Prostate Cancer Definition
Prostate cancer is a malignant tumor that grows in the prostate gland.
Prostate cancer is very common.
Microscopic examination of prostate tissue after surgery or at autopsy showed cancer in 50% of men aged over 70 years and in all men aged over 90 years.
Most cancers do not cause symptoms because the spread is very slow.
Prostate Cancer Causes
The cause is unknown, although several studies have shown an association between high-fat diet and increased levels of testosterone.
Prostate cancer is the leading cause of cancer deaths in men and no 3 is the leading cause of cancer in men kematin over 74 years.
Prostate cancer is rarely found in men younger than 40 years.
Men who are at higher risk for prostate cancer is a black man aged over 60 years, farmer, painter and cadmium exposure.
The lowest incidence was found in Japanese men and vegetarians.
Prostate cancers are grouped into:
Stage A: lump / tumor not palpable on physical examination, usually discovered by accident after prostate surgery because of other diseases.
Stage B: tumor confined to the prostate and is usually found on physical examination or PSA test.
Stage C: tumor has spread beyond the prostate capsule, but not yet spread to the lymph nodes.
Stage D: cancer has spread (metastasis) to the regional lymph nodes or other body parts (eg bones and lungs).
Sometimes the symptoms resemble BPH, which include difficulty in urination and frequent urination.
These symptoms occur because the cancer causing partial blockage of the flow of urine through the urethra.
Prostate cancer can cause red urine (because it contains blood) or urine caused the sudden arrest.
In some cases, newly diagnosed prostate cancer after spread to the bones (particularly the pelvic bones, ribs and spine) or to the kidneys (causing kidney failure).
Painful bone cancer and brittle bones that easily fracture (broken bone).
When cancer spreads, the patient will usually have anemia.
Prostate cancer can also spread to the brain and cause seizures and other neurological symptoms or mental.
Another Prostate Cancer symptoms are:
Diagnosis
If the digital rectal examination found a lump, then performed an ultrasound examination.
Skening with X-rays or bone, can be known of the spread of cancer to bone.
Other tests are performed:
Treatment options vary, depending on the stage:
In the early stages can be used prostatectomy (prostate removal) and radiation therapy
If the cancer has spread, hormonal manipulation can be done (to reduce testosterone levels through medication or removal of the testes) or chemotherapy.
Surgery
1. Radical prostatectomy (removal of the prostate gland).
Often done in cancer stage A and B.
The procedure is long and is usually performed under general anesthesia or spinal.
An incision is made in the abdomen or perineal area and the patient had to undergo hospital treatment for 5-7 days.
Possible complications and incontinence are impotensia uri.
In patients who are still active sexual life, can be done Potency-sparing radical prostatectomy.
2. Orkiektomi (removal of the testes, castration).
Removal of both testicles leads to reduced levels of testosterone, but the procedure is the physical and psychological effects that can not be tolerated by the patient.
Orkiektomi is an effective treatment, does not require re-treatment, compared to cheaper drugs and after undergoing orkiektomi patients do not need hospital treatment.
Orkiektomi usually done on the cancer has spread.
Radiation Therapy
Radiation therapy is mainly used to treat cancer A, B and C.
Usually if the risk of surgery is too high, then do radiation therapy.
Radiation therapy to the prostate gland can be done in several ways:
1. External radiation therapy, performed in a hospital without needing to be hospitalized.
Side effects such as decreased appetite, fatigue, skin reactions (such as redness and irritation), injury or burns to the rectum, diarrhea, cystitis (bladder infection) and hematuria.
External radiation therapy is usually performed 5 times / week for 6-8 weeks.
2. Transplant iodine beads, gold or radioactive iridium directly in the prostate tissue through small incisions.
The advantage of this form of radiation therapy is that radiation is directed to the prostate with tissue damage around a little more.
Drugs
1. Hormonal manipulation.
The goal is to reduce testosterone levels.
Decrease in testosterone levels are often very effective in preventing the growth and spread of cancer.
Hormonal manipulation is mainly used to alleviate symptoms without curing the cancer, ie for example in patients whose cancer has spread.
Synthetic drugs whose function resembles LHRH (luteinizing hormone releasing hormone), is increasingly being used to treat advanced prostate cancer. An example is Lupron or zoladeks.
These drugs suppress the testes to the formation of testosterone (this is called chemical castration because it has the same result with the removal of the testes).
Drugs administered in the form of injections, usually every 3 months.
The side effects are nausea and vomiting, facial flushing, anemia, osteoporosis, and impotence.
Other drugs used for hormonal therapy is androgen inhibitors (eg flutamid), which serves to prevent the attachment of testosterone on prostate cells.
Side effects include impotence, liver problems, diarrhea, and gynecomastia (breast enlargement).
2. Chemotherapy
Chemotherapy is often used to treat symptoms of prostate cancer is resistant to hormonal treatment.
Usually given a single drug or combination of drugs to destroy cancer cells.
Drugs that can be used to treat prostate cancer are:
- Mitoxantronx
- Prednisone
- Paclitaxel
- Dosetaxel
- Estramustin
- Adriamycin.
The side effects vary and depend on the drugs administered.
Monitoring
Whatever type of treatment he underwent, the patient will be monitored closely on the development of the disease.
Prostate Cancer Monitoring include:
Blood tests to determine levels of PSA (usually every 3 months - 1 year).
Skening and / or CT scan to determine the spread of bone cancer.
Complete blood tests to monitor the signs and symptoms of anemia.
Monitoring signs and symptoms that indicate progression of the disease (such as fatigue, weight loss, more severe pain, decreased bowel and bladder function, and weakness).
Stage A: lump / tumor not palpable on physical examination, usually discovered by accident after prostate surgery because of other diseases.
Stage B: tumor confined to the prostate and is usually found on physical examination or PSA test.
Stage C: tumor has spread beyond the prostate capsule, but not yet spread to the lymph nodes.
Stage D: cancer has spread (metastasis) to the regional lymph nodes or other body parts (eg bones and lungs).
Prostate Cancer Symptoms
Prostate cancer usually develops slowly and causes no symptoms until the cancer has reached an advanced stage.Sometimes the symptoms resemble BPH, which include difficulty in urination and frequent urination.
These symptoms occur because the cancer causing partial blockage of the flow of urine through the urethra.
Prostate cancer can cause red urine (because it contains blood) or urine caused the sudden arrest.
In some cases, newly diagnosed prostate cancer after spread to the bones (particularly the pelvic bones, ribs and spine) or to the kidneys (causing kidney failure).
Painful bone cancer and brittle bones that easily fracture (broken bone).
When cancer spreads, the patient will usually have anemia.
Prostate cancer can also spread to the brain and cause seizures and other neurological symptoms or mental.
Another Prostate Cancer symptoms are:
- Immediately after urination, the urine is usually still dripping
- Pain when urinating
- Pain when ejaculating
- Lower back pain
- Pain when defecating
- Nocturia (urination at night)
- Incontinence uri (beser)
- Bone pain or bone pain when pressed
- Hematuria (blood in urine)
- Abdominal pain
- Weight loss.
Diagnosis
- The best way to screen for prostate cancer are digital rectal examination and blood tests.
- Digital rectal prostate cancer patients would indicate a hard lump of irregular shape.
- Blood tests performed on the measured levels of prostate specific antigen (PSA), which is usually elevated in patients with prostate cancer, but also may increase (not too high) in patients with BPH.
If the digital rectal examination found a lump, then performed an ultrasound examination.
Skening with X-rays or bone, can be known of the spread of cancer to bone.
Other tests are performed:
- Analysis of the urine
- Cytology of urine or prostatic fluid
- Prostate biopsy.
Prostate Cancer Treatment
Appropriate treatment for prostate cancer is still debated.Treatment options vary, depending on the stage:
In the early stages can be used prostatectomy (prostate removal) and radiation therapy
If the cancer has spread, hormonal manipulation can be done (to reduce testosterone levels through medication or removal of the testes) or chemotherapy.
Surgery
1. Radical prostatectomy (removal of the prostate gland).
Often done in cancer stage A and B.
The procedure is long and is usually performed under general anesthesia or spinal.
An incision is made in the abdomen or perineal area and the patient had to undergo hospital treatment for 5-7 days.
Possible complications and incontinence are impotensia uri.
In patients who are still active sexual life, can be done Potency-sparing radical prostatectomy.
2. Orkiektomi (removal of the testes, castration).
Removal of both testicles leads to reduced levels of testosterone, but the procedure is the physical and psychological effects that can not be tolerated by the patient.
Orkiektomi is an effective treatment, does not require re-treatment, compared to cheaper drugs and after undergoing orkiektomi patients do not need hospital treatment.
Orkiektomi usually done on the cancer has spread.
Radiation Therapy
Radiation therapy is mainly used to treat cancer A, B and C.
Usually if the risk of surgery is too high, then do radiation therapy.
Radiation therapy to the prostate gland can be done in several ways:
1. External radiation therapy, performed in a hospital without needing to be hospitalized.
Side effects such as decreased appetite, fatigue, skin reactions (such as redness and irritation), injury or burns to the rectum, diarrhea, cystitis (bladder infection) and hematuria.
External radiation therapy is usually performed 5 times / week for 6-8 weeks.
2. Transplant iodine beads, gold or radioactive iridium directly in the prostate tissue through small incisions.
The advantage of this form of radiation therapy is that radiation is directed to the prostate with tissue damage around a little more.
Drugs
1. Hormonal manipulation.
The goal is to reduce testosterone levels.
Decrease in testosterone levels are often very effective in preventing the growth and spread of cancer.
Hormonal manipulation is mainly used to alleviate symptoms without curing the cancer, ie for example in patients whose cancer has spread.
Synthetic drugs whose function resembles LHRH (luteinizing hormone releasing hormone), is increasingly being used to treat advanced prostate cancer. An example is Lupron or zoladeks.
These drugs suppress the testes to the formation of testosterone (this is called chemical castration because it has the same result with the removal of the testes).
Drugs administered in the form of injections, usually every 3 months.
The side effects are nausea and vomiting, facial flushing, anemia, osteoporosis, and impotence.
Other drugs used for hormonal therapy is androgen inhibitors (eg flutamid), which serves to prevent the attachment of testosterone on prostate cells.
Side effects include impotence, liver problems, diarrhea, and gynecomastia (breast enlargement).
2. Chemotherapy
Chemotherapy is often used to treat symptoms of prostate cancer is resistant to hormonal treatment.
Usually given a single drug or combination of drugs to destroy cancer cells.
Drugs that can be used to treat prostate cancer are:
- Mitoxantronx
- Prednisone
- Paclitaxel
- Dosetaxel
- Estramustin
- Adriamycin.
The side effects vary and depend on the drugs administered.
Monitoring
Whatever type of treatment he underwent, the patient will be monitored closely on the development of the disease.
Prostate Cancer Monitoring include:
Blood tests to determine levels of PSA (usually every 3 months - 1 year).
Skening and / or CT scan to determine the spread of bone cancer.
Complete blood tests to monitor the signs and symptoms of anemia.
Monitoring signs and symptoms that indicate progression of the disease (such as fatigue, weight loss, more severe pain, decreased bowel and bladder function, and weakness).
