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Prostate cancer is one of the most frequent malignant tumors in men. In many countries in the list of oncological diseases, prostate cancer ranks the 2nd or the 3rd place in frequency and in reasons of mortality of male patients.
The disease affects men of presenile and elderly age. After 60 years with each passing year, the risk of prostate cancer increases for 3-4%. At a younger age, the tumor is rarely fixed: men under the age of 60 - no more than 7% of all newly derived diagnoses.
In most countries over the world, the incidence is progressively increasing. Partially, it is connected with an increase of life expectancy and introduction of methods of early diagnosis, but the true increase in the prevalence of pathology is out of doubt. Despite the slow progression of disease and the high diagnostic information of the PSA method, which was introduced into cancer practice as far back as the 1980s, more than half of newly diagnosed cases of prostate cancer occur in the late stages with seeding of cancer cells into the lymph nodes and metastasis.
Malignant tumors of prostate gland result from mutations that lead to cell changes and their uncontrolled growth. The mechanism of tumor formation is also associated with a violation of immune defense: mutated atypical cells "deceive" antitumor protection, and as a result - antibodies can not detect and destroy destroyed structures in time.
The exact cause of critical mutation of the prostate cells is not known, but there are risk factors that significantly increase the likelihood of the disease:
According to statistics, the presence of a relative of the first line (father or brother) with a diagnosis of prostate cancer increases the risk of developing this disease 2 times. The more patients with prostate cancer are in one family, the higher the risk of disease for othe members of this family, with an earlier appearance of the disease. The study of monoval twins also confirms the significance of genetic predisposition to this tumor: if one of twins is diagnosed with prostate cancer, the probability of disease for another one increases up to 40%.
In carrying out a genetic study, several genes that encode different structures and functions involved in the formation of a malignant tumor in the prostate gland are taken into account. The genetic basis for the development of prostate cancer can be expressed in the features of the structure of the gland and its ducts, the parameters of hormonal regulation, as well as the characteristics of the immune system, which normally provides the destruction of mutated cells.
The tumor does not manifest itself for a long time: in most cases, prostate cancer gives the first clinical symptoms only after the primary focus has spread to the capsule.
A tumor can manifest itself by the following symptoms:
feeling of incomplete emptying of the bladder;
frequent urination, including nighttime urination;
increasing of duration of the act of urination;
symptom of "intermittent jet" (urination in small successive portions);
retention of urination;
pain in the lower abdomen or in the pelvic region;
symptoms of bone marrow metastases: bleeding, thrombophlebitis.
The primary tumor is mosty located in the peripheral areas of prostate, therefore it is available for palpation through anus. Progression of the disease occurs both by capturing the surrounding tissues, and by hematogenous (through blood) metastasis. Metastases are most often found in bone tissue and can lead to pathological fractures.
Signs, which are associated with urinary dysfunction are indicative not only to a prostate cancer: in addition to cancer, prostate adenoma and bladder cancer may have the same symptoms.
For the diagnosis the following methods are used:
Digital rectal examination:
is performed at the first reception of a specialist and allows preliminary assess the condition of the prostate gland, its consistency
Laboratory analysis of the level of PSA (prostate-specific antigen)
— unique for malignant neoplasms method. Unlike other oncomarkers, PSA is noteworthy for its high informative value and can be used in isolation at absolute level of the substance. PSA is used both for early diagnosis of the disease, and for evaluating the course of cancer and detecting relapse.
Ultrasound of prostate:
a method of safe imaging of organ with a description of the structure of its tissues and the size of gland.
Biopsy with subsequent histological examination:
allows to clarify the nature of the detected tumor and its histological features. The sampling of the material is usually carried out from several access points through anus using ultrasound imaging.
Magnetic resonance imaging (MRI)
— laminography of tissues with the possibility of constructing a three-dimensional image. The method is used to assess the size of the primary focus and the detection of metastases.
Computed tomography (CT)
— a layered X-ray image of the prostate and adjacent organs.
Scintigraphy:
is prescribed for suspected metastases. A small amount of isotope is injected into the patient's body, and then it is absorbed by atypical cancer cells. Special equipment detects metastases by accumulation of isotope in the patient's body.
Millions of patients with prostate cancer spend hundreds of thousands dollars for treatment, and often all efforts are directed only on prolonging life and alleviating suffering.
Do not wait for the first symptoms of a terrible disease! Take the DNA test for genetic predisposition to prostate cancer - protect yourself and your beloved ones.
The standart classification of the disease is based on the TNM system, which is used for the most malignant neoplasms. In this system, the letter
each letter has a digital category indicating the severity of the characteristic.
The primary focus in the TNM system is characterized as follows:
For N and M there are two parameters — 0 and 1, where 0 — absence of sign, 1 — its availability.
The choice of tactics for treating prostate cancer depends on the stage of the process, the age of the patient, the histological type of the tumor and the concomitant diseases.
There are two fundamentally different approaches to treatment:
Complete recovery is possible only in the case of localized forms. If prostate cancer does not affect her capsule and there are no metastases, the following methods are used:
Prostatectomy
— prostate removal. In modern clinics for surgical treatment of prostate cancer, operations are performed with the help of using computerized manipulation systems that improve the excision of ablation of the gland tissues. This gives an opportunity to reduce the frequency of relapses and reduce the severity of side effects and complications. After automated nerve-sparing operations of prostate cancer, potency is retained by more than half of the patients.
Radiotherapy
— remote and interstitial (brachytherapy). The principle of operation is based on the use of dosed ionizing radiation, which blocks the division of tumor cells DNA. Minimal side effects with the best result usually shown by brachytherapy, in which the source of radiation (grain with radioisotope) is placed inside the prostate.
Ablation methods
— the destruction of a tumor by physical agents (critically high or low temperatures). For this purpose high-intensity ultrasonic technologies and cryotherapy are used.
Hormone therapy:
based on the dependence of prostate cancer on testosterone levels. Antiandrogenic drugs are prescribed in a dose sufficient to achievement of effect of drug castration, while the tumor not only ceases its growth, but also decreases in size. At the early stages of disease, this method is rarely used.
When the primary focus is spread to contiguous organs, as well as the detection of affected lymph glands and metastases, methods of minimally invasive surgery (ablative technologies) are not used, and prostatectomy is rarely performed - only as a palliative operation that improves the quality of life. In the advanced stages, preference is given to medical castration in combination with various types of radiotherapy.
Prostate cancer is a disease with an unidentified cause that is why prevention of neoplasm is nonspecific.
To prevent prostate cancer, it is recommended:
It is important to undergo periodic medical examinations with mandatory digital rectal examination. Early detection of prostate cancer in men at risk group is possible even before the first symptoms appear: regular passage of the PSA test allows to diagnose in time and start treatment at the optimal time with maximum efficiency.
The DNA test is a unique technique for detecting a genetic predisposition to prostate cancer. The results of research will give your doctor valuable information for planning an individual scheme for early diagnosis of the disease.
Save your health! Take the DNA test for a genetic predisposition to prostate cancer: start prevention as early as possible.
