Prostate cancer (prostate cancer) -malignant neoplasm arising from the epithelium of the alveolar-cell glands. Prostate cancer is the cause of almost 10% of male deaths from cancer and one of the main causes of death in older men.
Content
For example, among men under 45 years, mortality from prostate cancer is negligible
(3 cases per 1 million. Pers.), But after 75 years, this value increases
more than 400 times, reaching 130 cases per 100 000 people. In the territory
Russia prostate cancer is almost 2 times less than the world as a whole.
However, the growth rate of the disease over the past 10 years have been so great,
that over the next decade the incidence can catch up with global
digits.
The causes of prostate cancer
age-related hormonal changes in the male, associated with
changes in the hypothalamus - pituitary - adrenal glands - the testes. In
persons with high androgenic background (eg, persons with high sexual
activity) prostate cancer is more common
- genetic predisposition
- place of residence and race (prostate cancer less often
found in eastern Europe and Asia, mostly in America and Scandinavia)
- cadmium toxicosis (chronic cadmium intoxication)
- nutrient imbalance (reduction in food products of plant and vitamin
E, with increased animal fat and protein intake)
Prostate cancer
often runs precancer stage, timely detection
which is extremely important in terms of prognosis and treatment
disease.
TO precancer prostate relate:
- Atypical hyperplasia. It fakultatiyny precancer that is convertible to a cancer under certain conditions.
- Intraepithelial neoplpaziya. It is an obligate precancer predecessor adenokartsnomy prostate.
The classification of cancer of the prostate founded
in the histological pattern and characteristics of growth. Unlike adenoma
Prostate cancer develops most frequently in the peripheral area and only
10% of cases in a transitional zone, the most characteristic of the adenoma.
There are
adenocarcinoma (glandular cancer) and squamous cell carcinoma of varying degrees
differentiation and scirrhous and solid cancer. Prostate cancer,
It is typically characterized by multifocal growth and different levels of
differentiation of cells of tumor tissue. The degree of differentiation of cancer
It can be divided into 5 levels, determining its further classification
Gleason. Depending on the resulting number is determined by the Gleason
prognosis and further treatment. More
common practice is the TNM-classification, giving
clinical and histological characteristics of the tumor itself (T),
the existence and extent of lymph node involvement (N), the availability and
characteristic of distant metastases (M).
Prostate Cancer Clinic
symptoms,
characteristic only for prostate cancer, unfortunately does not exist. More
addition, many of the symptoms are similar to those of prostate adenoma
cancer that requires more attention when they are identified. complaints
patients usually associated with symptoms or proliferation of the tumor,
or the emergence of metastases. Due to the long asymptomatic
current and late detection, more than half the time at
primary prostate cancer already have metastases.
Typically, the tumor detected incidentally during prophylactic or diagnostic examinations. Prostate cancer
It has a relatively slow growth. When metastasis
Tumor propagation occurs both in the blood and by
lymphatic system. With the growth of the tumor to the urethra
there are frequent urination, blood in the urine, disturbance
urination up to the edge of his delay. During germination of tumor
adjacent organs (seminal vesicles, bladder, rectum)
observed symptoms of these bodies. Thus, by
urinary system may cause cystitis, pyelonephritis, and even chronic renal failure.
Possible bone metastases in a pelvis, and other
parts of the skeleton. Nearest metastases are often accompanied by swelling of the legs and
scrotum. Distant metastases are most common in the lungs, liver and
adrenals.
Diagnosis of Prostate Cancer
The most effective methods of early diagnosis prostate cancer is an:
digital rectal examination of the prostate
- rectal prostate ultrasound study (transrectal sonography)
- determining the level of prostate specific antigen (PSA).
All of these methods complement each other and allow the suspect or detect prostate cancer
the early, pre-clinical stages of development. Thus, the level of definition
PSA provides 15 to 40% of false positive and false negative
results because It depends on such factors as the previous massage
prostate, instrumental examinations, inflammation, and even
ejaculation long before the study.
Another, more accurate
the method is to determine the prostate-density index
specific antigen, PSA obtained to-volume ratio
Prostate. Even more valuable indicator is the rate of rise
PSA levels. When the antigen level increase of 20% or more per year
It must be a thorough investigation. Recently, use
and measuring the ratio of free and total PSA fraction, reduction
which suggests a possible malignancy.
In general, diagnosis
the level of prostate specific antigen - is extremely necessary
examination for men over 40 years. And if during the examination level
PSA greater than 2 ng / ml, then the risk of developing prostate cancer is considered high, so it is necessary an annual preventive care.
Other survey methods include:
- urofluometriya
- prostate biopsy
- abdominal ultrasound
- X-ray examinations, including CT scans
- radioisotope studies
- magnetic resonance imaging, and others.
Prostate Cancer Treatment
how
and in many other fields of oncology treatment depends
variety of factors. The first pay attention to step
disease and the degree of tumor differentiation.
When local forms
cancer (no metastasis) following treatment methods are used:
- Removal of the prostate (radical prostatectomy). deleted
Prostate with seminal vesicles regional lymph nodes.
The most popular today laparoscopic surgical technique as
the least traumatic.
- External beam radiotherapy. irradiate
prostate and regional lymph nodes in a dose of from about 40 Gray
additional primary tumor followed by irradiation to a total
dose of 70 Gray.
- Brachytherapy or interstitial radiation
therapy. The essence of the treatment is the local irradiation of the prostate
microcapsules radioactive drugs. "Grain" with the drug
administered under anesthesia special needle directly into the tumor
fabric, which allows to significantly increase the radiation dose to the tumor and
reduce the exposure of healthy tissue. treatment and better results
complications is less than the external radiotherapy.
- Monotherapy
antiandrogens. This treatment is rarely used and is carried out
Patients who do not show other treatments.
Prostate Cancer Treatment
with nearby metastases is usually limited to a maximum of androgenic
blockade comprising antiandrogenic therapy with drug
operational or castration. Sometimes radiotherapy and shows
chemotherapy. Common (dissemenirovanny) prostate cancer
gland amenable, as a rule, only symptomatic or palliative
therapy. However, the use of radiation therapy and antiangrogennoy
can significantly improve the quality and duration of life for patients.
