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Prostate Cancer Causes, Diagnosis, Treatment
Prostate Cancer Causes, Diagnosis, Treatment
Prostate cancer (prostate cancer) - malignant neoplasm that arises from the alveolar epithelial-cell glands. Prostate cancer is the cause of almost 10% of male deaths from cancer and one of the main causes of death in older men. For example, among men and 45 deaths from prostate cancer is small (3 cases per 1 million. People.), But after 75 years, this value increases by more than 400 times, reaching 130 cases per 100 000 population. In Russia, prostate cancer occurs almost two times less than the world as a whole. However, the growth rate of the disease over the past 10 years have become so large that for the next decade, the incidence can catch up with global figures.
The causes of prostate cancer:
age-related hormonal changes in the male associated with changes in the hypothalamic - pituitary - adrenal glands - the testes. In individuals with high background androgen (eg, those with high sexual activity), prostate cancer is more common
genetic predisposition
place of residence and race (prostate cancer is less common in eastern Europe and Asia, mostly in America and Scandinavia)
cadmium toxicosis (chronic intoxication with cadmium)
nutrient imbalance (reduction in food plant products, and vitamin E, with increased consumption of animal fats and proteins)
Prostate cancer often goes precancer stage, early detection is extremely important in terms of prognosis and treatment of disease.
By precancer prostate include:
Atypical hyperplasia. This fakultatiyny precancer, which can transform into cancer under certain conditions.
Intraepithelial neoplpaziya. This obligate precancer adenokartsnomy predecessor of the prostate.
Classification of prostate cancer based on histologic features and growth pattern. In contrast to BPH, cancer most often develops in the peripheral zone, and only 10% of cases in the transient zone, the most typical of the adenomas.
There are adenocarcinoma (glandular cancer) and squamous cell carcinomas of varying degrees of differentiation, as well as scirrhous and solid cancers. Prostate cancer is generally characterized by multifocal growth and differentiation of cells of different levels of tumor tissue. The degree of differentiation of cancer can be divided into 5 levels, further defining its classification according to Gleason. Depending on the resulting number is determined by the prognosis of Gleason and tactics to further treatment. A more common practice is to TNM-classification, which gives the clinical and histological characteristics of the tumor itself (T), the presence and extent of lymph node involvement (N), the presence and characteristics of distant metastases (M).
Clinic for prostate cancer.
Symptoms specific to prostate cancer, unfortunately does not exist. Moreover, many of the symptoms are similar to those of prostate cancer that requires more attention when they are revealing. Complaints of patients, usually associated with symptoms or tumor growths or the appearance of metastases. Because of the long asymptomatic and late detection, more than half of the cases during the initial detection of prostate cancer already has spread.
Usually the tumor detected incidentally during prophylactic or diagnostic examinations. Prostate cancer has a relatively slow growth. In metastatic spread of tumor occurs through the blood and the lymphatic pathways. With the growth of the tumor to the urethra there are frequent urination, blood in the urine, disturbance of micturition until his severe delays. Upon germination of the tumor to adjacent organs (seminal vesicles, bladder, rectum) observed symptoms of these bodies. So, with the urinary system may cause cystitis, pyelonephritis, and even chronic renal failure. There may be metastases in the bone tissue as the pelvic region and other parts of the skeleton. Surrounding metastases are often accompanied by swelling of legs and scrotum. Distant metastases are most common in the lungs, liver and adrenal glands.
Diagnosis of prostate cancer.
The most effective methods of early diagnosis of prostate cancer are:
rectal finger examination of the prostate
rectal ultrasound of the prostate (transrectal ultrasound)
determine the level of prostate specific antigen (PSA).
All of these methods complement each other and allow the suspect or detect prostate cancer at early, preclinical stages of development. Thus, PSA gives 15 to 40% false positive and false negative results, because depends on factors such as pre-prostate massage, instrumental examinations, inflammation and even ejaculate just before the study.
Another, more accurate method is to determine the index of prostate specific antigen density of the obtained ratio of PSA to prostate volume. Even more valuable is a measure of the rate of increase in PSA levels. By increasing the level of antigen by 20% or more per year must be more thorough investigation. Recently used as the measurement of the ratio of free PSA and total fractions, reduction of which indicates a possible malignancy. In general, diagnosis of prostate specific antigen levels - a very necessary examination for men older than 40 years. And if in the survey the level of PSA greater than 2 ng / ml, the risk of developing prostate cancer is high, and therefore should be an annual preventive examination.
The other survey methods include:
urofluometriya
biopsy of the prostate
ultrasound of the abdominal cavity
X-ray examinations, including computed tomography
radioisotope studies
magnetic resonance imaging, etc.
Treatment for prostate cancer.
As in many other areas of cancer treatment depends on many factors. First of all, pay attention to the disease stage and degree of tumor differentiation. If local forms of cancer (metastasis-free) use the following treatments:
Removal of the prostate (radical prostatectomy). The prostate is removed along with the seminal vesicles regional lymph nodes. The most popular today laparoscopic surgical technique as the least traumatic.
External beam radiotherapy. Irradiated prostate and regional lymph nodes at a dose of 40 Gray followed with additional irradiation of the primary tumor to a total dose of 70 Gray. Brachytherapy, or interstitial radiation therapy. The essence of treatment is local irradiation of cancer microcapsules with radioactive drugs. "Corn," with the drug entered under anesthesia with a special needle directly into the tumor tissue, which can significantly increase the radiation dose to the tumor and reduce the exposure of healthy tissue. Results and complications of treatment better than less, than in remote irradiation. Antiandrogen monotherapy. This treatment is rarely used and is carried out in patients who are not shown in other treatments.
Treatment of prostate cancer metastasis to the nearest usually limited to a maximum androgen blockade, which includes antiandrogen therapy with medical or operative castration. Sometimes it shows the radiation therapy and chemotherapy. A common (dissemenirovanny) prostate cancer amenable, as a rule, only symptomatic or palliative treatment. However, the use antiangrogennoy and radiation therapy can significantly improve the quality and duration of life of patients.
