28 diseases - Prostate cancer

DNA test for genetic predisposition to prostate cancer

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.

Warn yourself from diseases
Prostate cancer

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.

Causes of the disease and risk factors

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:

Hereditary predisposition.
Negroid race.
Excessive consumption of animal fats.
Chronic intoxication with salts of heavy metals and some other substances (cadmium, waste of the rubber industry, etc.).
Hormonal imbalance.
Some viral infections.
Excessive insolation.
Presenile and elderly age.
The importance of genetic predisposition in the development of prostate cancer

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.

Prostate Cancer: Symptoms and Diagnosis

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.

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.

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Prostate cancer stages and course of disease

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


the primary focus,


— lesion
of the lymph nodules,


— presence or
of metastases;

each letter has a digital category indicating the severity of the characteristic.

The primary focus in the TNM system is characterized as follows:


the tumor is small, not palpable, not detectable by X-ray examination, the diagnosis is usually established randomly.


the tumor increases in size, it is visualized during examination, is limited by the glandular capsule.


the primary focus is outside the capsule, it can affect seminal vesicles.


the tumor adheres to underlaying organs - the bladder, rectum, pelvic floor muscles, etc.

For N and M there are two parameters — 0 and 1, where 0 — absence of sign, 1 — its availability.

Example 1

T2N0M0: — primary focus within the prostate, the affected lymphonodus and metastasis are absent. Т3N1M0 — a tumor with the capture of capsule of prostate, atypical cells are found in regional lymphonodus, metastases are absent.

The prognosis of the disease and the tactics of managing the patient depend not only on the stage of the process, but also on the histological type of the tumor. Taking into account the fact that in most cases prostate cancer is polymorphic, that is, it has areas with different degrees of differentiation, Gleason score is used to assess malignancy. This indicator has to be calculated by the pathomorphologist accordinng to sum of conditional scores for two the most characteristic zones of the removed tumor. As a result, each neoplasm can be attributed to one of 5 degrees of differentiation, where the 1st degree is the most differentiated (the most favorable) tumor, and the 5th degree is a low-grade or undifferentiated (the most aggressive form).

Treatment of prostate cancer

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:

for localized forms (stages 1 and 2), the radical treatment aimed at complete removal of cancer cells is optimal;
for common forms (stages 3 and 4), the tactic is aimed at eliminating painful symptoms, prolonging life and improving its quality.

Radical treatment for 1 and 2 stages of prostate cancer

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:

  1. 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.

  2. 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.

  3. 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.

  4. 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.

Treatment of common forms of prostate cancer (stages 3 and 4)

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:

to adhere to a healthy lifestyle,
to observe proper nutrition,
harmonize sexual life,
to treat infectious and endocrine diseases on time.

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.

Your future in your hands!

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.