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  Prostate cancer

Prostate cancer is a malignant disease that develops in the prostate, a gland in the male reproductive system. The prostate gland is a male reproductive organ located in the pelvis, beneath the urinary bladder and in front of the rectum which produces prostatic fluid, one of the components of the semen. It is about 3-cm long and weighs about 20 grams.

Prostate cancer Cancer
Prostate cancer


In prostate cancer, the cells of the prostate undergo mutation or genetic change hence, these cancer cells begin to multiply rapidly and out of control. It eventually infiltrates, invades nearby organs like the seminal vesicles and metastasizes or spread to distant parts of the body like the rectum, bladder, bones and lymph nodes. It is classified as an adenocarcinoma or glandular type of carcinoma. The region of the prostate gland where the adenocarcinoma is most common is the peripheral zone.

The cause of the prostate cancer remains unknown. Risk factors include: age, genetics, race, diet, lifestyle and medications. The primary risk factor is advancing age. It is uncommon in men less than 45 years of age. At the time of diagnosis, the average age is around 70. There is no correlation whatsoever between prostate cancer and a pre-existing condition common in elderly males known as benign prostatic hypertrophy (BPH). BPH is not a pre-malignant condition. Incidence rates of prostate cancer are higher in Europe and United States though it may vary widely between countries. It is least common in South and East Asia. However, the high rates may be affected by advanced techniques for early detection of the cancer. Prostate cancer is considered to be the most common type of cancer in men in the United States and second to lung cancer as the most common cause of cancer deaths.

Patients with early prostate cancer are usually asymptomatic. It is often diagnosed as an incidental finding of an elevated PSA during routine checkup. This necessitates further diagnostic work-up. Sometimes, though it causes symptoms similar to benign prostatic hypertrophy which is more of urinary in nature. These include: frequent urination, nocturia, hesitancy, hematuria and dysuria. It may also cause erectile dysfunction in some men. In advanced stage, the most common symptom is bone pain when the cancer cells spread to the bones of the spine (more common), pelvis or ribs. Compression of the spinal cord can later on lead to lower extremity weakness, urinary and fecal incontinence.

Though this may happen in advanced cases, prostate cancer is a slow-growing type of cancer. Most prostate cancers never grow to the point where they cause symptoms and most men afflicted with this cancer die of other causes than due to prostate cancer.

As of 2006, prostate cancer screening options include the digital rectal examination (DRE) and the prostate specific antigen (PSA) blood test. However, elevation of PSA in the blood is not a reliable indicator of prostate cancer. It is non-specific because even infections such as prostatitis can lead to elevated PSA level. Therefore, these tests are just screening tests and follow-up diagnostic test by a urologist is needed such as biopsy (obtaining tissue samples from the prostate via the rectum) for a more definite diagnosis. Other diagnostic tools may be performed to gather more information prior to biopsy such as cystoscopy (visualization of the bladder), magnetic resonance imaging and transrectal ultrasonography (creates a picture of the prostate using sound waves). The most important part of evaluating prostate cancer is determining the stage. Staging will measure the extent of the cancer and helps define prognosis which is useful for the oncologist when selecting the most effective therapy. The most common system used is the four stage TNM (tumor/node/metastasis) system of classification. Grading of the tumor is likewise important to determine the degree of malignancy of the cancer cells. The Gleason scoring is most commonly used for grading prostate cancer. Proper grading of the tumor is also critical, since it is one of the major factors used to determine treatment recommendation.

Treatment for prostate cancer may involve watchful waiting (active surveillance) which refers to observation and regular monitoring without invasive treatment, surgery, and radiation therapy, high intensity focused ultrasound (HIFU), chemotherapy, cryosurgery, hormonal therapy or combination of the above. Treatment options need to focus on balancing the goals of therapy with the risks of lifestyle alterations. Palliative care for advanced stage is more for extending life and relieving the patient of symptoms of metastatic disease. This is focusing on improving the quality of life of the patient. The most important prognostic indicators of disease outcome are stage, pre-therapy PSA level and Gleason score. In general, the higher the grade and the stage, the poorer the prognosis.

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Propecia tablet

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Flomax capsule

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Doxazosin tablets

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Estradiol tablets

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