What is Prostate Cancer?
Prostate cancer is a malignant tumor or lesion that occurs in the prostate gland. Prostate gland is a walnut-sized gland enclosed by a capsule and situated below the urinary bladder. It produces prostatic secretion which forms part of semen.
Prostate cancer develops when cells in the prostate gland turn malignant, i.e. uncontrolled growth, and forms a lump. This cancer grows out of the prostate capsule and invades surrounding tissue like seminal vesicles, bladder neck. It can also spread to the lymph glands in the pelvis. It also often spreads via the blood stream to the backbone.
What are the signs and symptoms of prostate cancer?
Early stage prostate cancer is usually asymptomatic, which means that there are no obvious symptoms for early stage prostate cancer. Early stage prostate cancer can be detected only by examinations and lab tests.
The following are symptoms of advanced stage prostate cancer:
- Difficulty in passing urine due to obstruction to the passage of urine;
- Back pain due to bone metastases (which means the cancer spread to the bone);
- Weakness or swelling of lower limbs due to obstruction of the lymphatic channels.
Are you at risk?
These are the identified risk factors:
- Family history of prostate cancer;
- Aged;
- Unbalanced diet such as rich in animal fat;
- Dirty reproductive organs environment;
How to prevent?
Have a healthy and balanced diet, no too much fat;
No smoking, no alcohol drinking;
Have regular exercise;
Take regular health check.
The application of using Prostate-Specific-Antigen (PSA) blood test for the early detection of prostate cancer is recommended to quite many patients.
How is prostate cancer diagnosed?
Biopsy;A biopsy with using a special needle called core needle is inserted into the prostate gland. In this procedure, an ultrasound scan guides the needle. The tissue obtained is examined under the microscope to confirm the diagnosis of prostate cancer.
Other important investigations are:
CT or MRI scans of the pelvis;These two scans will reveal the extent of the spread – capsular invasion, invasion of adjacent tissue or the lymph nodes.
Radioisotope bone scan;It helps to detect if the cancer has spread to the bone. When prostate cancer spreads, bone is the most common place it goes to.
Two parameters are used to determine the severity of prostate cancer.
- Stage measures the extent of spread:
| Stage | Extent of Spread |
|---|---|
| I | Localised –cancer is still in the prostate gland |
| II | Locally invasive – capsular invasion –invasion of adjacent organs such as seminal vesicles – spread of pelvic lymph organs |
| III | Metastatic – cancer is widespread, accompanied with bone involvement |
How is prostate cancer treated?
| Treatment | |
|---|---|
| Very small and well differentiated cancer | Surveillance especially for those over 70. |
| Localised cancer | Prostatectomy: major surgery to remove prostate and adjacent seminal vesicles.Alternative: radiation therapy etc. |
| Locally invasive cancer | Combination of prostatectomy, radiation and hormonal therapies etc. |
| Metastatic cancer | Besides surgery and other related treatments, the prescription of drugs may also used to modify hormone levels in the body. When the disease becomes resistant to hormone therapy, palliative chemotherapy or radiotherapy and so on may be used to treat symptomatic patients to improve the quality of life. |
Besides surgery, chemotherapy and radiotherapy, prostate cancer patients can also consider treatments like seed implantation, cyrotheraoy, radiofrequency ablation, immunotherapy, Chinese medicine etc.
In recent years, individual treatments are recommended more and more, which means that treatments are given according to every individual patient’s condition. Doctors will evaluate their condition fully before giving proper suggestions.
Patients with advanced diseases are often in pain, and also at risk of fractures due to bone metastases.
The following supportive cares are very important to help them cope:
- Adequate pain control;
- Measures to stabilize fracture;
- Chemotherapy, radiotherapy etc.
- Hospice home care
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