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Prostate cancer, PC,
malignancy of the prostate
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- The Prostate is a gland in males
that surrounds the neck of the bladder (where urine is
stored) and the urethra (urine leaves the bladder
and exits the penis via this canal). During sex, the
prostate secrets a milky fluid (necessary to keep sperm
alive) that mixes with sperm and makes semen. The prostate
is also the source for testosterone (an important male sex
hormone) metabolism.
- Cancer of the prostate refers to the
growth of abnormal cells (tumor) within the prostate that
destroy its structure and spread to other sites in the body.
- PC is the third leading cause of
cancer death in men.
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- Slow growing tumor -- may take years
for symptoms to develop
- Frequent urination
- Weak urinary stream
- Interruption of urinary stream
(starting-stopping)
- Pain on urination
- Burning on urination
- Urinary dribbling -- urine drips
after urination
- Difficulty in starting urination
- Pinkish urine or blood in urine
- Inability to urinate
- Pain during ejaculation
- Pain on moving the bowels
- Weight loss
- Loss of appetite
- Weakness and fatigue
- Shortness of breath
- Bone pain -- lower back pain,
thighs, etc.
- Fractures may occur
- Urine infections may occur
- Blood clots may form in the
legs
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- Unknown
- Prostate Cancers are
classified (staged) by how aggressive they are and by the
degree that they differ from the surrounding prostate
tissue.
- The staging most generally used classifies the cancer
into:
- A -- the doctor is not able to feel the tumor on exam,
but a biopsy (piece taken) will show the cancer cells
under a microscope.
- B -- the tumor is felt on the exam, but is still
limited to the prostate.
- C -- the tumor has extended outside the prostate, and
may have invaded some of the nearby tissues (e.g., seminal
vesicles and lymph nodes), but has not spread to distant
body parts.
- D -- the tumor cells have used the blood stream and
lymphatic system (a system carrying a fluid containing
white blood cells) to spread to distant body parts and
organs (e.g., bones, lungs, liver, kidney, etc).
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- Symptoms
- Illnesses
- Family history
- Dietary history
- Habits
- Surgeries
- Occupation
- Medications
- Allergies
- Most important is the direct
examination of the prostate (rectal exam) by the doctor.
- By inserting his index fingers in
the rectum (using a gel) the doctor may discover an
enlarged, irregularly-shaped, hard mass.
- PSA is a chemical secreted by
prostate cells to keep the semen liquid-cancer cells
produce a lot of PSA.
- PSA (prostate specific antigen) is elevated to values of > 4 -10ng/ml. Values above 10ng/ml are strongly suggestive of Prostate Cancer.
- PSA can also be elevated with
non-cancerous enlargement of prostate (BPH) and other
factors.
- Free-PSA is new blood test -- low levels of free-PSA are seen in Prostate Cancer.
- Alkaline phosphatase
enzyme may be elevated with bone metastasis (spread to the
bone).
- Urine analysis may show red blood cells or, rarely, the cancer cells (cytology). Prostate Ultrasound (using
sound) is performed by a microphone-like device that is
inserted into the rectum to take pictures of the tumor.
- A Biopsy of the tumor is done by inserting a biopsy
device into the rectum and removing a tiny piece of the
tumor to be sent to a laboratory and examined under a
microscope (view cancer cells).
- Chest X-Ray may show metastasis to
lungs.
- Bone scan is a special radiologic test that can show
metastasis to the bone.
- CAT scan (using computers) can show metastasis to other
organs such as lungs and kidney, as well as to the lymph
nodes.
- To find the stage to which the cancer has progressed
(i.e., outside the prostate, Stage C or greater), a surgeon
may need to do a lymphadenectomy by entering (using a camera
called laparoscope) the lower part of the abdomen and
removing the pelvic lymph nodes (lymph glands near the
prostate).
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- Age -- rarely occurs under 40, but
very high rate in those over 75
- Eating animal products (fats) --
Japanese (high fish diet) and vegetarians have a lower
incidence (chance of having) of PC
- Diet low in Zinc and vitamins such
as E may play a role.
- Family history of PC and, in some cases, Ovarian Cancer (in
mothers and sisters)
- African American males have highest
rate of PC.
- Highest rate occurs in northern
Europe and America.
- Lowest rates seen in Israel, Russia,
and Japan.
- Moving from lowest risk areas to
highest risk areas.
- Sexually transmitted diseases may
play a role in PC.
- Hormones (i.e., testosterone) -- men
who have been castrated (testicles removed) do not develop
PC.
- Alcohol
- Smokers do worse when diagnosed with
PC.
- Cadmium, Acrylonitrite, and
Dimethylformamide (DMF) exposure
- Farmers
- Vasectomy
- Non-melanoma skin
cancer
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- The doctor may consult with an
urologist (male urine, prostate, penis doctor), surgeon, and
oncologist (cancer specialist).
- Treatment depends on the stage of
cancer.
- If biopsy shows a pre-cancerous (not
yet cancer) condition known as intraepithelial neoplasia,
treatment is necessary, and close observation and follow up
will be needed (every 3-6 months for 2 years).
- When diagnosed in early stages
(A-C), the cure rate is almost 98%.
- Because of the slow rate of growth,
early stages can often be watched and followed clinically.
- Aggressive therapies (surgery and
radiation) are often recommended for younger men (50 and
younger) who have a life expectancy of 10 years or longer.
- Surgery and radiation both have many side effects including Impotence (inability
to have an erection) and incontinence (inability to control
or hold urine).
- Stages of A (A1 and A2) or age
>70 are often followed without treatment.
- For other stages without metastasis and low grades of stage C (C1) -- prostatectomy (surgical removal) of prostate and/or radiation (using radioactive substances or X-Rays) therapy are the
options.
- For stages of C (more advance C2)
and D-chemotherapy (cancer killing drugs), hormone therapy
using medications (Eulexin, Leupron, Zoladex), or removing
the testicles (orchiectomy) may be combined with radiation.
- Pain management -- medications and
therapies such as massage and physical therapy can help with
pain.
- Eat a diet high in vitamins, zinc,
vitamin E, fish, fruit, and vegetables.
- Ketoconazole and other drugs,
immunotherapy (drugs that enhance the body's natural
defenses), and the use of herbs such as PC-SPES are all
being researched as forms of therapy.
- American Cancer Association
recommends all men to have a PSA and rectal exam every year
starting age 50.
- African Americans and those with
risk factors may start as early as age 40.
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Contact your
physician. Treating or not treating PC depends on your age,
other medical problems, and lifestyle. PC is slow growing in
most cases, so do not lose hope. Ask about new research and
clinical trials. You can call the American Cancer Institute
for more Information at 1-800-4
-CANCER.
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- Benign prostatic growth --
non-cancerous growth
- BPH -- benign prostatic
hyperplesia-prostate begins to enlarge after the age of 40
in most men
- Prostatitis --
inflammation (swelling ) due to infection
- Prostatitis --
the accumulation of fluid in prostate
- Prostate stones
- Seminal vesicle (tiny tubes transporting sperm) enlargement
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