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Carcinoma of the prostate is the most common cancer in the men above 65 years of age. Its incidence is highest in the American Negroes and lowest in the Japanese. Carcinoma of the prostate is usually an adenocarcinoma. The risk factors include a high-fat diet, exposure to cadmium and the positive family history. The men working in rubber industry and those who have undergone vasectomy are more likely to develop carcinoma of the prostate. The prostate carcinoma is associated with BRCA-1 and BRCA-2 genes. Studies have shown that the male hormone (Testosterone) plays an important role in the genesis of prostate carcinoma. It has been observed that there is little risk of the prostate carcinoma in those men whose testicles have been removed before the age of puberty.
Carcinoma of the prostate usually remains asymptomatic in the initial stages. Symptoms that appear in later stages of the disease include:
Retention of Urine
Increased Frequency of Urine
Nocturia
Poor Stream
Terminal Dribbling
Decreased Potency
Anaemia
General Debility
Malaise
Weight Loss
A focal nodule or induration may be felt on digital rectal examination. Carcinoma of the prostate usually invades seminal vesicles, ureters, rectum and base of the bladder. Local invasion of the tumour may lead to perineal pain. There may occur obstruction in the ureters leading to acute renal failure. Carcinoma of the prostate usually metastasies to the bones (including the pelvic bones, lower lumbar vertebrae, femoral head, rib cage and the skull) leading to pathological fractures. Metastases in the spine may lead to backache and bilateral sciatica.
There may be spinal cord compression due to the epidural metastases leading to the neurological symptoms. Other sites of metastases include the liver, lungs, kidneys, thyroid, retroperitoneal and the mediastinal lymph nodes. Sometimes, the prostate carcinoma metastasise to the supraclavicular lymph nodes.
Staging of the prostate cancer is done as follows:
In stage I of the prostate carcinoma, the tumour is so small that it cannot be felt by the digital rectal examination. The stage I prostatic carcinoma is usually detected incidentally after a surgery performed for benign prostatic hyperplasia.
In stage II of the prostate carcinoma, the tumour is still localised in the prostate, but can be felt during digital rectal examination.
In stage III, the tumour invades the adjacent tissues.
In stage IV of the prostatic carcinoma, the tumour metastasise to the regional lymph nodes and distant organs of the body.
Recurrent carcinoma of the prostate is the one that reappears after an apparent recovery in response to the initial treatment.
Procedures used to diagnose carcinoma of the prostate include digital rectal examination, urine analysis, flow cytometry, blood test for serum prostate specific antigen (PSA), prostatic acid phosphatase (PAP), ultrasound, X- rays, IVP, CT scan, MRI and biopsy.
Disclaimer:
This content is for information and educational purposes only and should not be perceived as medical advice. Please consult a certified medical or healthcare professional before making any decision regarding your health using the content above.
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Prostate Cancer