According to statistics, prostate cancer is diagnosed in 14% of cases. Most often, pathology is detected in men after 50 years. It is also the cause of death of the representatives of the stronger sex of early old age in 73% of cases. Such sad statistics makes us think about regular monitoring of the he alth and functionality of the prostate gland. The symptoms and treatment of cancer will be discussed in today's article.
Description of the disease
The prostate is an endocrine gland that is part of the reproductive system. It performs several functions: the production of seminal fluid, participation in ejaculation. The gland is located above the bladder and next to the large intestine, wrapping around the urethra. Outwardly and in size, it resembles a walnut.
Prostate cancer is a serious oncological disease. malignant tumortends to allocate metastases to other organs. The progression of the pathological process is extremely slow and imperceptible. The appearance of microscopic signs of neoplasm, the onset of a critical stage can take from 10 to 15 years. Patients turn to the doctor with complaints when it reaches an impressive size and begins to metastasize.
Main reasons
Prostate cancer incidence varies by geographic area. For example, in East and South Asia it is much lower when compared with the European region. Doctors have not yet been able to determine the exact causes of the development of pathology. However, science knows the main risk groups:
- Age. In men who are under 40 years of age, the risk of developing a malignant tumor is minimal. It increases after age 60. At this age, oncopathology is diagnosed in every eighth representative of the stronger sex.
- Heredity. If close relatives have been diagnosed with prostate cancer, the likelihood of them getting sick increases several times. At the same time, its first symptoms are detected before the age of 60.
- Lifestyle. Bad habits (smoking, alcohol abuse) can activate the process of degeneration of an existing tumor into a malignant process.
- Food. Red meat, foods high in animal fats, and fiber deficiency in the diet can provoke cancer.
- Hormonal background. There is direct evidence of a link between malesex hormones with the emergence of malignant nodules in the glandular tissue of the prostate.
- Chronic diseases. We are talking about prostatitis, diabetes, obesity.
If a man falls into one or several risk groups at once, he should pay special attention to his own he alth. Timely detection of the disease allows you to immediately begin therapy and defeat the disease.
Clinical picture
At the initial stage, it is quite difficult to diagnose prostate cancer. Symptoms of the disease are absent at all or have a latent course. Its first manifestations are observed when the neoplasm crosses the boundaries of the urethra. However, patients may complain about:
- intermittent urination;
- multiple night and daytime bowel movements;
- strong urge to urinate accompanied by severe pain;
- feeling of incomplete bladder emptying;
- discomfort in the lumbar area;
- blood in urine or semen.
With a further increase in the size of the neoplasm, the intensity of the listed symptoms increases. When metastases begin to penetrate into nearby organs, the clinical picture changes somewhat. The occurrence of swelling in the legs indicates the defeat of malignant cells of the groin lymph nodes. Violation of the defecation process in the form of constipation indicates the penetration of metastases into the rectum. Metastasis can occur in the abdominal and thoracic organs. In this case, about involvement in the pathological process of the lungssays severe cough, and liver - jaundice.
Degrees and stages of disease development
There are some differences between the two concepts of “stage” and “grade” of cancer. In the latter case, it is customary to take the results of studies of the cell mass of the gland at the histological and cytological level as the basis for the classification.
There are 5 grades of prostate cancer:
- Initial. It is characterized by a slow morphological transformation of cellular elements.
- Second. Altered cells are already significantly different from he althy ones. At the same time, their accumulation in one area is detected, and a pathological node is formed.
- Third. Cells with different morphology are isolated. If left untreated, the tumor begins to rapidly increase in size.
- Fourth. Most elements are difficult to differentiate.
- Fifth. The cell mass is not differentiated, is completely atypical.
When prostate cancer is suspected, the stage of the disease is also important to determine. There are four in total:
- Changes are detected only at the microscopic level after a biopsy of the organ. Ultrasound and palpation do not allow diagnosing the disease.
- At the second stage, the pathology can already be detected by ultrasound. The node is still limited to the capsule, and the size of the neoplasm does not go beyond the organ.
- The third stage is determined by the exit of the tumor outside the gland. High probability of detection of metastases in the bladder and rectum.
- The last stage is comparable to grade 4 prostate cancer. Metastases continue to actively spread throughout the body. The man feels constant pain while urinating and complains of exhaustion.
For the treatment to be effective, the doctor must correctly determine the degree and stage of development of the disease. This approach also allows predicting its further course.
Diagnostic Methods
At the slightest suspicion of prostate dysfunction, a man should consult a urologist. The standard examination begins with rectal palpation and examination of the patient's history. With normal organ sizes, an additional analysis is prescribed - measuring the concentration of prostate specific antigen (PSA) in the blood. It acts as a kind of cancer marker. A blood test is the most informative diagnostic method. Additionally, ultrasound and MRI of the prostate are prescribed.
Only a biopsy can confirm the final diagnosis. This procedure involves the use of a special needle that is inserted into the rectum. With the help of it, the doctor takes tissue from the neoplasm for further research in the laboratory. This examination method has side effects - the appearance of blood impurities in semen and urine. Normally, these complications should pass in a few days. However, the likelihood of developing inflammation at the biopsy site is quite high.
Therapy options
The choice of treatment for prostate cancer is up to the doctor. In this case, the doctor must take into account a number of factors: the age of the patient, the degree of development of the pathology, the presence of metastases, etc.
The same algorithm does not exist. Most often, surgical removal of the neoplasm is recommended if there are no contraindications to surgery. These include senile age, the presence of concomitant problems on the part of the central nervous system and the vascular system. Otherwise, the intervention will cause more harm to the patient than alleviate his condition. In stage 1-2 oncology, radical therapeutic methods are not required. In this case, drug therapy is dispensed with. More details about each method of treatment for prostate cancer will be described below.
Surgery
The procedure to remove a neoplasm can be carried out in two ways: abdominal surgery or laparoscopy.
In the first case, the doctor makes a small incision in the lower abdomen, separates the gland from the bladder and excised. At the same time, the nerves responsible for erection are preserved. Then, by means of a catheter, the urethral stump is connected to the bladder, which is removed after 2 weeks. Such a procedure is often accompanied by complications in the form of urinary incontinence, impotence.
Doctors today prefer the laparoscopic way to eliminate prostate cancer. The operation is characterized by low trauma and a fast recovery period. During the procedure, severalpunctures in the abdominal cavity, through which instruments for surgical manipulations are then inserted. However, it can only be performed in the absence of metastases.
Medicine use
Elderly men who have contraindications to surgery are prescribed drug therapy with the use of hormonal drugs. This approach prolongs the life of the patient with advanced forms of cancer with metastases. Its main goal is to lower high levels of androgens artificially.
Hormone therapy includes the following medications:
- Medicines that block the production of testosterone ("Triptorelin", "Goselerin"). They are introduced once every 30 days, but sometimes less frequently.
- Antiandrogens that stop the action of testosterone on the prostate ("Flutamide", "Nilutamide"). The first 4 months of treatment, these funds are prescribed simultaneously with agonists. Their use often allows you to save libido and erectile function.
- Estrogens. The use of drugs from this group is characterized by high efficiency, but may be accompanied by side effects. We are talking about myocardial infarction, disruption of the gastrointestinal tract, thromboembolism.
Modern medicine does not consider it appropriate to use hormone therapy in the early stages of cancer, since in this case its effectiveness is equal to zero.
Chemotherapy
In the advanced stages of prostate cancercancers with metastases are treated with chemotherapy. Her help is also resorted to with insensitivity of the tumor to hormonal drugs, relapse after surgery. Treatment involves the use of drugs with toxic substances in the composition, which block the growth of cancerous elements. Once in the body, their components are carried throughout the body along with the bloodstream and find the most distant metastases.
However, they also have a detrimental effect on normal cells. Scientists have not yet been able to come up with a universal drug with a selective effect. Therefore, patients after a course of chemotherapy often develop symptoms of intoxication (diarrhea, nausea with vomiting, anemia, hair loss). It is carried out in cycles of 3 to 6 months, after which time is given for the body to recover.
Radiotherapy
Radiation or radiotherapy is used to reduce the rate of division of malignant elements. However, the latter method of treatment is not a guarantee of the patient's recovery. Therefore, it is used together with hormonal drugs.
An alternative method of destruction of pathological cells in the initial stages of prostate cancer is brachytherapy. It is based on the introduction of radioactive iodine into the body. The whole procedure is carried out under the control of an ultrasound machine. Due to localized exposure, the level of radiation increases only in the lesion, and he althy tissues remain intact. The procedure is performed on an outpatient basis and takes no more than an hour.
Prognosis for recovery
According to statisticsstudies, every seventh representative of the stronger sex after 50 years of age has prostate cancer. The prognosis for this disease depends on its stage. In the initial stages, if the patient follows all the doctor's recommendations, the five-year survival rate is 100%. At the second stage, this figure is slightly lower - 85%. In the case of tumor growth outside the organ, only every second patient can hope for a favorable outcome. With metastases and an aggressive course of the disease, patients live no more than three years.
Prevention Methods
When symptoms of prostate cancer appear, treatment should begin immediately. Only in this case can we hope for a favorable outcome. How to prevent the development of the disease?
There is no specific prevention. However, the risk of getting sick is significantly reduced if a person:
- monitor your diet;
- avoids exposure to toxic substances;
- he althy lifestyle;
- has a regular sex life.
It is also important to have a full check-up with a urologist from time to time.
