Carcinoma prostate

Prostate cancer is an important growing health problem, presenting a challenge to urologists, radiologists, and oncologists. Prostate cancer is the most common nondermatologic cancer, yet despite this frequent occurrence, the clinical course is often unpredictable. Most prostate cancers are slow growing and do not manifest themselves during the man's lifetime; in fact, many men are found to have had incidental microscopic foci of prostate cancer at postmortem examination.

Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize (spread) from the prostate to other parts of the body, particularly the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, problems during sexual intercourse, or erectile dysfunction. Other symptoms can potentially develop during later stages of the disease.

Symptoms:

Early prostate cancer usually causes no symptoms. Often it is diagnosed during the workup for an elevated PSA noticed during a routine checkup. Sometimes, however, prostate cancer does cause symptoms, often similar to those of diseases such as benign prostatic hyperplasia.

1. Frequent urination, increased urination at night, difficulty starting and maintaining a steady stream of urine, blood in the urine, and painful urination.

2. Problems with sexual function and performance, such as difficulty achieving erection or painful ejaculation.

3. Advanced prostate cancer can spread to other parts of the body, possibly causing additional symptoms. The most common symptom is bone pain, often in the vertebrae (bones of the spine), pelvis, or ribs.

Causes and Prevention

Causes:

1. Diet may be important. Red meat and unsaturated fats increase risk while Vitamin E, selenium and lycopene (antioxidant found in tomatoes) appear to have a protective effect.

2. Occupation: there is increased risk with farming and exposure to radiation or cadmium.

3. Links to alcohol consumption, sexual behaviour and exposure to ultraviolet light have been investigated but further research is needed.

4. Age,Race also may be the reason for the cancer.

Prevention

1. Maintain a Healthy Weight

2. Don’t Overindulge on Red Meat or Fatty Foods.

3. Eat the Right Amount and Type of Fruits and Vegetables

4. Exercise Regularly

Medical Tests & Diagnosis

1. Regular Screening: All men over the age of 50 should be screened annually for prostate cancer. African-American men and men with a strong family history of prostate cancer have been shown to have higher rates of prostate cancer and need to start their screening at age 40.Additionally, any men who have symptoms suggestive of prostate cancer need to undergo testing.

• Digital Rectal Exam (DRE)A digital (finger) rectal examination is done to check for problems with organs or other structures in the pelvis and lower belly. During the examination, a health professional gently puts a lubricated, gloved finger of one hand into the rectum. He or she may use the other hand to press on the lower belly or pelvic area.

A digital rectal exam is done for men as part of a complete physical examination to check the prostate gland. It is done for women as part of a gynecological examination to check the uterus and ovaries. Other organs, such as the bladder, can sometimes also be felt during a digital rectal exam.

• Prostate Specific Antigen (PSA) Blood Test

A small sample of blood is taken and then sent to a lab for analysis. PSA is a protein that is only produced by prostate cells. As the prostate enlarges, whether due to cancer or another cause, the amount of PSA produced increases.High levels of PSA or rapid increases in the PSA level can alert the physician to a possible underlying cancer.

2. Prostatic Biopsy: Prostate biopsy is a procedure in which small samples are removed from a man's prostate gland to be tested for the presence of cancer. It is typically performed when the scores from a PSA blood test rise to a level that is associated with the possible presence of prostate cancer.

The procedure, usually an outpatient procedure, requires a local anesthetic, with fifty-five percent of men reporting discomfort during the biopsy.The most frequent complication of the procedure is bleeding in the urine for several days, some bleeding in the stool for several days, and blood in the ejaculate for several weeks afterwards.

Tests Detect the extent of cancer: These tests are done to test how far the cancer is spread.

Ultrasound: A thin ultrasound probe is inserted into the rectum. The ultrasound can show if nearby organs and tissues have been invaded by cancer.

Bone Scan: Prostate cancer often spreads to bones if not detected early. For this reason, this test can be done to provide a detailed picture of the body’s bones.

CT scan or MRI – These two tests can be used to provide a detailed look at the organs and tissues in the abdomen and pelvis. Only large, bulky areas of cancer outside of the prostate can be seen with these, so they need to be combined with other tests to be most useful.

A lymph node biopsy: This removes lymph node tissue to be looked at under a microscope for signs of infection or a disease, such as cancer. Other tests may also be used to check the lymph tissue sample, including a culture, genetic tests, or tests to study the body's immune system (immunological tests).

Treatments

Radiation therapy: Radiation therapy (also called radiotherapy) is a type of local therapy. It affects cells only in the treated area. Radiation therapy is used alone for small tumors or for patients who cannot have surgery. It may be used before surgery to kill cancer cells and shrink the tumor. It also may be used after surgery to destroy cancer cells that may remain in the area.