereditary prostate cancer") was the first of several genes associated with inherited type of the disease.A gene is a short segment of DNA, which is interpreted by the body as a blueprint or template for the creation of a specific protein.Genes are long strands of DNA, which in turn make up the chromosomes.
Scientists study and other genetic variations, which may increase the risk of prostate cancer.
- race and ethnicity . African American men have higher rates of prostate cancer than men of other races.In addition, they are more likely to develop prostate cancer in younger patients, and are more aggressive forms of the disease.
- Hormones . Male hormones (androgens), particularly testosterone, may play a role in the development and growth of aggressive prostate cancer.Other types of hormones - such as growth hormone or insulin-like growth factor-1 (IGF-1) may also be associated with certain types of prostate cancer.
- Inflammation and infection. prostatitis (prostate inflammation) is associated with an increased risk of prostate cancer.It is also possible link between prostate cancer and infections, sexually transmitted infections - such as herpes and human papilloma virus, but it is not yet proven.
- Nutritional factors. In Western countries intensively studied dietary factors associated with prostate cancer.The results were contradictory:
- Fats.Some studies have found an association between high consumption of red meat is high in fat and dairy products - with an increased risk of developing prostate cancer.Unlike omega-3 fats contained in certain types of fish (salmon, sardines, fresh tuna), consumption of which is not associated with a similar risk;
- Fruits and Vegetables.A diet rich in vegetables, fruits and legumes, provides good protection against prostate cancer.However it is not clear, this is due to the nutrients contained in all of these products, or due to the fact that they all - very low fat content.Not been proven concrete fact reduce the risk of this disease.We studied the lycopene contained in tomatoes, but evidence of its protective functions still do not have;
- Vitamins and minerals.Major clinical studies have shown that vitamin and mineral supplements (vitamin E, vitamin C, vitamin D and selenium) do not prevent prostate cancer (the researchers found that vitamin E can reduce the risk of prostate cancer, but to create the opposite effect than the increased risk ofdisease).And the best sources of vitamins and minerals - foods in a healthy diet.In some studies, high calcium intake was associated with an increased risk of prostate cancer.
Symptoms of prostate cancer
(prostate) Prostate cancer usually causes no symptoms in the early stages.When the cancer spreads, it may compress the urethra and cause problems with urination.
Urine flows from the kidneys through the ureters into the bladder, where it is temporarily stored.The bladder is stretched, the nerve impulses from the bladder signals the brain that it is full.Sphincter muscles surrounding the urethra relax and the bladder is released from urine.Then the urine out through the urethra to the outside.
Symptoms of prostate cancer in the later stages:
- weak urinary stream;
- inability to urinate;
- blood in the urine;
- interrupted urinary stream (stopping and starting);
- frequent urination (especially at night);
- pain or burning during urination.
Although these symptoms and can cause prostate cancer, they are more likely to be caused by benign prostatic hyperplasia (benign prostate enlargement, or benign tumor, an increase in the number of periurethral prostate gland cells) and other non-cancer diseases.
Significant bone pain may indicate the occurrence of metastasis (spread of the disease in other parts of the body).Chronic pain occurs most often in the spine, and sometimes flares in the pelvis, lower back, hips or upper leg bone.This can be accompanied by significant and unexplained weight loss, fatigue.
diseases with similar symptoms
- Benign prostatic hyperplasia (BPH).A condition that can develop in the enlarged prostate puts pressure on the urethra and cause problems with urination.BPH is not a cancerous or precancerous condition, but its symptoms can mimic the late-stage prostate cancer.
Benign prostatic hypertrophy is a non-cancerous enlargement of the prostate and is often found in men aged 50 years.
- Prostatitis. This is inflammation of the prostate, often caused by bacterial infections.Symptoms include pain and urinary frequency, sometimes - lihoradke in urine or blood.
Diagnosing prostate (prostate) cancer
purpose of screening (from English screening -. «Selection, sorting, sifting" - a method of active detection of patients with any pathology or risk factors for its development) isdetection of cancer at an early stage, before it has caused symptoms.To be considered successful, the screening test should lead to a treatment that prolongs life, reduces discomfort and improves quality of life.
Two standard screening test used for the early detection of prostate cancer:
- PSA test. PSA (prostate-specific antigen) measures the level of PSA in the blood protein.It is a protein produced in the prostate, which keeps the sperm in liquid form.Prostate cancer cells produce a protein in high quantities;
- Digital rectal examination (from the Latin rectum -. «Rectum" - a method of diagnosing by introducing a finger into the rectum to detect tumors at a touch, etc.) . At physical examination the doctor inserts a lubricated gloved finger into the patient's rectum and feels for lumps or other abnormalities in the prostate.
There is great uncertainty and debate as to outweigh whether for most men the benefits of regular screenings of prostate cancer disease risks.Prostate cancer is very common, especially among older people.And doctors are not able to accurately predict which tumors at an early stage is a risk of becoming aggressive (malignant) and need treatment, and what better not to touch.Regular examinations for early detection of cancer can lead to an extreme, invasive (assuming the invasion of the patient's body - for example, surgery), the treatment methods.
Screening for prostate cancer using the PSA test as a screening tool - this test is not accurate enough to categorically rule out or confirm the presence of cancer.In men with prostate cancer PSA levels are often elevated, but, nevertheless, PSA can be increased and because of other factors, including those due to benign prostatic hyperplasia, prostatitis, elderly or ejaculation (separation of semen duringmale orgasm) within 48 hours of the test.
PSA screening may lead to the detection of certain cancers, which would never bother the patient and will not pose a threat to his life.Many older people are less likely to die from prostate cancer than from heart disease and other problems.Relying too much on test, the doctor may perform a biopsy unnecessary and potentially dangerous procedure.Several large studies have shown that PSA screening does little to prolong patients' lives.Accordingly, in the present PSA screening for prostate cancer is recommended.
Men 50 years of age is recommended to discuss with your doctor the pros and cons of having a PSA and digital rectal examination.
- biopsy.If suspected cancer, the doctor will order a biopsy.Only the biopsy in which tiny samples of prostate tissue is surgically removed, may actually confirm the diagnosis of "prostate cancer".A biopsy is usually performed to confirm or rule out cancer and is based on a combination of test PSA level, the analysis of the history of the family and the patient's age and ethnicity.If the biopsy is negative, but the doctor still suspects cancer, then repeat biopsy may be performed.
- transrectal ultrasound - TRUS can be used to help the doctor determine how to take a biopsy.Ultrasound on its own is not effective as a diagnostic tool, since it can not distinguish well benign inflammatory cancer.
- level and PSA velocity. Once cancer is diagnosed, the PSA level can help to determine its scope.If the PSA level less than 20 ng / ml, it is likely that the cancer has not spread to distant parts of the body (metastasis occurs without).PSA levels over 40 ng / ml is a serious indication that the cancer has metastasized.The PSA level is also monitored after starting treatment.Changes in the level may show whether the treatment works or cancer returns.
Doctors also control how quickly the PSA level increases over time.This figure is called the PSA V. It can help determine when to start treatment and what treatment should be used.High PSA considered V 2 ng / ml per year.Recent studies have shown that men with early prostate cancer who have a slow PSA V, is likely to live longer than men with a rapidly rising PSA levels;
- Test metastasis. If the biopsy reveals cancer, and PSA greater than 20 ng / ml, the doctor will prescribe other tests to determine how far the cancer has spread.
- X-ray bone can reveal whether bone cancer has invaded.To perform a bone scan, the doctor inserts into a vein of the patient a low dose of a radioactive substance that accumulates in the bones, damaged as a result of cancer.Scanner shows how accumulated radioactive material;
- Computed tomography (CT) or magnetic resonance imaging (MRI) can more accurately determine the location of the cancer that has spread beyond the prostate.
Classification of prostate cancer degrees
classification shows how the abnormal (cancerous) cells look under a microscope and how likely the cancer is progressing and spreading.The doctor makes the diagnosis "cancer" on the basis of statement of class, TNM staging system, the result of the PSA test, digital rectal examination, and possibly imaging tests.General stages of cancer can help your doctor determine treatment options.
- Classification System Gleason. Gleason score (or Gleason score - used for histological evaluation dedifferentiation of prostate cancer, small-scale value correspond to highly differentiated forms, and high - poorly differentiated, high value Gleason score is associated with a poor prognosis disease outcome) grade tumors from 1 to 5 operates on the basiswell or poorly differentiated cancer cells, viewed under a microscope.Briefly, grade 1 means that the cells resemble normal prostate tissue.Class 5 means that the cells look very abnormal and poorly organized throughout the prostate.Classes 2-4 are between cells and show the transition to an increasingly wrong tissues.In most cases of prostate cancer tumors comprising a combination of different grades.
- TNM - clinical classification. stage tumor is an indication of how far it has spread from the original site.the stage of cancer - in particular, prostate cancer put, depending on whether it is still localized (still within the prostate) or has spread beyond the organ under consideration.To date, the exact formulation stage prostate cancer is the TNM system.
TNM system refers to the clinical stage of the tumor:
T - a tumor in the body;
N - a tumor in the regional lymph nodes;
M - tumor metastases (it develops for prostate limits).
T, N, and M stages are used along with the PSA-test assessment, and other factors that determine the overall stage of cancer:
- cancer stage I and II are considered early.