2- Prostate Cancer
Prostate Cancer is cancer that occurs in a man's prostate — a small walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm.
Prostate cancer is one of the most common types of cancer in men. Prostate cancer usually grows slowly and initially remains confined to the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.
Prostate cancer that is detected early — when it's still confined to the prostate gland — has a better chance of successful treatment.
Symptoms of Prostate Cancer
Prostate cancer may not cause signs or symptoms in its early stages. Prostate cancer that is more advanced may cause signs and symptoms such as:• Trouble urinating.
• Decreased force in the stream of urine.
• Blood in the urine.
• Blood in the semen.
• Swelling in the legs.
• Discomfort in the pelvic area.
• Bone pain.
When to see a doctor
Make an appointment with your doctor if you have any signs and symptoms that worry you.Ask your doctor about the benefits and risks of regular prostate cancer screening. Medical organizations differ on their recommendations for prostate cancer screening, but many advise men in their 50s to discuss the issue with their doctors.
Causes
It's not clear what causes prostate cancer. Doctors know that prostate cancer begins when some cells in your prostate become abnormal. Mutations in the abnormal cells' DNA cause the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living, when other cells would die. The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. Some abnormal cells can break off and spread (metastasize) to other parts of the body.Risk factors
Factors that can increase your risk of prostate cancer include:• Older age. The risk of prostate cancer increases with age. Prostate cancer is most common in men older than 65.
• Being black. Black men have a greater risk of prostate cancer than do men of other races. In black men, prostate cancer is also more likely to be aggressive or advanced. It's not clear why this is.
• Family history of prostate cancer. If men in your family have had prostate cancer, your risk may be increased.
• Obesity. Obese men diagnosed with prostate cancer may be more likely to have advanced disease that's more difficult to treat.
Complications
Complications of prostate cancer and its treatments include:• Cancer that spreads. Prostate cancer can spread to nearby organs or travel through your bloodstream or lymphatic system to your bones or other organs. Advanced prostate cancer can cause fatigue, weakness and weight loss. Prostate cancer can grow to block the tubes (ureters) that carry urine from the kidneys to the bladder, causing kidney problems. Prostate cancer that spreads to the bones can cause pain and broken bones. Once prostate cancer has spread to other areas of the body, it may still respond to treatment and may be controlled, but it can no longer be cured.
• Incontinence. Both prostate cancer and its treatment can cause urinary incontinence. Treatment for incontinence depends on the type you have, how severe it is and the likelihood it will improve over time. Treatment options may include medications, catheters and surgery.
• Erectile dysfunction. Erectile dysfunction can be a result of prostate cancer or its treatment, including surgery, radiation or hormone treatments. Medications, vacuum devices that assist in achieving erection and surgery are available to treat erectile dysfunction.
Tests and diagnosis
Digital rectal examTransrectal biopsy of the prostate
Prostate cancer stages
Screening for prostate cancer
Whether to test healthy men with no prostate symptoms for prostate cancer is controversial. Medical organizations don't agree on the issue of screening and whether it has benefits. Some medical organizations recommend men consider prostate cancer screening in their 40s, or sooner for men who have risk factors for prostate cancer. Other organizations advise against screening. Discuss your particular situation and the benefits and risks of screening with your doctor. Together you can decide whether prostate cancer screening is appropriate for you.Prostate screening tests might include:
• Digital rectal exam (DRE). During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is adjacent to the rectum. If your doctor finds any abnormalities in the texture, shape or size of your gland, you may need more tests.
• Prostate-specific antigen (PSA) test.A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that's naturally produced by your prostate gland. It's normal for a small amount of PSA to be in your bloodstream. However, if a higher than normal level is found, it may be an indication of prostate infection, inflammation, enlargement or cancer. PSA testing combined with DRE helps identify prostate cancers at their earliest stages.
Diagnosing prostate cancer
If an abnormality is detected on a DRE or PSA test, your doctor may recommend tests to determine whether you have prostate cancer, such as:• Ultrasound. If other tests raise concerns, your doctor may use transrectal ultrasound to further evaluate your prostate. A small probe, about the size and shape of a cigar, is inserted into your rectum. The probe uses sound waves to make a picture of your prostate gland.
• Collecting a sample of prostate tissue. If initial test results suggest prostate cancer, your doctor may recommend a procedure to collect a sample of suspicious cells from your prostate (prostate biopsy). Prostate biopsy is often done using a thin needle that's inserted into the prostate to collect tissue. The tissue sample is analyzed in a laboratory to determine whether cancer cells are present.
Determining whether prostate cancer is aggressive
When a biopsy confirms the presence of cancer, the next step, called grading, is to determine how aggressive the cancer is. The tissue samples are studied, and the cancer cells are compared with healthy prostate cells. The more the cancer cells differ from the healthy cells, the more aggressive the cancer and the more likely it is to spread quickly. More-aggressive cancer cells have a higher grade.The most common scale used to evaluate the grade of prostate cancer cells is called a Gleason score. Scoring combines two numbers and can range from 2 (nonaggressive cancer) to 10 (very aggressive cancer).
Determining how far the cancer has spread
Once a cancer diagnosis has been made, your doctor works to determine the extent (stage) of the cancer. Many men won't require these additional tests. But if your doctor suspects your cancer may have spread beyond your prostate, imaging tests such as these may be recommended:• Bone scan.
• Ultrasound.
• Computerized tomography (CT) scan.
• Magnetic resonance imaging (MRI).
Once testing is complete, your doctor assigns your cancer a stage. This helps determine your treatment options. The prostate cancer stages are:
• Stage I. This stage signifies very early cancer that's confined to a small area of the prostate. When viewed under a microscope, the cancer cells aren't considered aggressive.
• Stage II. Cancer at this stage may still be small, but may be considered aggressive when cancer cells are viewed under the microscope. Or cancer that is stage II may be larger and may have grown to involve both sides of the prostate gland.
• Stage III. The cancer has spread beyond the prostate to the seminal vesicles or other nearby tissues.
• Stage IV. The cancer has grown to invade nearby organs, such as the bladder, or spread to lymph nodes, bones, lungs or other organs.
