According to statistics, prostate cancer (prostate) is diagnosed in 14% of cases. Most often, the pathology is detected in men after 50 years. It is also the cause of death of the representatives of the stronger sex of early advanced age in 73% of cases. Such sad statistics make us think about regular monitoring of the health and functionality of the prostate gland. The symptoms and treatment of cancer will be discussed in today's article.
Disease Description
The prostate is the endocrine gland, which is part of the reproductive system. It performs several functions: production of seminal fluid, participation in ejaculation. The gland is located above the bladder and next to the colon, grasping the urethra. Outwardly and in size, it resembles a walnut.
Prostate cancer is a serious cancer disease. A malignant tumor has the ability to secrete metastases in other organs. The progression of the pathological process occurs extremely slowly and imperceptibly. The appearance of microscopic signs of a neoplasm, the onset of a critical stage can take from 10 to 15 years. Patients turn to a doctor with complaints when it reaches an impressive size and begins to metastasize.
Main reasons
The incidence of prostate cancer varies by geographic area. For example, in East and South Asia it is much lower when compared with the European region. The exact causes of the development of pathology, doctors have not yet been able to determine. However, science knows the main risk groups:
- Age. In men who have not yet turned 40 years old, the risk of developing a malignant formation is minimal. It rises after 60 years. 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. In this case, its first symptoms are detected up to 60 years.
- Lifestyle. Bad habits (smoking, alcohol abuse) can activate the process of transformation 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 connection between male sex hormones and the onset 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 health. Timely detection of the disease allows you to immediately start 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 altogether or have a hidden course. Its first manifestations are observed when the neoplasm passes the boundaries of the urethra. In this case, patients may complain of:
- intermittent urination;
- multiple night and day emptying;
- strong urination, accompanied by acute pain;
- a feeling of incomplete emptying of the bubble;
- discomfort in the lumbar region;
- blood in urine or semen.
With a further increase in the size of the neoplasm, the intensity of these symptoms increases. When metastases begin to penetrate into nearby organs, the clinical picture is somewhat modified. The occurrence of swelling in the legs indicates damage to the groin lymph nodes by malignant cells. Violation of the bowel movement in the form of constipation indicates the penetration of metastases into the rectum. The organs of the abdominal cavity and chest can undergo metastasis. In this case, a strong cough speaks of involvement in the pathological process of the lungs, and jaundice indicates the liver.
Degrees and stages of the development of the disease
There are some differences between the two concepts of stage and degree of cancer. In the latter case, the classification is usually based on the results of studies of the cell mass of the gland at the histological and cytological level.
There are 5 degrees of prostate cancer:
- Initial. It is characterized by a slow morphological transformation of cellular elements.
- The second one. Altered cells are already significantly different from healthy ones. At the same time, their accumulation in one area is detected, the formation of a pathological node.
- The third. Cells with different morphology are distinguished. If untreated, the tumor begins to rapidly increase in size.
- Fourth. Most elements are difficult to differentiate.
- Fifth. Cell mass is not amenable to differentiation, is completely atypical.
If prostate cancer is suspected, the stage of the disease is also important to determine. There are four of them:
- Changes are detected only at the microscopic level after an organ biopsy. Ultrasound and palpation do not allow to diagnose the disease.
- In the second stage, pathology can already be detected by ultrasound. The node is still limited to the capsule, and the size of the neoplasm does not extend beyond the organ.
- The third stage is determined by the exit of the tumor beyond the gland. There is a high probability of detecting metastases in the bladder and rectum.
- The last stage is comparable to grade 4 prostate cancer. Metastases continue to spread actively throughout the body. The man feels constant pain during urination and complains of exhaustion.
In order for the treatment to be effective, the doctor must correctly determine the degree and stage of development of the disease. This approach also allows us to predict its further course.
Diagnostic Methods
At the slightest suspicion of prostate dysfunction, a man should consult a urologist. A standard examination begins with rectal palpation and a study of the patient's history. With normal sizes of the organ, an additional analysis is prescribed - a measurement of the concentration in the blood of a specific prostate antigen (PSA). He acts as a kind of cancer tumor marker. A blood test is the most informative diagnostic method. In addition, ultrasound and MRI of the prostate are prescribed.
Confirm the final diagnosis can only a biopsy. This procedure involves the use of a special needle, which is inserted into the rectum. With her help, the doctor takes tissue from the neoplasm for subsequent research in the laboratory. This examination method has side effects - the appearance of blood impurities in semen and urine. Normally, these complications should go away after a few days. However, the likelihood of developing inflammation at the site of the biopsy is quite high.
Therapy options
The choice of treatment for prostate cancer is up to the physician. In this case, the doctor must take into account a number of factors: the age of the patient, the degree of development of 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 do more harm to the patient than to ease his condition. In oncology, stages 1-2 of radical methods of therapeutic effect are not required. In this case, drug therapy is costed. In more detail about each method of treatment of prostate cancer will be discussed below.
Surgical intervention
The procedure for removing the 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 excises. In this case, the nerves responsible for the erection retain. Then, through a catheter, the urethral stump connects to the bladder, which is removed after 2 weeks. This procedure is often accompanied by complications in the form of urinary incontinence, impotence.
Doctors today prefer a laparoscopic way to eliminate prostate cancer. The operation is characterized by low morbidity and a quick recovery period. During the procedure, several punctures are performed in the abdominal cavity, through which instruments for surgical manipulations are then inserted. However, it can only be performed in the absence of metastases.
Use of medicines
Older men who have contraindications for surgery are prescribed drug therapy using hormonal drugs. This approach prolongs the life of the patient with advanced forms of cancer with metastases. Its main goal is to lower the high rates of androgens artificially.
Hormone therapy includes taking the following drugs:
- Medicines that block the production of testosterone ("Triptorelin", "Goselerin"). They are administered once every 30 days, but sometimes less often.
- Antiandrogens that suspend the effects of testosterone on the prostate (Flutamide, Nilutamide). The first 4 months of treatment, the listed drugs 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 highly effective, but may be accompanied by side effects. We are talking about myocardial infarction, a violation of the digestive 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 cancer with metastases, chemotherapy is used for treatment. Her help is also resorted to when the tumor is insensitive to hormonal drugs, relapse after surgery. Treatment involves the use of drugs with toxic substances in the composition that block the growth of cancer elements. Once in the body, their components are carried throughout the body along with the blood stream and find the most distant metastases.
However, they are detrimental to normal cells. Scientists have not yet been able to come up with a universal medicine with selective action. Therefore, patients after a course of chemotherapy often have 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 restoration of the body.
Radiotherapy
To reduce the rate of division of malignant elements, radiation or radiotherapy is used. However, the latter method of treatment does not guarantee a patient's recovery. Therefore, it is used together with hormonal drugs.
An alternative method of killing abnormal 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 the localized effect, the level of radiation increases only in the lesion, and healthy tissues remain intact. The procedure is performed on an outpatient basis, takes no more than an hour.
Prognosis for recovery
According to statistical studies, every seventh representative of the stronger sex after 50 years has prostate cancer. The prognosis for this disease depends on its stage. In the initial stages, if the patient complies with all the doctor's recommendations, the five-year survival rate is 100%. In the second stage, this indicator 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 the aggressive course of the disease, patients live no more than three years.
Prevention Methods
When symptoms of prostate cancer appear, treatment should be started immediately. Only in this case can we hope for a favorable outcome. How to prevent the development of the disease?
There is no specific prophylaxis. However, the risk of getting sick is significantly reduced if a person:
- monitors his diet;
- avoids exposure to toxic substances;
- adheres to a healthy lifestyle;
- leads a regular sex life.
It is also important to periodically undergo a full examination by a urologist.