PROSTATE CANCER

Disease information

PROSTATE CANCER

Prostate cancer.

It is the most common cancer in men.

Closely related to age, appears in the autopsies of more than 40% of men of fifty years, to increase its frecuensia to 67% (one in three) between 80 and 89 years.

Nevertheless, the appearance of symptoms of the same in life is much lower (about one per cent)

The risk of developing prostate cancer in a Spanish 50 - year lifetime is about 40%, but this clinical symptoms that occur less than 10%, and the possibility that it produces is below the muetre 3%.

Complications.

It depends on the evolutionary stage where it has.

The localized disease can be cured without affectation of hope or quality of life.

The hormone reduces the quality of life, to cancel sexual function and libido.

The disease can be cured locally advanced, but more often falling in less than three years, reducing life expectancy.

Metastatic disease reduces life expectancy, although initially usually stop with treatment.

Causes.

The basic cause is unknown, although various theories and data pointing to a trauma as a trigger.

Signs and symptoms.

Initially produce few symptoms.

The presence of obstructive symptoms:

Delay in starting urination,

Jet recently Urine powerful, with breaks,

Feeling incomplete emptying,

Dribbling after finishing.

is much more common in benign prostatic hypertrophy (BPH)

Already very advanced cancers cause:

Circulatory problems in his legs, with swelling,

Bone pain, especially vertebral, or.

neurological symptoms (impotence, lack of emptying of the bladder with retention of urine)

Risk Factors.

Age.

It is assumed that there are environmental or dietary factors that influence their progress, but have not yet been able to realize.

Prevention.

Urinary obstruction, with impact on the kidneys.

Pathological fractures of the vertebral column, for metastasis.

Neurological effects caused by the above.

Diagnosis and Treatment.

The usual procedure for diagnosis comes as follows:

Performed digital rectal screening in asymptomatic people.

In cases in which the gland is enlarged and hardened, is a determination of tumor markers in the blood (PSA)

Its outcome should be interpreted with great caution in this context, since this test produces many false positives (say that a healthy person is sick) and negative (say a patient is healthy) so they're much more useful for monitoring the disease that his initial diagnosis. It also explores other parameters in the blood, more indicative of distance development of the disease (acid phosphatase)

It is desirable, if there is obstructive symptoms, studies of renal function.

Then, to confirm or ensure the diagnosis is proceeded to a puncture biopsy transrectal (obtaining a tissue sample through the introduction of a needle from the rectum is a little annoying)

From here, is passed to the visualization techniques, to assess the chances surgery (before doing so produces confusing results)

Transrectal Prostatic Ultrasonography: Allows you to detect if the cancer is confined to the prostate or has overflowed. Also used to guide the needle into the pre - puncture biopsy.

Nuclear Magnetic Resonance (NMR) Allows you to evaluate the pelvic lymph nodes (which will soon affect, and whose involvement influences the therapeutic decision)

T. A. C. CT, scanner) Used recently passed by the RMN.

Bone scan: It is used to detect bone metastases.

Once you've made all these tests, determining the degree of volution of the tumor and the most appropriate therapeutic intervention.

Treatment of localized disease.

There are three possibilities:

Surgical removal of the gland. Very effective in selected patients, usually the preserve urinary function (continence) in most patients, and erectile function in selected cases.

Radiotherapy. Effective alternative in selected cases, it avoids the need for intervention. Well implemented, facilitate the preservation of erectile and urinary function.

Surveillance: In some selected cases, may be the best option, but treatment for any of the above methods prolongs survival in general, it is not the first option.

Treatment of locally advanced disease.

In these cases the optimal treatment is being intensively investigated.

Combining the techniques of previous techniques with hormone treatment:

By relying on prostate tissue of male hormones, its cancellation caused its demise, at least in part.

Today the agents of choice are the LHRH antagonist (Leuprolida, etc. So effective that avoid the need for surgical castration (previously required to avoid a source of male hormones) or other similar measures.

It was often accompany, so that a complete blockade of androgenic receptor antagonists (flutamide, etc.

Produce cancellation of sexual function and libido.

Treatment of metastatic disease.

In these cases, treatment is limited to the hormonal patterns.

For some bone metastases causing symptoms, radiation therapy can be applied locally.

They are very important palliative care (treatment of pain, incontinence, bone lesions,

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