Prostate Cancer – All You Need to Know
Prostate cancer – what is it?
Many recent studies define prostate cancer as the most widely spread cancer among men.
Prostate cancer represents the degeneration of normal cells of the gland. This degeneration violates their function and they begin to divide and multiplyuncontrollable in the body. The speed of this process depends on how cancer cells differ from normal, which determines its degree of malignancy. When the cancer cells look more like normal, this means the cancer grows slowly, giving metastases later and therefore the prognosis is better. The degree of malignancy is measured by the so-called Gleason Score which will become the subject later.
In the early stages, the tumor is small and localized only in the prostate gradually with advancing the process, it can come out of it, affect surrounding tissue and organs. The cancer can also affect distant organs (metastasis), as typical in prostate cancer is the involvement of regional lymph nodes and bones.
Prostate cancer is very rare in men younger than 40 years. With aging, the risk of prostate cancer has increased significantly, approximately 60% of cases are diagnosed at the age of about 65 years. This is the reason for its active search in men over 50 years through annual reviews at urologist and study of PSA.
It has been proven that prostate cancer is more common among some families and heredity also is a risk factor. The presence of a close relative with prostate cancer (father, grandfather, uncle, etc.) increases the risk of disease 2-3 times. In such cases, the annual reviews should begin after the age of 45.
In recent years, examining the influence of paths for cancer genes, BRCA1 and BRCA2, like breast cancer, which might influence the frequency of cancer, but as yet there is no clear evidence that this is so.
The incidence of cancer is higher among Afro-Americans and lower among Asians. Curiously, the rate among Asians immigrated to the United States is the same as the rest of the population there, suggesting that harmful environmental factors also influence disease risk.
4. Overweight and diet
Current studies suggest that perhaps obesity and excess weight could also increase the risk of disease.
Typical of prostate cancer is that it has a slow development for years. Often occurs with no or very mild and non-specific symptoms that closely resemble those of benign prostate enlargement. Moreover, a large proportion of patients already have a benign increase which symptoms can mask those of cancer. This makes it quite insidious disease in which the occurrence of its specific complaints is already a sign of late stage disease.
Complaints may be:
Symptoms similar to benign enlarged prostate (BPH):
Blood in the urine – a rare and non-specific symptom;
Bone pain – in advanced process and bone metastasis.
Lack and weak, non-specific symptoms of this disease are the reason for its active search through annual reviews at urologist and study of PSA for all men over 50 years. Because prostate cancer is curable if detected at an early stage.
1. Increased PSA
In order to find out if the man has increased PSA there should be made a tumor marker for prostate. PSA stands for prostate specific antigen. This is a protein molecule that is secreted by prostate cells only. Often it is called PSA tumor marker that is not entirely correct because it is secreted by both – normal prostate cells and by cancer cells. This means that except for cancer, it may be increased because of other processes in the prostate gland – inflammation, trauma, and others. Although it is not cancer specific, the study is easy, fast and cheap way of screening of the risk group of men because high levels of the tumor marker is often the first and only “red light” that alerted us to a possible risk of cancer. This is why it is imperative study in men over 50 years. Any rise in PSA above normal was suspicious for cancer and must be clarified.
PSA generally rises with age. The following values roughly and tentatively indicate which the „normal” values are for age:
-up to 3 ng / ml in 50 years old men
-up to 4 ng / ml in 60 years old men
-up to 5 ng / ml in 70 years old men
2. Rectal examination
Rectal examination until recently was the only method of studying prostate. The medical examination at urologist still is associated by many people mainly with “agitation in the butt.” Despite its replacement by some modern methods, rectal examinations remains standard procedure and no matter how unpleasant is for men, touching the prostate remains serious “tool” in the hands of experienced urologist because there is no machine that can replace the feeling of the gland. This is supported by global data showing that about 10-20% of cases of prostate cancer are diagnosed with rectal examination, despite normal levels of PSA. When the urologist feels suspect and hard area, he appoints a biopsy.
Imaging – scanner or MRI – are follow procedures most often after biopsy-proven prostate cancer. Their task is to determine the stage of spreading the disease, i.e., there’s invasion of surrounding tissues or lymph metastasis.