What can you confuse with prostate cancer

Prostate cancer symptoms can be confused with other diseases

Oncologists from the United States issued a warning that the symptoms of Prostate cancer can be confused with signs of other diseases. Scientists talked about which factor is the most significant in terms of increasing the risk of getting prostate cancer.

The problem of the uncertainty of symptoms in the case of prostate cancer was raised by specialists from the Fox Chase Cancer Center in Philadelphia. They reported that the signs of this disease are often vague and not obvious. The list of symptoms of prostate cancer includes frequent urination, incomplete emptying of the bladder, pain or burning during urination, pain in the back, hips or pelvic area, as well as other manifestations that are not always characteristic of cancer.

"Symptoms of prostate cancer can be confused with those of other common but non-cancerous conditions, such as benign prostatic hyperplasia," researchers at Fox Chase stated.

At the same time, scientists insist: as men age, screening for prostate cancer should be carried out as carefully as possible. The age factor in relation to this disease is very significant, experts say.

They recalled that prostate cancer overtakes every seventh man on the planet. (READ MORE)

Modern methods of diagnosing "male" oncology, or how to determine prostate cancer

Even young people are susceptible to cancer.

Let's talk about how prostate cancer should be diagnosed in men of different age groups.

What symptoms can be used to identify oncology?

There is only one way to detect the disease at the first stage - by passing an analysis called PSA. This happens, as a rule, by chance, as part of the diagnosis of other male problems. The symptoms of cancer itself can be easily confused with signs of other diseases, such as prostatitis.

If you are attentive to your health, you can detect a tumor already at the second stage, but, unfortunately, in most cases, men come to the doctor at the third or fourth stage, when it is extremely difficult to achieve a full recovery.

What should alert:

Early diagnosis of prostate cancer in men

At the age of 50, the problem is quite rare: only 2-3 representatives of the male half of humanity out of 1000 are diagnosed with oncology.

Among men over 60, the statistics are completely different: one out of a hundred is sick. When approaching the age of eighty, the risk increases tenfold more: cancer affects every eighth man.

There is only one conclusion: those at risk should carefully monitor their own health, as well as periodically take tests.

Early diagnosis includes:

• rapid test for the detection of prostate-specific antigen in the blood. The study is abbreviated as PSA;
• blood and urine tests;
• external palpation examination performed by a urologist.

Surveillance tactic

In 90% of cases, male oncology is treated with radiation therapy, the remaining 10% fall precisely on the tactics of active surveillance.

Surveillance tactics have not only many supporters, but also opponents.

The medical community is divided into two camps: some are convinced that those who have a low risk of death from prostate cancer can live long enough (up to 10 years) without the use of aggressive methods of treatment, while the other part of urologists believe that such tactics lead to an increase in mortality.

Transrectal finger test

Despite the existence of other methods for examining the condition of the prostate gland, the palpation method remains quite popular. Much depends on the qualifications of the doctor, as well as how accurately the patient can describe the sensations experienced.

What can be revealed:

• degree of gland growth;
• presence of dense knots;
• the presence of seals with clear boundaries.

The main disadvantages of the method: the effectiveness strongly depends on the qualifications of the doctor, at stage 1-2 it is almost impossible to detect cancer in this way, the discomfort experienced by the patient (the index finger is inserted into the anus by 3-5 cm, then palpation examination begins).< /p>

Screening is understood as a complex diagnostic measure, including regular measurement of PSA in the blood, followed by a systematic biopsy if an elevated value (more than 4 ng / ml) is detected.

Indications for screening:

• age between 40 and 50 if at least one of the man's relatives has been diagnosed with prostate cancer;
• age from 50 to 70 years - for all other categories.

Prostate ultrasound

An ultrasound examination of the prostate can be performed in several ways: transrectal (through the rectum), transurethral (the probe is inserted into the urethra), as well as externally (through the perineum or abdominal wall).

The doctor evaluates the shape and volume of the gland, its structure, as well as other important indicators.

The external method of examination is significantly inferior to the transrectal one. The efficiency of the latter reaches approximately 80%. The transurethral technique is quite complicated, it requires the use of anesthesia and the high qualification of the doctor conducting the examination.

Ureteroscopy and cystoscopy

In ureteroscopy, the ureter is examined using a special instrument - a ureteroscope. It is injected directly into the body. The method is used, as a rule, to study the urethra, as well as the renal pelvis.

Cystoscopy is an examination of the bladder using a special instrument called a cystoscope inserted into the bladder through the urination canal.

Both methods are used only indirectly in the diagnosis of prostate cancer, for example, if a man has complaints, and no signs of cancer are detected during an in-depth examination.

Prostate specific antigen (PSA) test

The specified antigen is a protein that is produced exclusively in the prostate gland. The release into the blood in large quantities is an alarm.

The norms of the indicator are as follows (it is better if the value tends to zero):

• up to age 50, PSA should not exceed 2.5 ng/ml;
• if a man is between 50 and 60 years old, then the antigen norm rises to 3.5 ng/ml;
• from 0 to 4.5 ng / ml - the acceptable range for the age group from 60 to 70 years old;
• For older men, up to 6.5 ng/mL is acceptable.

The main advantage of this test is that it allows you to quickly and easily make an accurate diagnosis and clarify whether a man is suffering from oncology, or other diseases of the prostate and / or genitourinary system are the cause of health problems.

Relatively recently, a molecular PSA test has appeared, which is the most modern way to verify prostate cancer. Thanks to this test, the frequency of biopsies performed on patients was reduced immediately by a third.

How else can you diagnose cancer?

The main diagnostic methods were listed above.

Sometimes, in addition to them, CT or MRI is prescribed, but they are performed if oncology has already been diagnosed, and there is a need to determine the size of the tumor, its structure, etc.

Separately, it is worth mentioning the analysis of urine, which has a fairly high information content. Three components are usually determined: the presence of leukocytes, the analysis of the oncomarker UBS, the level of hemoglobin.

Histology

Prostate biopsy is performed through the rectum.

With the help of an ultrasound probe, the doctor controls the process of the "operation", and a special device called a gun takes tissue from different parts of the prostate gland.

As a rule, at least 10-12 sampling points are required. The method is quite effective, but it can be erroneous if the tumor is too small, located in a hard-to-reach place, or the examination was carried out using the old method (not a gun, but a sampling needle).

Morphological verification of cancer

Morphological diagnosis refers to the determination of the histogenesis of tumor tissues.

When determining prostate cancer, the main verification method is a histological examination - a biopsy.

Tissue sampling allows you to determine the degree of damage to cells, tissues, the degree of growth of the neoplasm, and so on.

Related video

About methods for diagnosing prostate cancer in men in the video:

Despite the difficulties in detecting prostate cancer, every year doctors manage to make some progress. Thanks to early and timely diagnosis, men gain a chance for a long and fulfilling life.

Prostate cancer. Causes, symptoms, stages, treatment of the disease. Surgery for prostate cancer.

The site provides background information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious physician. All drugs have contraindications. Expert advice needed

Prostate cancer (prostate carcinoma) is a malignant tumor that develops from prostate cells. This internal genital organ is only in the representatives of the stronger sex. He is deservedly called the second male heart for playing a big role in the sexual sphere. A malignant tumor of the prostate grows relatively slowly. It can remain small for years, but, like other types of cancer, it is dangerous and forms metastases.

Prostate cancer is the most common malignant tumor in men and has become more common in recent decades. But our compatriots are relatively lucky, because this disease often affects representatives of the Negroid race. But the Japanese and South Asians get sick several times less often than Europeans.

A neoplasm can occur after 35 years in 1 in 10,000, but with age, the risk of getting sick increases hundreds of times. Among men over 60 years old, one in a hundred is sick. And in old age, after 75 years, prostate cancer is found in one in eight men. Therefore, after 50 years, you need to be especially attentive to your health and take special blood tests that will indicate that there are problems with the prostate.

Anatomy of the prostate

The prostate or prostate gland is the internal gonad in men. In shape, it resembles a chestnut, 4 by 3 cm in size. It consists of lobes of different sizes: right, left and middle.

The prostate gland is located in the small pelvis. It is located below the bladder, between the rectum and the pubis. The prostate surrounds the urethra (urethra) with a wide open ring. Therefore, its increase causes problems with urine excretion.

The prostate performs many functions that provide "male power":

Prostate structure

• Prostatic glands, there can be from 30 to 50 of them - this is the main part of the prostate. Their task is to produce prostatic juice, which makes up a third of the sperm.
• Smooth muscles contract and remove prostatic juice from the gland. Its congestion in the prostate can cause inflammation.
• A connective tissue capsule covers the outside of the gland. Inside, elastic partitions depart from it, between which the glands are located. The prostate can be felt through the rectum. It is located at a depth of 5 cm from the anus. Normally, the gland is resilient and elastic to the touch, without compacted areas and nodules.

Causes of prostate cancer

Scientists are still looking for an answer to the question of what causes prostate cancer. Some doctors argue that a malignant tumor develops only on the affected gland. Chronic diseases and other changes undermine the functioning of the body and cause disturbances in the structure of cells.

Most often, the appearance of a tumor is preceded by:

• Hormonal failure. The cause of the appearance of a cancerous tumor may be an increase in the concentration of male sex hormones: testosterone, dihydrotestosterone and androstenedione. They cause the growth of the gland and the multiplication of tumor cells. In connection with this feature, prostate cancer is called a hormone-dependent tumor.
• Prostate adenoma and other benign changes cause the growth of cells that should not be in the gland. They mutate more often than healthy cells of the glandular epithelium.
• Prostatitis. Chronic inflammation in the prostate causes poor circulation and lack of oxygen.

In addition, prostate cells attack bacteria and immune bodies. Under their onslaught, the genetic apparatus in the nucleus, which is responsible for cell reproduction, changes. Such conditions contribute to the appearance of a tumor.

Precancerous conditions

There are also precancerous conditions. They are more likely than others to lead to the appearance of a cancerous tumor. These changes may be congenital or develop in adulthood. These include:

• Atypical adenosis (atypical prostatic hyperplasia). Nodules appear in the central part of the gland, in which cells grow and multiply more actively than the surrounding ones. In addition, they change their structure. Their large nuclei indicate that the cells are in a borderline state between the norm and the tumor. It is considered an optional precancerous condition - this means that cancer can occur in its place if mutagenic factors act on the body.
• Hyperplasia with malignancy (intraepithelial neoplasia of the prostate gland). Cells in individual foci of the prostate begin to multiply actively. Gradually, they become less like typical cells of the prostate gland, and acquire the properties and signs of a malignant tumor. It is considered an obligate precancer - this means that the likelihood of a malignant tumor is very high.

But still, not every man has changes in the prostate that turn into cancer. This happens if the body is affected by factors that increase the risk of developing a malignant tumor.

Signs of prostate cancer

In the early stages, signs of prostate cancer will not be noticed. The tumor behaves secretly and does not cause any symptoms. Only an increase in the level of specific prostate antigen (PSA) in the blood can give it away.

So doctors discover prostate cancer by accident when a man is being examined for another disease. Symptoms of the disease appear when the tumor has affected neighboring organs: the bladder and intestines.

• I have to get up 2-3 times at night to empty my bladder (normally 1 time)
• urination during the day becomes more frequent up to 15-20 times
• there is a strong urge to urinate that is difficult to endure
• severe pain and burning during urination
• urinary incontinence
• pain in the perineum and pubis

• difficulty initiating urination
• Intermittent urine stream
• at the end of urination, urine does not flow, but is excreted in drops
• after going to the toilet, there is a feeling that the bladder is still full

All these symptoms do not appear at once, but gradually, and grow over several years. But none of these signs clearly indicates prostate cancer, and may be a manifestation of other diseases. But in any case, this is a reason to consult a urologist.

Degrees and stages of prostate cancer

The grade or stage of prostate cancer is determined based on the size of the tumor and its spread to neighboring organs. Another important factor is the presence of metastases. This is the name of secondary tumors that appeared due to the fact that blood and lymph carried malignant cells to distant organs.

In order to establish the stage of prostate cancer, you need to conduct an examination. To do this, use different diagnostic methods.

Staging of prostate cancerAfter the examination, the doctor makes a diagnosis and determines the stage of prostate cancer.

I stage - the tumor has a microscopic size. It cannot be felt or seen on ultrasound. It is indicated only by an elevated level of prostate specific antigen (PSA). At this stage, the patient does not notice any signs of the disease.

Stage II - the tumor grows, but does not go beyond the boundaries of the organ. It is limited to the prostate capsule. Cancer of the second degree can be felt with a digital examination in the form of dense nodes and detected by ultrasound. With second-degree prostate cancer, urination disorders may appear, which are associated with the fact that the prostate squeezes the urethra. At the same time, the urine stream becomes sluggish, cramps and pains appear in the perineum. The need to go to the toilet makes a man wake up 3-4 times at night.

Stage III - a cancerous tumor extends beyond the prostate and grows into neighboring organs. The seminal vesicles, bladder and rectum are the first to be affected. Tumor metastases do not penetrate into distant organs. Prostate cancer of the third degree is manifested by a violation of potency, pain in the pubis and lower back. There is blood in the urine and a strong burning sensation when emptying the bladder.

IV stage - a malignant tumor increases in size. Metastases form in distant organs: bones, liver, lungs and lymph nodes.

With cancer of the fourth degree, severe intoxication, weakness, loss of strength appear. When emptying the bladder and intestines, there are difficulties and severe pain. Often a man cannot urinate on his own and has to put a catheter.

Prostate cancer treatment

The doctor selects the treatment of prostate cancer individually for each man. An oncologist-urologist must take into account the age, stage of the tumor, concomitant diseases and the wishes of the patient.

Waiting tactics. The advanced age of a man (over 70 years), severe chronic diseases of the heart, blood vessels and lungs can become contraindications to the treatment of prostate cancer. It can be more life-threatening than the disease itself. If the tumor is small, does not go beyond the boundaries of the gland and has stopped its development, then the doctor will suggest postponing the treatment. In this case, you will have to do an ultrasound of the prostate every 6-12 months and take a PSA test.

Surgery to remove the prostate gland (radical prostatectomy) is one of the main methods of treating a tumor. This is the most common method of fighting cancer in men under 65.

The surgeon makes a small incision in the lower abdomen or perineum. Through it, the gland is completely removed. The doctor also dissects the surrounding tissue and, if necessary, the lymph nodes. The operation lasts 2-4 hours. The man is currently under general anesthesia. Sometimes they do regional anesthesia (epidural anesthesia) when there is no sensitivity below the belt.

If the tumor has not gone beyond the connective capsule, then it is possible to defeat the disease in 100% of cases. But if the tumor has grown into neighboring organs, then it can also be removed, but the prognosis for recovery worsens. Additional chemotherapy or radiotherapy may be required.

Modern clinics offer treatment with the help of a special Da Vinci robotic surgeon. The doctor controls all the actions of the robotic system, which rids the body of the tumor with high accuracy. The operation is performed through small punctures, which then heal quickly. New technologies can reduce the risk of complications to a minimum. It is possible to avoid side effects such as urinary incontinence and impotence.

Chemotherapy

Chemotherapy for prostate cancer is the destruction of tumor cells with drugs that contain special toxins. These substances destroy cells that are rapidly dividing. It is this feature that distinguishes cancer cells from the rest. Chemotherapy destroys the nuclei and membranes of tumor cells, causing their death.

Chemotherapy is used instead of surgery for stages III and IV, when the tumor has grown and metastases have appeared. Toxins are carried by the blood throughout the body, find cancer cells and destroy them. The drugs are administered intravenously in courses (Paclitaxel), sometimes they are taken in the form of tablets. In total, the treatment lasts six months.

Prostate cancer is sensitive to chemotherapy, but it is rarely prescribed in the early stages. The reason is that chemotherapy drugs also affect healthy cells and cause many side effects (baldness, weakness, nausea).

Radiotherapy

Radiotherapy is the treatment of prostate cancer using x-rays, neural, gamma, beta or other radiation. Radiation damages the DNA of tumor cells. This leads to the fact that they cannot divide, grow old and die.

In the treatment of prostate cancer, irradiation is carried out using special equipment - a linear accelerator. This method is called external beam radiation therapy.

The doctor will advise remote irradiation if the neoplasm is large and metastases have appeared in other organs. In this case, it is necessary to irradiate not only the tumor itself, but also the lymph nodes. The course of treatment lasts about 2 months, 5 days a week. Irradiation lasts 15 minutes and is absolutely painless. After the procedure, you need to rest for 1-2 hours and you can return home the same day.

But it will be more effective to inject radioactive particles directly into the prostate. The method is called brachytherapy. For this purpose, iridium or radioactive iodine is used. As a result of such exposure, the cancerous tumor dies off, and healthy tissues are irradiated minimally. This avoids serious side effects.

The procedure is performed under anesthesia. There are methods when radioactive granules remain in the gland. There are also those when needles with irradiating material are inserted for a while and removed on the same day.

Radiation therapy is used to treat cancer in the early stages, and in advanced cases, when surgery is no longer possible.

Fewer complications occur if prostate cancer is cauterized with a thin beam of high frequency ultrasound (HIFU therapy). Under its influence, the protein in cancer cells is destroyed, and they die

Medicine treatment

Treatment with hormones

For older men who cannot have surgery for health reasons and for those with stage 4 cancer, hormone therapy is the only treatment available.

To treat prostate cancer without surgery, use:

• Antagonists of gonadotropin-releasing hormone: Firmagon, Fosfestrol, Diethylstilbestrol. Drugs lower testosterone levels. They inhibit tumor growth, help its cells become more differentiated (similar to other prostate cells).
• Analogues of the pituitary hormone: Diphereline, Lucrin, Decapeptyl. Injections of these hormones provide "medicated castration". The level of male hormones after 2-3 weeks drops as much as if a man had his testicles removed. But this phenomenon is temporary, and gradually the concentration of testosterone in the blood rises again.
• Antiandrogens: Casodex, Flucinom, Anandron. These drugs prevent tumor cells from interacting with hormones that are secreted by the adrenal glands. They are used in conjunction with analogues of the pituitary hormone. This combination is called "maximum androgen blockade" and allows you to achieve the best result in the treatment of cancer.

In some cases, the doctor prescribes only one drug from the group of antiandrogens - Casodex. If this treatment is suitable for a man, then it is possible not only to stop the growth of the tumor, but also to maintain sexual desire and erection.

In men under 60, hormone treatment is combined with cryotherapy - freezing the tumor with low temperatures. Ice crystals that form in cancer cells destroy their membranes. The combined use of hormones and radiation therapy has a good effect.

If hormonal treatment does not work, the doctor will advise you to have an operation to remove the testicles. After it, testosterone levels fall and tumor growth stops. But men have a hard time undergoing surgical castration psychologically.

Monoclonal antibodies

Virotherapy

Among the new methods of treatment, virotherapy is considered the most promising. Viruses are specially developed that find and dissolve (lyse) cancer cells. ECHO 7 Rigvir proved to be the best. The drug reduces the tumor and stimulates the immune system so that it fights mutant cells on its own.It is prescribed in the early stages of the disease before and after surgery.

In the event that cancer is detected at stage 4, the doctor prescribes treatment that is aimed at relieving pain and improving the condition. In this case, the tumor is not removed, but they try to stop the spread of metastases.

An operation or the right treatment can help a man live 15 years or more. Research is ongoing in this area and new drugs are being tested. This gives hope that in a few years doctors will be able to cope with the disease in the later stages.

Prognosis for prostate cancer

The prognosis for prostate cancer is favorable if the man consulted a doctor on time and the disease was detected at stage I. Treatment allows you to completely get rid of the tumor, as well as maintain male strength and avoid problems with urinary incontinence. The man can continue to work. Life expectancy with successful treatment is unlimited.

At the diagnosis of "prostate cancer" stage II or III, more complex and lengthy treatment will be required. Its success depends not only on the skill of the doctor, but also on the age of the man and his state of health. Life expectancy in most patients with stage II is more than 15-20 years. Patients with stage III who have successfully completed a course of treatment can live 5-10 years.

It is believed that with stage IV prostate cancer, the prognosis for recovery is unfavorable. The average life expectancy is 3 years. But a combination of treatment and the will to live can work wonders. And some men manage to live longer than 5-7 years.

Doctors have a 5-year survival rate. He talks about what percentage of patients after treatment live five or more years. This allows you to judge what are the chances of a successful cure in patients with different stages of cancer.