Prostate cancer

Prostate cancer is the malignant outgrowth of prostate gland’s tissue. The gland is located at the base of urinary bladder and is a part of male reproductive system. It functions in producing constituents of semen. Generally the gland is of walnut size, but when affected with cancer it grows in size. The cells of prostate tissue proliferate and turn into a tumor. This tumor may be latent without showing any symptoms for years together. The cancerous cells may however metastasize to various other parts of body such as liver, surrounding bones, and also kidneys.

 

Causes of prostate cancer

 

The causes of prostate cancer are pretty much unknown; however there are certain factors that appear to be causes of cancer. It is the third most common cause of death in men around the world. Mostly older men are prone to this type of cancer (over 50 years). Here are some of the factors that contribute to causes:

 

  • Hereditary conditions where ancestors are prostate cancer patients.
  • Hormonal influences, where excess of testosterone secretions.
  • African-American men are more prone to acquire this type of cancer.
  • Men who consume excess alcohol.
  • Exposure to pollen grains, especially farmers.
  • Men consuming more animal fat.
  • Exposure to materials like paint, tire, and cadmium.

 

Vegetarians are less likely to acquire cancer than non-vegetarians.

 

Symptoms and signs:

 

Usually the prostate cancer does not show any symptoms in the early stage, however there could be some symptoms at some stage which include the following:

 

  • Difficulty in urination
  • Dribbling of urine after completion of urination.
  • Slow urine stream.
  • At some stages, there could be blood or even semen in urine.
  • In cases where the cancer has metastasized, bones may also be affected and may turn tender and painful.

 

The prostate cancer can be screened using Prostate Specific Antigen (PSA) Test. With this test, one can easily identify cancer before any symptoms show up. After this diagnostic test, a prostate biopsy can be done to confirm the presence of cancer in prostate gland. The biopsy results are given using the Gleason’s score which have a scale on (2-10) points. Screening can also be done using Digital Rectal Exam (DRE).

 

  • A score of 2-4 points indicates low intensity cancer.
  • A score of 5-7 indicates mild intensity cancer wherein most of the cancers are into this category.
  • A score of 8-10 indicates severe intensity of cancer.

 

There are other ways also to diagnose prostate cancer, and these include the Computed tomography (CT) scan and Bone scan. There are also Tumor markers which can be used to diagnose cancerous cells.

 

Treatment of prostate cancer

 

The treatment options vary from patient to patient and also depend on the stage in which the cancer is prevailing. The treatment options can be carried out only after screening and diagnostic tests are conducted and a certain stage of cancer is identified. Following are the options for treatment of prostate cancer:

 

Surgery: The patient must be healthy and young individual to undergo surgery as a treatment option. After careful examination of the patient, following two basic types of surgeries can be carried out.

 

  • Pelvic lymphadenectomy: This procedure involves removal of lymph nodes in the pelvic region which are cancerous.

 

  • Radical prostatectomy: This procedure involves removal of prostate, or even the tissue surrounding it, or sometimes even seminal vesicles if they are affected too. This procedure can be conducted using Robotic instrumentation too. There are again two subtypes of this surgery.

 

    1. Reteropubic: In this procedure, the surgery is done by making incisions around the abdominal wall and tissue may be removed.
    2. Perineal: In this procedure, surgery is done by making incision in the perineum, the area between anus and scrotum.

 

  • Transurethral Resection of Prostate (TURP): This procedure involved removal of tissue using a resectoscope which is inserted via urethra. This procedure is usually opted for elderly patients who cannot undergo the above two surgical procedures.

 

Radiation Therapy: This procedure involves use of high energy X rays which penetrate the tissues and kill the cancerous cells. This generally has some side effects such as impotence and sometimes the surrounding tissues may also become cancerous.

 

Hormonal Therapy: In this method of treatment, hormone levels are lowered to reduce the cancerous growth of tissues. The entire treatment regimen in this section work to antagonize or reduce the testosterone levels. The therapy includes the use of Luteinizing hormone-releasing hormone agonists which lower the testosterone levels. Sometimes Antiandrogens may also be given. Estrogens are also effective but pose serious side effects.

 

New therapies are being investigated and they seem to show some positive results in prostate cancer patients. Following are some of the treatment options:

 

  • Cryosurgery: This procedure involves use of freezing instruments which freeze the prostate tissue and destroy the cancerous cells. This procedure shows impotence and leakage of stools and urine as side effects.

 

  • Chemotherapy: This treatment method involves use of anticancer drugs to treat the growing cancer.

 

  • Immune therapy: This involves usage of substances such as monoclonal antibodies to boost the body’s immune system to combat the cancerous growth.

 

  • High intensity focused ultrasound: This uses high energy ultra sound waves to destroy the cancerous cells.

 

  • Proton beam therapy: This is a type of radiation therapy which involves use of high energy proton beams to target cancerous cells and destroy them.

 

Prognosis: The prostate cancer patients have poor survival rates in developed countries than in less developed countries due the improper lifestyle. The life expectancy can be calculated by conduction PSA levels test and if the score is high, the expectancy could be short. The patients undergoing antiandrogen therapy have survival of about 11-34months.

The prognosis also differs in different phenotypes of individuals, African-Americans are more prone to deaths after the treatment.

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