Prostate cancer is the most common
malignancy diagnosed in men. On an annual basis globally, approximately 1.1
million men are diagnosed with prostate cancer and more than 300,000 will die
of prostate cancer each year.
The prostate is a walnut sized gland
that is part of the male reproductive system. It is located beneath the urinary
bladder and in front of the rectum. The prostate makes some of the fluid that
nourishes and protects sperm cells in the semen.
Just behind the prostate are the
seminal vesicles, which make most of the fluid for the semen. The urethra is a
tube that carries urine and semen out of the body through the penis, running
through the prostate.
The activity and growth of the
prostate is stimulated by male hormone Testosterone. Prostate cancer is to men
what breast cancer or cervical cancer is to women. Prostate cancer has the
potential to grow and spread quickly, but for most men, it is a relatively slow
growing disease.
It is important for patients to
discuss with their doctors the various aspects of their particular type of
prostate cancer to understand how aggressive it is and how best to treat it.
Symptoms Many men with prostate cancer have no symptoms related to their
cancer.
For those that do have symptoms,
they could include any of the following: Urinary problems – weak urine stream,
difficulty initiating urination, stopping and starting during urination;
urinating frequently, especially at night, pain or burning with urination.
These symptoms are also often
associated with noncancerous enlargement of the prostate, called benign
prostatic hypertrophy (BPH). Blood – in the urine and semen. Pain – in the
hips, pelvis, spine or upper legs. Also pain or discomfort during ejaculation.
Risk factors
Men with certain risk factors are
more likely to develop prostate cancer. Perhaps the most significant of these
risk factors is age. Old age particularly 65 and over is the main risk factor
for prostate cancer. The older a man gets, the more likely he will develop
prostate cancer. The disease is rare in men under 45 years of age.
Family History – one’s risk of
prostate cancer is higher if you have a father, brother or son with prostate
cancer.
Race
Prostate cancer is more common among
black men and less common among Asians and Caucasians. Certain Prostate Changes
– men with cells called high grade prostatic intraepithelial neoplasia (PIN)
may be at increased risk for prostate cancer. Certain Genome Changes – research
suggests that the risk for prostate cancer many be linked to specific changes
on particular chromosomes.
Having a risk factor does not mean
that one will develop prostate cancer. Most men with any of the above risk
factors will still never develop the disease.
Screening and diagnosis
Diagnosis of prostate cancer should
be part of a routine annual examination by a primary care doctor. The prostate
cancer tests for early detection and screening are the Digital Rectal Exam,
DRE, combined with a blood test to measure the Prostate Specific Antigen, PSA
level, in the bloodstream.
Abnormal DRE, elevated PSA or
confirmation of more advanced Prostate Cancer will require additional testing.
Prostate biopsy A prostate gland biopsy is a test to remove small samples of prostate
tissue to be examined under a microscope. Needle biopsies of the prostate are
usually done under TRUS guidance. Prostate Specific Antigen – PSA .
This is an enzyme found in the blood
produced exclusively by prostate cells. Normal levels of PSA in the blood are
small amounts between 0-2.5 ng/ml. Higher than normal levels, greater than 2.5
ng/ml, can be caused by cancer or benign, non-cancerous conditions such as
enlarged prostate, prostate inflammation, infection, or trauma.
All elevated readings of PSA should
be checked. Occasionally, a Digital Rectal Exam, DRE, does not reveal any
abnormalities, but the PSA is elevated. Sometimes the opposite is true, and PSA
is normal, but the DRE is abnormal.
For this reason, the Prostate
Specific Antigen PSA blood test together with the DRE is best for early
detection. Normal prostate cells and prostate cancer cells make PSA even if
they are outside the prostate.
That is why PSA monitoring after
treatment is so important. Returning prostate cancer cells, confined to the
prostate or that have spread to the bone or lymph nodes, will cause the PSA to
rise. Prostate Specific Antigen PSA is important for diagnosis, treatment and
follow-up as well as useful for comparing treatment results.
How age affects PSA Research has investigated
what PSA levels within age ranges should raise concern about the likelihood of
significant prostate cancer. Based on age, what PSA level might trigger a
referral to a urologist? Using these PSA trigger levels they “detected all
relevant PCa with a significant reduction of biopsies.” If you are less than 49
the trigger level is 1.75ng/ml; 60-69 (2.25) and above 70 (3.25). PSA is
measured by a simple blood test. The typical test for diagnosis and risk group
determination is the “total PSA” which is simply a measure of all the PSA.
Since the amount of PSA in the blood is very low, detection of it requires a
very sensitive technology (monoclonal antibody technique). Prostate Cancer
Gleason Score Diagnosis is confirmed with a biopsy.
The biopsy can give important
indications as to how extensive the cancer is within the prostate by the number
of cores that are positive for cancer. The pathologist will also look for
perineural invasion, (cancer invading small nerves within the prostate), which
can be an indication of how likely the cancer is to spread outside of the
gland. Prostate Cancer Gleason Score is Set by Inspection of Prostate Cancer
Cells how quickly it grows and how likely it is to spread outside of the gland.
The Prostate Cancer Gleason Score score ranges from 2 to 10. To determine the
Gleason score, the pathologist uses a microscope to look at the patterns of
cells in the prostate tissue.
The most common cell pattern is
given a grade of 1 (most like normal cells) to 5 (most abnormal). If there is a
second most common cell pattern, the pathologist gives it a grade of 1 to 5.
The pathologist adds the two most common grades together to make the Gleason
score. If only one pattern is seen, the pathologist counts it twice, e.g. 5 + 5
= 10. A high Gleason score (such as 10) means a high-grade prostate tumour.
High-grade tumours are more likely than low-grade tumours to grow quickly and
spread.
When diagnosed with prostate cancer
When facing a diagnosis, there are a lot of things for you to consider. Is prostate
cancer or a benign condition? How bad is this prostate cancer ? Which treatment
is right for you ? What are the side-effects of treatment? How long is the
recovery time and which doctor is best ? The good news is that the probability
of survival for most prostate cancer patients is very good.
However, you need to complete
treatment. Some treatments increase the likelihood that your prostate cancer
will not return. What to do next It is extremely unusual that there is any need
for you to rush to a decision. Most cancers have been quietly sitting in the
prostate, slowly growing for 10-15 years.
You haven’t just gotten cancer, you
have just been diagnosed with cancer, that you have been living with for a long
time. No need to become an instant expert. Take your time, become informed.
Learn about available treatment options. Select several specialists who can
describe the different treatments.
Arrange consultations and discuss
the options. World Cancer Day: Lifetouch Africa tasks Nigerians President/Executive
Director, Lifetouch Africa, an African women health initiative, Mrs Awele
Chukwuedo Ossai, has called for a collective effort to check the rise of breast
and cervical cancers scourge in Nigeria.
She made this known during a
one-week programme held in Ibadan to mark the World Cancer Day,which was set
apart by the World Health Organisation to create awareness on the need to rise
against cancers . In a bid to ensure a cancer-free society, Lifetouch Africa
engaged in a multi-dimensional intervention to commemorate the world cancer day
with activities such as a football match/awareness campaign, followed by an
awareness session with the disabled, a radio awareness session reaching over
250,000 workers in Lagos State, and a flag off of the nation-wide capacity
building project for nurses in selected local government areas in Oyo State, in
collaboration with the Oyo State Ministry of Health (Non Communicable Disease
Unit.
Through this programme the NGO
trained nurses from selected local governments in the state on cervical
screening (Visual inspection with acetic acid and Papsmear ). The aim is to
ensure adequate trained hands in cancer preventive services towards a free
breast and cervical cancers Nigeria.
Source:Vanguard
Source:Vanguard
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