Skip to main content

Prostate cancer - summarised

DEFINITION


Prostate Cancer is a cancer that occurs in a man’s prostate –a small walnut shaped gland that produces the seminal fluid that nourishes and transports sperm. It is one of the most common types of cancer in men as such much preventive measure should be put in place to avert the growth of prostate cancer.



RISK FACTORS


Increasing age, Family history, African origin, Dietary factors.



PROTECTIVE FACTORS


Nutritional factors have protective effect against prostate cancer, reduced fat intake, Soy protein, Lycopene, Vitamin E, Selenium, Race-Incidence doubled in African Americans compared to white Americans.



PROSTATE ANATOMY


Prostate lies below the bladder and encompasses the prostatic urethra, surrounded by a capsule and separated from the rectum by layer of fascia termed the Denonvilliers aponeurosis. Blood supply-Inferior vesical artery ad Nervous supply is derived from the pelvic plexus Important for erectile function.


[su_youtube url="https://www.youtube.com/watch?v=flHXrnSWxCU"]

CLINICAL MANIFESTATIONS


Read more on Symptoms, Diagnosis and Treatment.

Early state (organ confined) and is asymptomatic


 - LOCALLY ADVANCED


Obstructive voiding symptoms, Hesitancy, Intermittent urinary stream, Decreased force of stream, May have growth into the urethra or bladder neck , Hematuria , Hematospermia . Advanced (spread to the regional pelvic lymph nodes), Edema of the lower extremities and pelvic and perineal discomfort.



- CLINICAL MANIFESTATIONS OF METASTASIS


Most commonly to bone (frequently asymptomatic) can cause severe and unremitting pain. Bone metastasis can result in pathologic fractures or Spinal cord compression. Visceral metastases (rare) can develop pulmonary, hepatic, pleural, peritoneal and central nervous system metastases late in the natural history or after hormonal therapies fail.



DETECTION AND DIAGNOSIS


PSA level is helpful in asymptomatic patients and more than > 60% of patients with prostate cancer are asymptomatic. Diagnosis is made solely because of an elevated screening PSA level. A palpable nodule on digital rectal examination is next most common clinical presentation and prompts biopsy. Much less commonly, patients are symptomatic. In advanced disease cases patients manifest with Obstructive voiding symptoms, Pelvic or perineal discomfort, Lower extremity edema and symptomatic bone lesions.


A digital rectal examination is of low sensitivity and specificity for diagnosis. However, a biopsy of a nodule or area of induration reveals cancer 50% of the time and that suggests that prostate biopsy should be undertaken in all men with palpable nodules.


The PSA level a better sensitivity but a low specificity, it indicates Benign prostatic hypertrophy and prostatitis . The PSA Velocity is a better measure of high risk patients. A rate >0.75/year increase warrants biopsy.



TREATMENT


          Surgery




  1. Traditional

  2. RoboticRadiation



  1. Brachytherapy

  2. External beam

    • Cryotherapy

    • Androgen Deprivation

    • Watchful waiting




RECOMMENDATIONS


It is recommended that PSA screening with direct rectal examination should be done




  1. Yearly after age 50 w/ 10 year life expectancy.

  2. May start at 45 w/ close relative w/ prostate cancer <65.


May start at 40 for multiple close relatives w/


[su_youtube url="https://www.youtube.com/watch?v=soNIj6fEhfc"]

All about Prostate cancer - summarised was written by Dr LB Basaru. You can follow him on Social media. 

More articles across the web


Labels:

Comments

Post a Comment

Popular posts from this blog

Nigeria health expenditure (Inforgraphic)

Post a Comment
Read more

Children and Vaccination

“So it's an absolute lie that has killed thousands of kids. Because the mothers who heard that lie, many of them didn't have their kids take either pertussis or measles vaccine, and their children are dead today. And so the people who go and engage in those anti-vaccine efforts -- you know, they, they kill children. It's a very sad thing, because these vaccines are important.” ― Bill Gates Since the advancement of medicine, medical practitioners found out there are ways you could prevent your child from suffering some terminal diseases as they grow up. They called this “Immunization or Vaccination”. Today, medical centers all over the world advise you to immunise your children so as to protect them from some certain diseases. You immunize your children through the use of vaccines, and this vaccination comes in different forms, and different age grades. Whаt аrе vaccines? Whеn germs enter thе body, thе immune system recognizes thеm аѕ foreign substances (antigens). Thе immun...
Post a Comment
Read more

Weight Loss Surgery

Weight loss surgery or bariatric surgery is a type of surgery that involves series of procedures performed on people suffering from obesity. There are different types of weight loss surgery and there are different procedures to performing a weight loss surgery. When people hear weight loss surgery, the first thing that comes to mind is; gastric bypass. This is probably the most common type of weight loss surgery, but the truth is, weight loss surgery is wider than just gastric bypass. In this article, we are going to be looking at the generalities of weight loss surgery, the different procedures involved in weight loss surgery, the types of weight loss surgery, how much weight loss surgery cost, etc. Procedures for Bariatric Surgery  Bariatric surgical procedures саuѕе weight loss bу restricting thе amount оf food thе stomach саn hold, causing malabsorption оf nutrients, оr bу a combination оf bоth gastric restriction аnd malabsorption. Bariatric procedures аlѕо оftеn саuѕе hormonal c...
Post a Comment
Read more