Prostate Cancer

Cancers are usually named after the part of the body where the abnormal cell growth begins.

Prostate cancers are cancer cells from the prostate. When prostate cancer cells spread to other parts of the body, they are called metastases.

The prostate is a part of the male reproductive system, which includes the penis, prostate, and testicles.

The prostate is located just below the bladder and in front of the rectum.

It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder).

The job of the prostate is to produce fluid that makes up a part of semen.

As a man ages, the prostate tends to increase in size. This can cause the urethra to narrow and decrease urine flow.

Research has found risk factors that increase your chances of getting prostate cancer. These risk factors include:

  • Age: The older a man is, the greater his risk for getting prostate cancer.
  • Family history: Certain genes that you inherited from your parents may affect your prostate cancer risk.
  • Currently, no single gene is sure to raise or lower your risk of getting prostate cancer. However, a man with a father, brother, or son who has had prostate cancer is two to three times more likely to develop the disease himself.
  • Race: Prostate cancer is more common in some racial and ethnic groups than in others, but medical experts do not know why.

Screening

Prostate cancer screening means looking for cancer before it causes symptoms. This helps to find cancer at an early stage when it may be easier to treat.

Tests that are commonly used to screen for prostate cancer are:

Digital rectal exam (DRE): A doctor or nurse will insert a gloved, lubricated finger into the rectum to feel the prostate. This allows the examiner to estimate the size of the prostate and feel for any lumps or other abnormalities.

Prostate specific antigen test (PSA): The PSA test is a blood test that measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other conditions that affect the prostate.

Normal PSA level <4).

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands produce more PSA than others.

PSA levels also can be affected by:

  • Certain medical procedures.
  • Certain medications.
  • An enlarged prostate.
  • A prostate infection.
  • PSA is the single best predictor of the presence of prostate cancer.
  • PSA testing detects prostate cancer 2-10 years earlier than a digital exam.
  • Most cancers detected with PSA testing are curable.
  • Any PSA level >2.5ng/ml signals trouble.
  • Levels 3-4 ng/ml needs a biopsy.
  • Yearly testing should start at age 50 but if you are in high risk group start test at age 40 yrs.

Diagnosis

If your PSA or DRE ( prostate Specific antigen or digital rectal exam) is abnormal, doctors may do additional tests to find or diagnose prostate cancer.

Transrectal ultrasound: A probe the size of a finger is inserted into the rectum, and high-energy sound waves (ultrasound) are bounced off the prostate to create a picture of the prostate called a sonogram. This test may be used during a biopsy.

Biopsy: A small piece of tissue is removed from the prostate and looked at under a microscope to see if there are cancer cells.

Gleason score: This score is determined when the biopsy is looked at under the microscope. If there is a cancer, the score indicates how likely it is to spread. The score ranges from 2–10. The lower the score, the less likely it is that the cancer will spread.

Treatment

Radiation therapy: Radiation destroys cancer cells, or prevents them from growing, by directing high energy X-rays (radiation) at the prostate.

There are two types of radiation therapy:

External radiation therapy: A machine outside the body directs radiation at the cancer cells.

Internal radiation therapy : Radioactive seeds or pellets are surgically placed into or near the cancer to destroy the cancer cells.

Hormone therapy: This treatment uses drugs, surgery, or other hormones to remove male sex hormones or block them from working, which prevents cancer cells from growing.

References

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