The prostate or prostate gland is an internal organ of the male reproductive system, which, like a wide bracelet, covers the initial sections of the urethra. The main functions of the prostate are to produce part of the seminal fluid (up to 30% of the total volume) and participate in the act of ejaculation. The prostate also has a direct bearing on a man's ability to hold urine.
Prostate cancer is a malignant tumor that usually develops from the tissue of the prostate glands. Like other malignant tumors, prostate cancer has a tendency to metastasize (spread throughout the body).
The statistics are inexorable: prostate cancer occurs in every seventh man over 50 years of age. And, unfortunately, this particular disease is one of the most common reasons deaths of elderly men.
Causes
Until now, the causes of prostate cancer have not been fully elucidated. However, it is known for certain that the disease is associated with the male sex hormone - testosterone. The higher its level in a patient's blood, the more likely he is to develop prostate cancer and the more malignant the disease will be.
Risk factors also include:
- elderly age;
- poor heredity (close relatives have prostate cancer);
- existing progressive prostate adenoma;
- bad environment;
- work with cadmium (welding and printing works, rubber production);
- improper diet (lots of animal fats, little fiber), etc.
What's happening?
Prostate cancer usually has a slow and malignant course. This means that the tumor grows relatively slowly (from the moment a microscopic tumor appears in the prostate to the last stage of cancer, an average of 10-15 years passes).
Prostate cancer can give early metastases, that is, even a small tumor can begin to spread to other organs. Most often, the spread goes to the lymph nodes, bones (pelvis, hips, spine), lungs, liver, adrenal glands. This is the biggest danger of cancer. Before metastases appear, the tumor can be removed, and this will stop the disease. But if metastases appear, no surgeon can remove them all, and it will no longer be possible to completely cure the person.
How to recognize?
The problem is that the symptoms of the disease begin to bother a man only when the disease has gone too far and there is little chance of a complete cure. Prostate cancer can manifest itself as increased frequency of urination, pain in the perineum, and blood in the urine and semen. But you may not experience any of these symptoms. And then the first manifestation of the disease will be signs that are characteristic of metastases: pain in the bones (pelvis, hip, spine) and fractures, chest pain.
In advanced cases, acute urinary retention may develop, as well as symptoms of cancer intoxication: a person suddenly loses weight, becomes weaker, and his skin becomes very pale with an earthy tint.
More rare symptoms of prostate cancer are impotence or weak erection (the cancer has affected the nerves that control erection), a decrease in the volume of sperm during ejaculation (the tumor is blocking the ejaculatory canal).
Diagnostics
If you have problems with urination, immediately contact a urologist. Perhaps not everything is so bad, and this is just an adenoma or inflammation of the prostate.
First of all, the doctor will check the condition of the prostate gland - conduct a digital rectal (through the rectum) examination. This is the simplest test method to suspect prostate cancer. Unfortunately, if the tumor can be felt, most often it is already one of the later stages of cancer. Therefore, even if the tumor cannot be palpated, the patient will be prescribed an additional test: a blood test for prostate-specific antigen (PSA).
PSA is a substance whose concentration in a man’s blood increases sharply with prostate cancer. To clarify the diagnosis, the patient may also be prescribed an ultrasound of the prostate, computed tomography, X-ray and radioisotope studies.
The final diagnosis of prostate cancer is made after a prostate biopsy - a small piece of the prostate is taken through the perineum or through the rectum for examination.
Treatment
There are surgical, drug and radiation treatments for prostate cancer. The oncologist will decide which method to choose individually, depending on the patient’s age, the extent and stage of the cancer, and the presence of metastases.
Surgical treatment methods (removal of the prostate gland) are usually used only when the tumor has not yet metastasized. If the operation is performed successfully, it practically guarantees a complete cure for prostate cancer without any health consequences.
Drug treatments are treatments with hormones that reduce or block testosterone, thereby reducing the rate of tumor growth and metastasis. Treatment with hormones does not provide a complete cure, but it improves the patient’s condition for a long time and reduces the symptoms of the disease. Radiation therapy - radioactive irradiation of a prostate tumor, also reduces the rate of tumor growth and reduces the likelihood of metastases, but does not guarantee a complete cure for cancer.
Radiation therapy and drug therapy are often used together to enhance the effect of treatment.
An alternative method of radiation exposure to the prostate gland initial stages diseases - brachytherapy. The essence of the method: under ultrasound control, granules of radioactive iodine are injected into the prostate gland, due to which a high dose of radiation is achieved in the area of malignancy, and the surrounding tissues are practically not affected. The procedure for introducing capsules takes about an hour and is carried out on an outpatient basis, which distinguishes it from other types of radiation treatment.
This type of cancer pathology is unique to the male sex, since the organ in which the tumor grows, the prostate, is found only in men. In the list of male cancer diseases, this consistently ranks first and, unfortunately, is being detected more and more often over time.
Prostate cancer can develop at any age, but most often it affects men aged 35–40 years, and with increasing age, the risks increase significantly. For example, among 35-year-old men, prostate cancer is detected in 10 cases per 10,000; upon reaching 60 years of age, this figure increases 10 times, and in men over 7 years of age, the pathology occurs in every eighth.
A distinctive feature of prostate oncology is the long and asymptomatic development of the disease. It seems to a man that everything is in order and he is leading his usual lifestyle, but when noticeable problems begin (usually already at stage 3), a complete cure may no longer be possible.
Due to such an insidiousness of the disease, men, especially those over 40 years of age, should be regularly examined by a urologist, or better yet, by a urological oncologist.
Functions of the prostate gland
The prostate is the main sex gland of a man, it is small in size - approximately 4 cm in diameter and consists of 2 equal lobes. Located in the pelvic cavity, under the bladder, it encircles the urethra like a horseshoe, which causes problems with urination in case of inflammation of the prostate. As it increases, it puts pressure on the ureter and blocks it.
The prostate is structured as follows: from its outer shell, the capsule, septa diverge, between which the prostate glands are located. Their tissue is formed by glandular epithelium, and in shape they are small tubes separated by vesicular formations. The glands are of paramount importance because they are responsible for the production of prostatic juice, one of the main components of semen. These tubes are surrounded by smooth muscle tissue and serve to remove excess juice and prevent congestion.
Regarding the functions performed by the gland, the main ones are:
- Production of seminal fluid;
- Secretion of sperm-releasing and diluting substances;
- Provides natural sexual desire.
In addition, the prostate gland is the main supplier of the main male hormone - testosterone and some others.
What can lead to prostate cancer?
Despite all the efforts of medicine, it still cannot unambiguously answer the question why, however, the accumulated experience and statistics clearly point to the reasons that significantly increase the risk of this disease.
A clear risk factor is chronic inflammation of the prostate. They may be infectious in nature or result from hormonal disorders. Constant irritation of cells can cause them to mutate and cause a tumor. In addition, inflammation leads to the activation of immune cells, which can disrupt the DNA structure of gland cells.
Most prostate tumors are sensitive to the hormones produced by the gland - androstenedione, testosterone and dihydrotestosterone, so it is logical to assume that the causes of prostate cancer may lie in an imbalance of these hormones, or more precisely, in their hypersecretion.
The risk is very high in men with prostate adenoma. Despite the safety of this tumor, it has a habit of mutating and turning into malignant. Therefore, if an adenoma is detected, it should definitely be removed.
Along with adenoma, there are a number of conditions – congenital and acquired – that need to be constantly monitored, since their development most likely ends in prostate cancer:
- Prostate neoplasia. For some reason, the gland cell division program malfunctions, and they begin to multiply at an accelerated pace. Over time, such cells become atypical and often become malignant;
- Hyperplasia of an atypical nature. The condition is characterized by the appearance of nodular lesions, the tissues of which change their nature and begin to grow. The cell nuclei gradually enlarge and over time, tumor foci appear in the nodules, initially benign. Gradually, it can change its nature.
Fortunately, such borderline conditions do not always lead to cancer, but the disease becomes almost inevitable when exposed to additional factors:
- Old age – over 40 years old;
- Unhealthy diet. A large amount of fatty foods and meat of animal origin, especially beef, is harmful to the prostate;
- Prolonged contact with carcinogens and their derivatives. This is relevant for men involved in hazardous industries associated with phenols, cadmium, and other aggressive substances;
- Lack of regular sex is especially true for young men. Their semen production is very active and its untimely excretion leads to stagnation - prostatitis and adenoma, and this is a borderline, precancerous condition;
- Lingering chronic diseases glands and other genitourinary organs;
- Viral infections - herpes, retrovirus, cytomegalovirus.
Bad habits that men often suffer from – smoking, excess alcohol, excessive coffee consumption and very spicy foods – also increase the risk of developing cancer cells.
Men whose closest relatives suffered from this disease at a young age - under 35 years old - should be especially careful.
Stages of the disease
The stage is determined based on the size of the tumor, the degree of damage to adjacent tissues, and the presence and number of secondary lesions. For the convenience of describing the condition, any cancerous disease, including prostate cancer, is usually divided into 4 stages:
- Stage 1. There are no visible symptoms at all. The size of the tumor is miniature, barely noticeable; palpation and ultrasound do not reveal the disease. At this stage, diagnosis is only possible using the PSA test, a specific antigen. The discovery of such a tumor is a rare success;
- Stage 2. The tumor grows to a size that can be detected by palpation and ultrasound, while its body does not penetrate beyond the gland capsule. There are no metastases yet, but symptoms appear and intensify - difficult, intermittent and frequent urination, sometimes painful. Symptoms are worse at night. Often you have to go around small 4, or even 5 times. The growing tumor compresses the urethral canal, which causes the described symptoms;
- Stage 3. The tumor becomes large in size and is easily diagnosed by any method. Clear, specific symptoms appear - severe pain in the pubic region, perineum and lumbar girdle, painful urination with burning, hematuria develops - blood in the urine. This occurs due to the tumor spreading beyond the prostate and affecting neighboring organs, primarily the bladder and urethra. At this stage, metastases often occur, but only to a regional location;
- 4 - final stage. The growth of the tumor becomes aggressive; its cells, carried through the blood and lymphatic system, become established in distant parts of the body and produce secondary foci - metastases.
The last stage is characterized by severe pain, intoxication of the body with waste products of cancer cells, a sharp decrease in body weight, interest in life, and rapid decline of the patient. Treatment of this phase of cancer is impossible, so they resort to palliative therapy, which, if possible, reduces the patient’s suffering and somewhat prolongs his life.
Symptomatic manifestations
In addition to natural causes, primarily associated with age-related changes, there are a number of others that provoke the occurrence of prostate cancer. Unfortunately, both groups of these disease-provoking factors do not manifest themselves with obvious and specific symptoms for a long time, and if they do arise, they are very similar to the manifestations of other, less dangerous diseases and do not cause due concern.
All this leads to the fact that the overwhelming number of men suffering from this disease find out about it at best at the 2nd stage of the disease, and often at the advanced stage - the third. The stage of active cell division of a malignant tumor is characterized by:
- Various disorders of the urinary system - from difficulty urinating to complete blockage of the ureter, which require immediate catheterization, otherwise the resulting stagnation will not only activate the disease, but can also complicate it with kidney problems. Sometimes the opposite picture is observed - partial and even complete incontinence;
- When a tumor grows through the capsule of the gland, the affected tissues and organs adjacent to it acquire atypical dysfunction, and trophic processes are disrupted. This is expressed by discomfort and pain, problems with erection and the appearance of blood in the ejaculate;
- The growth of the tumor and the occurrence of metastases also causes pain, usually in the lumbar and bone tissues, and their intensity is quite high, especially at night. Further development of the process leads to a sharp decrease in the concentration of hemoglobin in the blood, severe weight loss, swelling of the legs, and with compression spinal cord) metastases in the spine, partial or complete paralysis is possible.
If the cancer tumor consists of cells of an undifferentiated nature, the described symptoms are extremely severe, and the survival prognosis is extremely negative.
In view of the above, it becomes especially important early diagnosis diseases, and this is impossible without regular examination by a specialist. Men who have reached the age of 35 should consult a specialist annually, and those who have crossed this milestone every six months. Great importance also has an understanding of risk factors and disease prevention, especially for genetically predisposed people.
Prevention
Unfortunately, it is impossible to protect yourself with 100% probability by any measures, but if you follow a number of simple rules, possible risks will be minimized. These are the rules:
- Balance your diet towards fresh vegetables and fruits, reducing the consumption of animal fats and red meat as much as possible. It can be replaced with fish. Completely avoid processed foods and products with nitrates, food additives and artificial colors;
- Try to limit contact with carcinogenic substances as much as possible;
- To avoid congestion, avoid delays in emptying the bladder and prolonged sexual abstinence;
- Activate physical exercise– sports or physical exercise, even a simple walk in the fresh air, significantly improves both general blood supply and the prostate in particular, and this is the key to health;
- Healthy, full sleep also has a very beneficial effect on the condition of the gland, since sleep activates the production of melatonin, a hormone that prevents mutation of the glandular cells of the prostate.
And of course, a mandatory factor of prevention is regular examination:
- Tumor marker PSA;
- Palpation of the prostate;
And a group of people with chronic prostatitis or identified adenoma should be especially careful - regardless of age, a detailed examination should be completed twice a year.
Video on the topic
The prostate is a small gland responsible for the normal functioning of the male reproductive system. In youth, symptoms of organ dysfunction rarely occur. As you age, your risk of developing serious diseases increases. Men are often diagnosed with adenoma, prostatitis, prostate cancer and other troubles.
Causes
The organ is located in the bladder area (in its bottom part), therefore, when the gland grows, a man feels symptoms associated with impaired urination.
The main causes of prostate cancer lie in testosterone, a hormone that regulates the functioning of the gland. Its main quantity is produced by the testes, the rest is produced by the adrenal glands.
As a man gets older, the organ begins to slowly increase in size, so the need for testosterone increases. It is necessary to know the first signs of prostate cancer in order to consult a doctor in time.
Additional causes of cancer include:
- genetic predisposition;
- inflammatory diseases of the prostate;
- presence of bad habits;
- unhealthy diet (excess red meat and animal fats in the diet);
- viral diseases;
- influence of radiation;
- work in hazardous production.
Sad statistics show that among all malignant diseases in men, prostate cancer is the most common. In Russia, it is detected in 6% of people over 65 years of age.
Symptoms
The high mortality rate is explained by late diagnosis due to the absence of obvious signs.
Early symptoms of prostate cancer may include:
- increased fatigue, loss of strength;
- deterioration of appetite or complete aversion to certain foods (usually protein);
- weight loss;
- slight increase in body temperature (within 37.0 – 37.2 degrees Celsius).
However, they accompany most diseases and pathological conditions, and therefore are not specific precursors of oncology.
Prostate cancer
Often the patient does not pay attention to minor manifestations, and therefore does not voice complaints to the doctor.
Symptoms of prostatitis are added to the signs:
- slight pain when urinating;
- periodic problems with erection;
- nagging pain in the lower abdomen.
These symptoms of prostate cancer appear as the tumor grows, when the enlarged gland begins to put pressure on the urethra and nerve endings.
Most often, the disease is detected at stages 2–4, when the neoplasm extends beyond the capsule of the gland, spreads to neighboring organs and gives metastases.
With prostate cancer, a man experiences the following symptoms:
- severe pain when urinating;
- disturbance of urine outflow;
- blood in urine and semen;
- deterioration or complete absence of erection;
- feeling of pressure in the lower abdomen;
- increased urge to go to the toilet, especially at night.
When cancer cells enter the lymphatic system, symptoms of enlarged and inflamed lymph nodes are observed. As other organs are affected, other signs of prostate cancer in men appear. When metastasis occurs in the lungs, coughing up blood appears. When the bones are affected, pain is observed at the location. If the secondary focus is located in the liver, the organ increases in size, the skin turns yellow, and the limbs swell.
None of the above symptoms indicate the development of cancer, but their combination suggests a malignant cause of the ailment. To make an accurate diagnosis, you will need to undergo an examination.
Prostate cancer can be detected in its early stages in men who regularly visit the doctor for preventive purposes.
Diagnostics
Prostate cancer is treated by a urologist. At the initial visit, he will need to collect a detailed history and conduct an examination.
Palpation of the prostate gland is carried out through the patient's anus. The attending physician uses a finger to assess its size and structure.
Normally, the contours should be smooth and the sides should be symmetrical. In prostate cancer, multiple changes are observed.
Already at this stage, the doctor may suspect pathology. The preliminary diagnosis will need to be confirmed instrumentally using the following studies:
- Blood test for PSA (prostate specific antigen). It is not a marker of oncology, but indicates problems in the functioning of the prostate. Its rate varies depending on age. On average it is 2.5 – 4.5 ng/ml. An increase to 10 ng/ml indicates the possible presence of cancer, but often indicates other problems with the prostate. Too high indicators with a high degree of probability indicate that the cause is a tumor.
- Transrectal ultrasound. It is an informative method for visual assessment of an organ. The shape, structure, and presence of tumors are clearly visible on the monitor.
- MRI or CT. It is prescribed in controversial cases, for example, when the PSA level is very elevated, but a malignant prostate tumor is not visible on ultrasound. Sometimes it is carried out for a detailed examination of the tumor.
- Biopsy. Needed to study a tissue sample at the cellular and tissue level.
- Gleason index. Histological analysis of prostate biomaterial will allow us to study the cellular structure of the tumor. High rates indicate an aggressive course and an unfavorable prognosis.
PSA levels often rise long before a tumor is visually detected, so all men over 40 years of age are recommended to have it tested once a year in the absence of clinical signs.
It is extremely rare that a malignant tumor is detected with a normal PSA level.
Therapy methods
Your doctor will tell you how to treat prostate cancer. The selection of an individual scheme is carried out taking into account many factors. Among them:
- age;
- cancer stage;
- test results;
- Gleason score and more.
When diagnosing stages 1 and 2 of carcinoma, when the tumor does not extend beyond the capsule, the man has a chance of recovery.
In advanced cases, with extensive damage to neighboring organs and metastasis, it is problematic to cure the patient.
Prostatectomy
A radical method consisting of surgical removal of the prostate gland. Often, adjacent lymph nodes and seminal vesicles are cut off along with the affected organ.
Depending on the indications, the gland is removed:
- cavity method;
- using laparoscopy;
- a special “Da Vinci” installation (a type of laparoscopy performed by a robot, used mainly in foreign countries).
Treatment of prostate cancer by prostatectomy is relevant for stages 1 and 2 of cancer. If the tumor is not aggressive and is discovered after age 65, the prostate is rarely removed. Often a different treatment method or wait-and-see approach is selected.
Radiation therapy
On early stage For men, brachytherapy is recommended - a type of radiation treatment in which the prostate is directly irradiated. The procedure is carried out by introducing a capsule of radioactive iodine into the diseased organ. The substance deforms the DNA structure of pathological cells, leading to their destruction and reduction in the size of the malignant tumor.
Systemic radiation treatment is most often used for:
- Stages 3 and 4 cancer;
- spread to other organs;
- presence of metastases;
- relapse.
Often prescribed after prostatectomy to eliminate remaining cancer cells.
Hormones and castration
Androgen suppression treatments for prostate cancer are often combined with radiation, chemotherapy, or prostatectomy for different stages cancer. Such medications are rarely used as a monotherapy.
Chemical castration without surgery can reduce the rate of division of malignant cells or stop the process. Their action is to suppress testosterone production.
Surgical castration is an irreversible procedure that involves suppressing testosterone production by cutting off the testicles (testicles).
The decision is made based on the patient’s indications and wishes. The advantage of drug treatment is the complete restoration of function after drug withdrawal, so most men choose the latter option, despite the high cost.
Chemotherapy therapy
It is used at any stage of the disease if previous methods of treating prostate cancer have failed or there are contraindications to them. Its effectiveness depends on many factors.
How cancer is treated at a certain stage should be decided by a specialist based on the examination results. Drugs can be prescribed for the purpose of complete cure or to alleviate the patient’s condition.
The disadvantages of treatment include extremely negative impact on the body. The patient develops the following symptoms:
- hair loss;
- nausea;
- bleeding.
This happens because chemotherapy drugs do not selectively target diseased cells. During the healing process, healthy people also suffer.
A relatively new method is targeted therapy. Recent developments have addressed some of the shortcomings. These drugs cure cancer:
- disrupting the process of formation of new vessels feeding the tumor;
- reducing the activity of cancer cells in the bones;
- blocking receptors that affect the growth of a malignant tumor;
- by teaching the body to independently fight the threat, by introducing inactive fragments of malignant cells.
The drugs are still undergoing clinical trials, but many volunteers have already assessed the effectiveness of certain drugs in the treatment of prostate cancer.
Rehabilitation after treatment
Cure primarily depends on the degree of neglect, signs and aggressiveness of tumor cells.
If after treatment the disease has subsided and the symptoms of prostate disease are no longer bothersome, you must carefully listen to the doctor’s recommendations:
- to refuse from bad habits;
- to harden;
- do exercises regularly;
- avoid heavy physical activity;
- undergo examination in a timely manner;
- Tell your doctor if you feel worse.
Sexual relations are not contraindicated, but during hormone therapy erection in many men worsens or disappears altogether.
During the rehabilitation period, the cured man is recommended to exclude the following foods from food:
- sausages, canned food, pates;
- hamburgers, pies and other fast food;
- animal fats and red meat;
- store-bought sweets, home-baked goods;
- All fried foods, refined oil;
- coffee, cocoa, chocolate;
- carbonated drinks.
To never find out what prostate cancer is and its signs, you should pay attention to the use of:
- tomatoes;
- watermelons;
- pumpkins;
- persimmons;
- papayas;
- apricot;
- Guavas
These plant-based foods contain lycopene, which helps prevent the development of prostate cancer.
Curing prostate cancer is not an easy task, but is it possible to avoid the recurrence of the disease? Even with complete recovery, a relapse may occur after a while. Radical removal of the gland does not always help, because neighboring tissues may contain malignant cells that are difficult to diagnose. If new signs of the disease appear, you should immediately visit your doctor.
Prostate cancer is the most common cancer diagnosed in older men. Today, prostate cancer ranks second in prevalence and mortality. The disease is difficult to diagnose at an early stage due to the almost complete absence of specific symptoms.
Prostate cancer in men is an age-related disease. In men under 50 years of age, the pathology is very rare; exact statistics are unknown. Most patients have crossed the sixty-year mark. With age, the risk of developing prostate cancer increases, so age is one of the risk factors.
The exact causes of cancer are very difficult to determine. Doctors agree that the development of prostate cancer is the result of several factors. These include:
- hormonal background;
- age;
- Lifestyle;
- diet;
- race;
- heredity.
For prostate cancer, the causes are quite difficult to reliably establish. Heredity plays an important role, but is not the main factor in the development of this disease. However, statistics indicate that in approximately a quarter of cases of this disease, prostate cancer was also detected in the man’s immediate relatives.
If there is a family history of this disease, a man should undergo regular examinations by a urologist starting from the age of thirty. With timely treatment of prostate cancer, the prognosis is quite positive, but this is only true if the disease is detected at an early, or pre-symptomatic, stage.
Race also affects susceptibility to this disease. Most often, prostate cancer occurs in black men. In Asians, the incidence of this pathology is low.
Another important criterion that is taken into account when assessing susceptibility to developing cancer is the patient’s age. On average, men over 50-60 years old experience the disease; every year the chances of getting sick increase, the peak occurs at 75 years of age. This is due to a slowdown in processes occurring in the body and changes in hormonal levels. The prostate gland itself is a hormone-dependent organ. A slowdown in the production of male sex hormones or a change in the balance of androgens leads to the development pathological process. This is how prostate adenoma develops - a benign tumor. Changes in hormonal levels can lead to the development of prostate cancer or carcinoma.
In addition, the presence of adenoma in a man is also considered one of the risk factors. There is a possibility that a benign tumor will begin to degenerate into a malignant tumor as it grows. To identify the dynamics of changes occurring in the prostate against the background of adenoma, men with this diagnosis should regularly take a blood test to determine the level of prostate-specific antigen.
Prostate cancer in most cases is a disease of the elderly
When talking about the causes of cancer, one should take into account a person’s lifestyle. Bad habits, physical inactivity, irregular sex life or promiscuous relationships - all this increases the chances of developing the disease, but does not predetermine future fate person.
One of the latest hypotheses about the causes of prostate cancer is the viral nature of the disease. Some scientists believe that prostate cancer may be a consequence of the action of one of the retroviruses. The hypothesis is being actively studied, but has not been fully confirmed to date.
Considering the hormonal nature of prostate tumors, a man’s diet cannot be ignored when assessing his predisposition to cancer. The fact is that some animal products increase the production of androgens, which presumably cause the development of tumor processes in the prostate. These products include red meat. Abuse of meat (regular consumption of more than 350 grams daily) can theoretically increase the risk of developing cancer.
All of the above reasons describe risk factors, but do not predetermine the development of the disease, since scientists have still not been able to establish exactly why prostate cancer develops.
Symptoms of the disease
Specific signs of prostate cancer appear in the later stages of the disease, when the tumor reaches a significant size. It is difficult to recognize carcinoma, prostate cancer or prostatic cancer at an early stage; the signs of prostate cancer are in many ways similar to the symptoms of adenoma and prostatitis.
Long-term asymptomatic course is the main cause of high mortality among patients. The absence of symptoms in the early stages of the disease complicates diagnosis.
The first signs of prostate cancer are quite vague and subjective. Symptoms manifest differently in each patient, and in most cases they do not appear until the second stage of the disease. Among the first signs of prostate cancer in men:
- urinary disturbance;
- pain syndrome;
- violation of potency;
- general deterioration of health.
With prostate cancer, symptoms primarily affect the bladder. The prostate increases in size and puts pressure on the neck of the bladder, impairing urination. However, with prostate cancer, symptoms of urodynamic disturbances may be absent for a long time. Among patient complaints:
- frequent urge to go to the toilet at night;
- feeling of bladder fullness;
- weakening of the urine stream;
- pain syndrome after emission.
Urination often does not bring relief; the feeling of a full bladder remains. Nighttime urge to go to the toilet is a characteristic symptom of adenoma, but such complaints are also present in prostate cancer.
The first signs of prostate cancer are similar to the symptoms of adenoma or inflammation of the gland
Symptoms of prostate cancer include: sexual function men. Often the initial sign is deterioration in potency and weakening of libido. Pain in the bladder and perineum is often observed. One of the specific signs of progressive oncology is a feeling of fullness in the rectum.
In the early stages of the disease, there are no symptoms of intoxication, but the man may complain of general malaise. Quite often, a general deterioration in health, apathy, and decreased performance become the first clinical manifestation pathology.
The earlier the symptoms of prostate cancer appear, at an early stage of the disease, the higher the likelihood that men will consult a doctor in a timely manner. If detected early, prostate cancer (PCa) can be cured. Since the disease may not make itself felt for a long time, in the vast majority of cases the pathology is detected in the later stages.
Classification of prostate cancer
There are several methods for classifying prostate cancer. The three most common and widely used are:
- Gleason method;
- Jewitt-Whitemore system;
- TNM system.
The Gleason system is based on assessing the degree of malignancy of organ tissue cells. The Gleason score is a total score that is calculated based on the degree of differentiation of pathological cells.
The minimum value of this indicator is 2 points. This indicates a low aggressive form of the disease. This form of tumor progresses very slowly, and the risk of developing metastases with timely and adequate treatment is low.
The average Gleason score is 7 points. Such a tumor progresses at a moderate pace, and in the absence of adequate treatment poses a threat to the patient’s life.
A Gleason score of 8-10 points indicates a highly aggressive form of pathology. Such a tumor grows rapidly, metastasizes early, and metastases spread quickly. The prognosis for this form of the disease is usually unfavorable.
The Gleason score is based on a biopsy sample taken from two different areas of the prostate gland. Changes in the cells of each area are assessed on a five-point scale and then summed up.
Gleason classification is one of the most common
The TNM system uses three criteria for assessing the degree of aggressiveness of the disease:
- tumor size;
- spread of cancer to lymph nodes;
- metastasis.
There is a table detailing each indicator. Based on this table, further predictions can be made.
The Jewitt-Whitemore system classifies pathology into four stages:
- A – initial or presymptomatic stage;
- B – presence of a malignant tumor localized in the prostate;
- C – involvement of surrounding tissues in the pathological process;
- D – cancer metastasis to lymph nodes, internal organs, skeleton.
Each stage is divided into substages, which describe the pathological process in more detail. Cancer can be classified only after a biopsy and histological analysis of the cells.
Stages and grades of cancer
Symptoms and treatment of prostate cancer depend on the extent and stage of the pathological process. The stages of the disease, accepted in oncology, describe the spread of the pathological process.
The first stage is characterized by:
- absence of symptoms;
- the inability to detect cancer using conventional methods;
- no visible tumor.
The disease can be detected at this stage only by examining the cells of the biopsy specimen. This is complicated by the fact that the patient does not see a doctor and there is no reason to suspect the development of a dangerous pathology.
At the second stage, the formation increases in size. The tumor can be detected by ultrasound examination. The tumor cannot be felt upon palpation; it is localized in the prostate capsule.
At the third stage, the pathology begins to spread beyond the prostate capsule. The pathological process spreads to the tissues surrounding the organ.
The fourth stage is the spread of cancer beyond the prostate and the development of metastases. Most often, prostate cancer metastasis first affects the lymph nodes, then spreads to internal organs and bone tissue.
Grades of prostate cancer describe symptoms, the severity of which changes as the pathological process spreads. There are 4 degrees of cancer:
- Grade 1 – complete absence of symptoms;
- Grade 2 – most often there are no signs, there may be minor problems with urination;
- 3rd degree - the tumor extends beyond the organ, serious problems with urination and pain develop;
- Grade 4 – symptoms depend on the location of metastases.
The fourth degree of prostate cancer is accompanied by severe pain in the pelvic region and lower back, severe urination disorders. In most cases, there are signs of intoxication, neurological disorders, and general malaise.
Stages of prostate cancer according to the Jewitt-Whitemore classification
Diagnostics
If you discover alarming symptoms or suspect signs of prostate development in men, you should consult a urologist. The doctor will conduct an initial examination and prescribe standard diagnostic procedures - digital rectal examination of the prostate, TRUS and ultrasound, PSA blood test.
A digital rectal examination is palpation of the prostate through the rectum. The doctor can assess the size and contours of the organ, structure and presence of tumors. However, in the initial stages of development of the pathology, there are no changes in the structure of the prostate, so additional examinations will be needed.
An ultrasound examination of the prostate, bladder and kidneys is mandatory. To examine the prostate gland, a transrectal method is used, in which a sensor is inserted into the rectum. Already at the second stage of cancer, changes appear that are visible on ultrasound and are defined as areas with increased echogenicity. Ultrasound of the bladder and kidneys is necessary to exclude pathologies of these organs, which are symptomatically similar to cancer and other prostate diseases.
The most informative method of preliminary diagnosis is a PSA blood test. PSA is a protein produced by the prostate and is found in the blood only when the functioning of this organ is impaired. U healthy man the PSA level should be no more than 4. In old age, this value increases to 6.5, which is due to changes in the prostate against the background of a decrease in the production of male sex hormones.
An increase in the amount of protein to 10 indicates an adenoma. This is a benign tumor that worsens the quality of life, but does not affect its duration.
Cancer is diagnosed if the PSA is more than 10. Moreover, the higher this value, the more severe the stage of the disease. For example, at the fourth stage with metastases, the amount of protein reaches 100 units.
A high PSA level is a reason to conduct a magnetic resonance or computed tomography scan and biopsy. Tomography allows you to identify the exact location of the tumor. A biopsy is performed to obtain pieces of prostate tissue. A special instrument equipped with a camera, a light source and a hollow needle is inserted into the organ through the urethra or anus. A puncture is made at several points in the prostate gland, and tissue samples are stored inside the needle. For accurate diagnosis, fragments are taken from 10-12 points. Laboratory examination of such a quantity of tissue allows us to determine the stage of cancer, assess possible risks, make a prognosis and choose treatment methods for prostate cancer.
PSA is a tumor marker for prostate cancer
Features of treatment
Prostate cancer is treated with several different methods. Methods and methods of treating prostate cancer depend on several factors:
- severity of the pathological process;
- patient's age;
- general health.
If signs of prostate cancer are detected at the initial stage or early stage of development, a wait-and-see approach is often chosen, especially if the patient is over 75 years of age. In this case, it is necessary to track the dynamics of oncology development. With a slightly aggressive form of the disease, a man may be indicated for drug treatment.
Surgery for prostate cancer
Most effective method treatment is surgery. It is allowed in the following cases:
- absence of chronic diseases;
- age 60-65 years;
- normal tolerance to anesthesia;
- early stage of oncology.
In case of prostate cancer, tumor removal is not advisable, so a radical prostatectomy is performed - complete removal prostate gland. This is because if the doctor preserves the prostate, the risk of relapse remains.
Many factors are taken into account when choosing this method. Since prostate cancer is an age-related disease, not all patients can tolerate anesthesia. For many men, this procedure is contraindicated, which is why prostate cancer is treated with medication.
Quite often, not only the prostate is removed, but also nearby lymph nodes. This reduces the risk of relapse. If the pathological process spreads beyond the prostate capsule, removal of the organ may not be enough; the risk of further spread of the pathology remains very high.
Today, prostatectomy is performed using a robotic system. This ensures a high degree of safety of the operation.
Da Vinci surgical robot - the latest word in medical technology
Chemotherapy
Starting from the third stage of the disease, prostate cancer is treated with chemotherapy. The patient is prescribed medications in the form of injections or tablets. These medications contain toxic substances that destroy malignant cells.
The course of chemotherapy takes 6 months. This treatment helps stop the spread of the pathological process and prevents the occurrence of metastases. Chemotherapy is not used in the early stages of cancer due to large quantity side effects.
Treatment is carried out under the supervision of a doctor. After a course of chemotherapy, the patient undergoes tests again to assess the effectiveness of the treatment.
Radiotherapy
Radiation or radiotherapy is the irradiation of malignant cells with x-rays. Radioactive exposure disrupts cellular connections, stops tumor growth and destroys malignant cells. Radiotherapy also helps stop the spread of metastases.
Today, three methods of radiotherapy are used:
- remote;
- HIFU therapy;
- brachytherapy.
The first method involves a long course of treatment. The procedure is carried out daily for a week, with two one-day breaks. TODAY, the method is considered outdated, as it involves influencing large areas of the body, affecting not only pathological, but also healthy cells. External beam radiotherapy is used only for aggressive tumors with high speed progression.
HIFU therapy refers to a selective effect only on tumor cells. This is achieved through ultrasonic influence. The method is relatively safe and is used for stages 2 and 3 of cancer, when the pathological process has not yet spread beyond the prostate gland.
Brachytherapy is the safest treatment method in terms of overall harm to the body. The main advantage is a minimum of side effects. In this case, a radioactive drug is injected directly into the area where the tumor is located. The most commonly used are iodized capsules. The drug is administered using transrectal ultrasound equipment. Contact radiation therapy affects only pathological cells without affecting healthy tissue.
The method allows minimizing irradiation of healthy tissues
Drug treatment
An alternative surgical intervention and radiation therapy is a drug treatment. Typically, this method is used if there are contraindications in older men.
Today, two methods of drug therapy are practiced - hormonal and through the introduction of monoclonal antibodies.
Hormone therapy is also called medical castration. The goal of this treatment is to suppress the production of androgens. This is done by taking drugs that are analogues of hormones produced by the pituitary gland, or special antiandrogens. Treatment is also carried out with drugs that reduce the production of your own testosterone, thereby slowing down the progression of the tumor.
The disadvantage of drug therapy is the development of a large number of side effects. Hormones can cause problems blood pressure, affect kidney function, cause gynecomastia (enlarged mammary glands) in men. Nevertheless, medical castration shows enough good results in the treatment of prostate cancer.
A radical alternative to medical castration is surgery to remove the testicles. As a result of this procedure, the production of testosterone stops, which stops the growth of the tumor. Today, this radical measure is practically not used and is prescribed only in exceptional cases when no other treatment method can be used.
Treatment with monoclonal antibodies is aimed at activating one's own immunity to fight malignant cells. The method is very effective, but is not widespread enough in the CIS countries. This is due, first of all, to the high cost of drugs. One injection of monoclonal antibodies will cost more than 200 thousand rubles. Injections must be given monthly to curb the progression of cancer.
Hormone therapy has a large number of side effects
Folk remedies
Prostate cancer is a dangerous disease that kills thousands of men every year. Treatment folk remedies not advisable for cancer. The use of decoctions and infusions medicinal herbs does not cure cancer, but may make drug treatment significantly more difficult. Some herbal preparations reduce the effectiveness of drug therapy.
Trying to self-medicate for cancer can waste valuable time. While the man is self-medicating, the spread of the pathological process is not restrained in any way, and the disease progresses. It is important to understand that cancer in the initial stages is curable, but the fourth stage of the disease is fatal.
Followers traditional medicine must understand that in matters of fighting cancer, the only right decision is choice modern medicine. The cancer treatment methods used are very effective and can save the patient's life.
Forecast
When faced with the development of prostate tumors or oncology, patients ask their attending physician whether prostate cancer is curable and how to treat cancer. The exact forecast depends on the following factors:
- cancer stage;
- dynamics of tumor growth;
- effectiveness of treatment.
The most favorable prognosis is detection of cancer at the first stage and timely treatment. If the tumor is not aggressive, adequate therapy is carried out, the patient’s life expectancy is not reduced. Relapse cannot be completely excluded, so a man should be examined regularly.
Statistics show that five-year survival is observed in 8 out of 10 cases if treatment is started at the second stage of tumor development. Adequate therapy allows you to completely get rid of symptoms, stop the progression of the disease and leaves the man at least 5 years to live. Life expectancy can reach 7 years or more if there is no relapse.
At the third stage of the disease, the prognosis is favorable for 4 out of 10 patients. This only applies to the next five years of life after successful treatment, since the risk of relapse remains in the future.
The most unfavorable prognosis is for the fourth stage of the disease. Five-year survival is observed in only 15% of cases.
Prevention of prostate cancer
There is no specific prevention of cancer development. A man’s efforts should be aimed at eliminating risk factors. To do this you need:
- to refuse from bad habits;
- Healthy food;
- exercise;
- undergo regular examinations.
Avoiding red meat helps reduce the risk of developing prostate cancer. It must be replaced with fish or poultry. Tomatoes should be included in the diet large quantities. Recent studies have shown that they contain substances that prevent the development of cancer. Men can also benefit from eating citrus fruits, honey, nuts, olive oil and pumpkin oil.
Until August 10 The Institute of Urology, together with the Ministry of Health, is conducting the “Russia without prostatitis". Within which the drug is available at a discounted price of 99 rubles. , to all residents of the city and region!
Prostate cancer is one of the most common oncological diseases in men. The forecasts for a decrease in the number of patients are disappointing. Hundreds of thousands of people die from it every year, and the number is constantly increasing. Everyone knows that older men over the age of 50 are more susceptible to prostate cancer, but the disease is getting younger. How to recognize a disease in the early stages of development in order to decisively overcome it?
What is prostate cancer?
Prostate cancer is a malignant neoplasm that develops from the glandular tissue of the prostate. Scientists have long noticed a pattern: the higher the concentration of the hormone testosterone in a man’s body, the higher the likelihood of developing prostate cancer. Hormonal imbalances and tumor development are usually promoted by:
- elderly men: the dangerous period begins at the age of 40, the disease is observed in almost 50% of men after 70;
- hereditary predisposition: if a relative had a disease, the risk of getting cancer increases by 2 times;
- viral infections: contribute to disruption of hormonal metabolism;
- unbalanced diet: an abundance of animal fats prevents the body from fully protecting itself from cancer;
- unfavourable conditions environment: ultraviolet irradiation, work in industrial enterprises.
Prostate cancer grows by metastases, spreading through the blood and lymphatic pathways to the lungs, liver, adrenal glands, and bones. Prostate cancer is a slow disease, which, developing over 10-15 years, makes itself felt already at stages III-IV. When it's already too late. It is often discovered by chance - during rectal palpation or during a routine examination.
How does prostate cancer manifest?
It is important to detect prostate cancer before metastases appear. To diagnose the disease at the initial stage of development, you need to know the signs of prostate cancer in men. Scientists distinguish 4 stages of prostate cancer, each of which has its own symptoms.
Stage 1
The first signs of prostate cancer rarely appear at the first stage - the disease has just arisen in the male gland. It is limited to the prostate and does not leave it. There are no metastases - neither in the lymph nodes nor in distant organs. The tumor does not reveal itself in any way: it cannot be palpated rectally and is not visualized on ultrasound. Only a blood test and biopsy result can give a terrible diagnosis. Although in fact, if you find prostate cancer at this stage, you are very lucky, because in this case the pathology can be successfully treated.
Stage 2
Signs of malignant prostate cancer gradually begin to appear in the second stage. The tumor is growing, it can even be felt through the anus or seen on an ultrasound. When palpating rectally, one or more lumps may be felt. They seem to be made of cartilage tissue. As the disease progresses, the tumor loses its clear outline. Sometimes it puts pressure on the ureter, causing problems with urination.
Urine is retained and sometimes comes out drop by drop, so the process of urination itself becomes longer. You have to strain your stomach to get rid of urine. There is a burning sensation. If the problems that have arisen do not frighten the man, then blood in the urine causes panic and forces him to immediately contact a specialist. But the symptoms listed above do not always appear. A man can feel cheerful and healthy. Only an increased level of PSA (prostate specific antigen), which is a tumor marker, signals the presence of a serious disease. Men of different ages have different PSA levels:
- 40-49 years old - 2.5 ng/ml;
- 50-59 years old - 3.5 ng/ml;
- 60-69 years old - 4.5 ng/ml;
- 70-79 years old - 6.5 ng/ml.
Deviation from the normal level is a serious reason to begin treatment for prostate cancer.
Stage 3
The next stage is characterized by further growth of the prostate tumor. Metastases are not observed either in the lymph nodes or in distant places. But very soon they will appear. This is why this stage of the disease is dangerous.
Problems with urination that arise at stage 2 are aggravated: sensations of nagging pain and incomplete emptying of the bladder appear. I constantly want to go to the toilet. Severe spasms occur in the perineum, and pain also occurs in the anus and sacrum. Prostate cancer, affecting the nerve, provokes weak erection, even impotence. When the tumor begins to put pressure on the prostate channels, the volume of sperm released decreases.
Stage 4
The first signs of the formation of a malignant prostate tumor are behind us. At the last stage of development, the cancer becomes more and more aggressive: it spreads beyond the prostate, metastases appear, which affect the organs with amazing speed. At stage 4, prostate cancer is almost incurable. It is impossible to overcome the disease by simply removing the prostate - metastases penetrate everywhere. The man suddenly loses everything, becomes weaker, and his skin becomes pale from anemia.
Should all of these symptoms be considered manifestations of cancer? Problems with urination and potency, debilitating groin pain - there are a number of diseases that have similar symptoms. Prostate adenoma, or hyperplasia, is just such a disease, which in its symptoms is a twin of prostate cancer. But unlike a malignant tumor, an adenoma is a benign neoplasm. It is impossible to distinguish diseases from each other only by patient complaints.