What does prostate adenocarcinoma mean

Prostate adenocarcinoma: description, causes, stages, symptoms and treatment

Prostate adenocarcinoma is a serious oncological disease. Previously, it was considered one of the main causes of death among older men. Today, this disease is increasingly being diagnosed at a young age. Is it possible to prevent the development of cancer? How to recognize its manifestations in the early stages?

General information

Prostate adenocarcinoma is a malignant epithelial neoplasm that belongs to oncological diseases. Worldwide, this diagnosis is confirmed annually in 500,000 new patients. Despite the constant improvement of diagnostic and therapeutic methods, mortality from adenocarcinoma is still high. Why? Patients often ignore the initial symptoms of a problem and do not rush to see a doctor for help.

Main causes of disease

Adenocarcinoma develops by tumor invasion into the prostate or migration through the lymphatic ducts. The immediate cause of this disease is known - uncontrolled reproduction of atypical cells. They gradually penetrate into healthy tissues. Atypical elements are formed as a result of genetic mutations. Why this happens, modern medicine can not accurately answer. However, doctors identify a whole group of factors that increase the likelihood of developing the disease:

Other factors common to all forms of oncological diseases also have a certain influence. This is radiation, bad ecology, work in hazardous industries, etc.

How to recognize adenocarcinoma?

The manifestations of this disease cannot be called characteristic. Usually men have symptoms similar to the clinical picture of genitourinary infections. If the tumor is small, it does not make itself felt for a long time. As the neoplasm grows, the patient's condition deteriorates sharply. Here are some manifestations of adenocarcinoma of the prostate:

The initial symptoms of the disease are similar to those recorded in prostate adenoma. Therefore, even at the stage of diagnosis, it is important to differentiate one pathology from another. After the appearance of metastases (stage 4 of the disease), pain discomfort intensifies, swelling of the lower extremities appears. Sometimes paralysis develops against the background of compression of the spine by a tumor.

Types of prostate adenocarcinoma

One of the factors determining the tactics of treatment is the differentiation of adenocarcinoma. This term refers to the degree of maturity of the tumor, the difference between healthy cells and pathological ones. It is used to classify a disease. At the same time, low-, medium- and highly differentiated elements of the neoplasm are distinguished. According to the incidence of incidence, such types of adenocarcinoma are distinguished as:

• small acinar;
• highly differentiated;
• low-differentiated;
• squamous.

Small acinar adenocarcinoma of the prostate is the most common variant of the disease. Its source is the epithelium of the prostate acini. Neoplasms usually develop simultaneously in several places, and then merge together. For treatment, surgical intervention, hormonal blockade of testosterone and radiotherapy are used.

The second most common type of adenocarcinoma is highly differentiated. As a rule, the tumor develops slowly and does not metastasize. Its elements do not differ in structure from normal cells. With timely detection, the prognosis for treatment is favorable.

The rarest and most aggressive form of adenocarcinoma is squamous cell carcinoma. It is characterized by rapid metastasis to the bone. Hormonal therapy and chemotherapy in this form of the disease are often ineffective. Patients are advised to undergo radical prostatectomy.

Poorly differentiated adenocarcinoma of the prostate gland has an average severity. The tumor is characterized by a layered structure, and according to the Gleason scale it corresponds to 8-10 points. The neoplasm quickly grows into neighboring organs.

Disease diagnosis

In European clinics, all men over 45 undergo a mandatory examination to detect prostate diseases. It includes a consultation with a urologist and a blood test for a specific antigen. The latter is considered the most informative test for the early diagnosis of oncology. A high level of prostate-specific antigen in the blood indirectly indicates the presence of a pathological process.

Another indicative method of research is a rectal test. It allows you to assess the state of the body and the degree of its functionality. prostate adenocarcinoma has a positive prognosis only in the initial stages of development. In other cases, expensive and long-term treatment is required.

If this ailment is suspected, it is additionally prescribed:

In many modern clinics, a special rectal sensor is used to assess the condition of the prostate. It allows using a quick-firing needle to take material for research. This device is inserted into the rectum, and the results of the procedure are displayed on the monitor screen.

Stages of disease development

Before starting treatment, it is necessary to determine what type of acinar adenocarcinoma of the prostate gland (what it is is described a little higher), as well as the degree of the pathological process. The development of this disease occurs in the same stages as other forms of prostate cancer. The only difference is the prognosis for a complete cure. For example, squamous forms pass all stages of growth rapidly. Moderately differentiated adenocarcinoma of the prostate is also characterized by a rather high rate of development. However, their discovery at the initial stage of development is considered a real miracle. If you start treatment in a timely manner, you can hope for a favorable outcome.

What are the stages of prostate adenocarcinoma? There are four of them in total:

Basic principles of therapy

You can defeat adenocarcinoma only at the initial stage of the disease. With adequate and complete therapy, it is possible to stop the symptoms and slow down the progression of the pathological process at any stage. The choice of a specific treatment strategy depends on the degree of spread of the tumor. Some options for the location of the neoplasm allow an operation to excise the gland and regional nodes. Today, doctors are trying to use minimally invasive techniques that do not require a long rehabilitation period. Localized adenocarcinoma of the prostate often requires expectant management and constant monitoring. Survival prognosis does not always improve with active therapy.

Conservative and surgical treatment of adenocarcinoma

If the tumor is available for removal, the patient is scheduled for prostatectomy surgery. Currently, it is performed using a laparoscope or a robotic assistant. After a prostatectomy, a long rehabilitation period is required. It includes measures to restore the functions of the pelvic organs, male potency (if this is still relevant).

In the later stages, treatment is supplemented with hormonal drugs and radiation therapy. The latter has several options. The radiation source can be outside or inside (introduction of a capsule with radioactive isotopes of iodine). When prostatectomy is contraindicated, it is replaced by cryotherapy. During this procedure, the tumor is frozen, as a result of which the malignant cells are destroyed.

Acinar adenocarcinoma of the prostate gland of 7 points or higher in elderly patients is usually not amenable to surgical intervention. In this case, dynamic monitoring and palliative measures are prescribed.

What is the outcome of a diagnosis of prostate adenocarcinoma? The prognosis for this disease largely depends on the stage of development of the pathological process, the age of the patient and his general condition. In the early stages, it is assessed as conditionally favorable. Unfortunately, adenocarcinoma at the initial stages of development does not show a bright clinical picture. Therefore, patients do not rush to see a doctor for help. Most of them notice the problem at the 3-4th stage, when metastases are already appearing. In this case, the disease is irreversible.

Conclusion

Oncological diseases in the modern world are increasingly becoming a cause of early death. In the representatives of the stronger sex, adenocarcinoma of the prostate gland is most common. Treatment of this pathology is long and very difficult. Diagnosis of the disease in the later stages usually ends in a quick death. To prevent the development of such an insidious disease, it is necessary to adhere to a healthy lifestyle and regularly undergo preventive examinations. Stay healthy!

Prostate adenocarcinoma: types, prognosis, Gleason value

Prostate adenocarcinoma is prostate cancer. The disease is a common cause of death among men, not only older, but also middle-aged.

Cancer degeneration of cells develops so imperceptibly that a man may not be aware of it until the stage of inoperability.

Important! In the vast majority of cases, the disease originates on "prepared soil", when the prostate has hyperplastic cells of a benign nature (prostate adenoma), or when the patient has a history of chronic prostatitis. Photo 1: Treatment methods for adenocarcinoma depend on the type of tumor, its location, stage of development. These factors, medical technologies and the means available to the patient determine the final outcome of the treatment. Source: flickr (Eugene Evehealth).

Prognosis for adenocarcinoma

The diagnosis of "adenocarcinoma of the prostate" is not a sentence. Early detection of a tumor and its adequate therapy allow not only to completely cure the disease, but also to maintain a high level of quality of life for a man.

Important! A favorable prognosis in the treatment of a cancerous tumor depends on its individual characteristics.

• For prostate adenocarcinoma that has not spread beyond the body of the prostate, the survival rate of patients after removal of the prostate in a five-year period is 8-9 patients out of 10.
• Second stage - 70-60%.
• The prognosis for surgery at stage 3, when the tumor has grown beyond the prostate, but has not yet metastasized, is equal to 50% of the five-year survival of patients.
• The prognosis of treatment when a tumor is detected in the last stages of its development depends entirely on the quality of maintenance therapy. It cannot be called favorable. However, complex modern treatment can significantly prolong the patient's life.

Surgery here does not guarantee recovery, and effective therapy for the late stages of cancer is available to a few.

Gleason differentiation

To determine the aggressiveness of prostate adenocarcinoma, a special classification has been developed - the Gleason scale.

In the 70s of the last century, the American histologist Donald Gleason developed his own classification of the aggressiveness of adenocarcinoma cells, which is based on the histological analysis of tumor samples.

The Gleason index is determined by taking two tissue samples. Each sample is examined separately, then the results are summarized. Numerical values are assigned from 1 to 5. The numbers show the extent to which tumor cells differ from healthy ones in size and structure. The greater the deviation (less differentiation), the higher the malignancy index assigned to the sample.

The result of the study of one tissue sample according to Gleason consists of two numbers:

• the first one shows the number of cells most abundant in the sample (more than 51%)
• the second digit is the type of cells that are the second most common in the sample taken (from 5 to 50%)

The final result of the Gleason study of tissue samples is the sum of the results of both samples and is evaluated on a 10-point scale. For example, the following results are obtained:

• 2+35 - in the first sample;
• 3+25 - in the second sample;
• A Gleason index of 105+5 is the worst result possible.

Interpretation of Gleason scores

• from 2 to 6 - highly differentiated tumor, which is characterized by low aggressiveness and slow growth;
• indicator 7 - averages;
• 8 to 10 is a poorly differentiated tumor that grows rapidly.

Important! The lower the Gleason index, the better the forecast.

Causes of adenocarcinoma

Why people get cancer is not known for certain. It should be understood that the process of division, renewal of cells in a living organism is continuous. As a result of the birth of new cells, failures sometimes occur. In most cases, these are minor mutated formations that the body removes on its own.

Adenocarcinoma occurs as an "improper" division of the glandular (epithelial) cells of the prostate gland, which begin to grow and multiply uncontrollably, losing their original essence.

Glandular prostate cancer in most cases is a secondary malignant tumor that has migrated to the prostate gland from another organ.

The second most common cause of cancer is the degeneration of benign cells. However, recent studies do not confirm this.

Factors provoking the appearance of prostate cancer of this type:

• a history of prostate adenoma or chronic prostatitis;
• hormonal pathologies associated with the production of male hormones (men with high testosterone levels are at risk);
• insufficient content of biologically significant micro and macroelements in the diet of a man, which distorts the processes of formation and cell division;
• smoking, exposure to chemicals;
• age factor - the older the man, the more likely he is to get cancer;
• genetic factor - if blood relatives are diagnosed with cancer, the risk increases.

Fact! Like most oncological pathologies, it is impossible to name the exact and unambiguous causes of prostate adenocarcinoma.

Types of adenocarcinoma of the prostate

Classify adenocarcinoma of the prostate depending on morphological, functional, histological features. The growth rate of the neoplasm, its aggressiveness are taken into account.

Small acinar adenocarcinoma

The most common type of cancer, which is diagnosed in 9 out of 10 patients, is small acinar. Malignant degeneration of cells is fixed in different parts of the prostate gland with small foci. It grows from the epithelium of the prostate lobules - acini. Over time, it merges, forming solid foci.

Moderately differentiated

A tumor that is estimated at 6-7 points on the Gleason scale. The prognosis for the treatment of this type of cancer is positive with early treatment.

Acinar adenocarcinoma of the prostate

The most common type of glandular cancer that develops on the epithelium of the prostate lobules. It is divided into small-acinar and large-acinar species. Large acinar prostate cancer is extremely rare, characterized by exceptional aggressiveness and rapid development.

Highly differentiated adenocarcinoma

Highly differentiated adenocarcinoma in the prostate gland develops slowly, has from 2 to 5 points on the Gleason scale. The prognosis for treatment is very favorable.

Clear cell prostate cancer

The clear-cell form of prostate cancer is so named because neoplasm cells stain little during histological studies with staining elements.

Dark cell adenocarcinoma of the prostate

Dark cell adenocarcinoma of the prostate is characterized by intense absorption of the coloring element during histological studies.

Pay attention! Varieties of adenocarcinoma of the prostate are not limited to this list. There are rare forms of prostate cancer: glandular cystic, poorly differentiated, mucinous, etc.

Prostate adenocarcinoma does not have a specific clinical picture. At the first and even the second stage of tumor development, a man may not feel anything unusual.

May be added later:

• drawing pains in the lower back, pubic region;
• urination disorders, problems with defecation;
• sexual dysfunction;
• Loss of appetite, unmotivated weight loss;
• hematuria;
• Frequent inflammatory diseases of the genitourinary organs.

At the last stage of oncological disease, symptoms such as bone pain, enlargement and soreness of the lymph nodes may appear.

Due to the fact that glandular prostate cancer has no characteristic symptoms, patients often "write off" its manifestations for fatigue, age, and other diseases without seeking medical help.

Photo 2: The best prevention of prostate cancer is preventive examinations after 35 years. If you notice oddities, unusual sensations during urination or during an erection, sexual intercourse, then immediately go to an appointment with a urologist. It might save your life! Source: flickr (Eugene Evehealth).

Treatment of adenocarcinoma of the prostate

Modern medicine has a number of effective methods for the treatment of prostate adenocarcinoma. With timely treatment, complete recovery of patients is observed in more than half of the cases. Significant, from 5 to 10 years, life extension can be even with 4 stages of the development of the disease.

Methods of treatment

The tactics of treating prostate adenocarcinoma depends on the patient's condition, the degree of development and nature of the tumor, and the age of the patient.

Surgical

Complete removal of the prostate gland with regional lymph nodes and adjacent tissues is considered the most effective in the fight against this type of cancer. However, in the early stages of treatment, partial excision of the organ is possible, while maintaining its functions.

Chemotherapy

Drug destruction of cancer cells is especially effective in low-grade tumors.

Hormonotherapy

The treatment consists in blocking the production of male hormones. For this purpose, chemical (reversible) or surgical castration is often carried out.

Radiation therapy

In adenocarcinoma, it is prescribed infrequently, since the side effects of the treatment exceed the effectiveness of the therapy itself. The essence of the treatment is the point irradiation of a cancerous tumor.

The classical approach to treatment is to apply surgery at stages 1-2 of development.

At stage 3, if surgery is not possible, chemotherapy, radiation, cytostatic drugs, hormone therapy are used.

Old age, the last stage of cancer development, severe diseases of the heart (or other vital organs) are indications for palliative (not completely curing, but alleviating the condition) measures and observation.

What is prostate adenocarcinoma: etiology, pathogenesis, treatment methods and prognosis

Over the years, the health of the male reproductive system is deteriorating due to age-related changes occurring in the body of each member of the stronger sex.

It is extremely difficult to avoid the development of such pathologies. But they can be prevented by contacting a doctor in time.

In this way, you can stay in line by preventing the development of life-threatening abnormalities, which include adenocarcinoma.

Prostate adenocarcinoma: what is it?

Adenocarcinoma is the most common form of prostate cancer, accounting for about 90% of men diagnosed with cancer.

Many representatives of the stronger sex are afraid that the adenoma in their body can turn into adenocarcinoma. A direct link between the listed diseases has not been established. But this does not mean that a benign prostate tumor can not be treated.

Causes

Specialists still cannot establish the exact causes that cause the development of the disease. According to doctors, the same factors that create good soil for the growth of oncology can provoke the disease.

The following circumstances can be attributed to the number of reasons causing the development of the disease:

Other factors can also contribute to the appearance of a neoplasm.

Types of pathology

Adenocarcinoma can have different shapes. In order to properly influence the neoplasm and get the maximum effect, it is necessary to accurately determine which type of tumor belongs to.

Acinar (small and large acinar)

There are two variants of an acinar tumor, the formation of which occurs due to the degeneration of acini:

• small acinar - this is the most common type of formation, which occurs in 92% of patients. In this case, multiple tumors with a high concentration of mucin rapidly form and develop in the prostate, which subsequently transform into one;
• large acinar is a formation consisting of malignant glandular tissues. Diagnosis of this type of tumor is possible only after a histological examination. Such formations are characterized by high rates of malignancy, so patients with a similar diagnosis die in most cases.

Moderately differentiated

This formation slowly degenerates into a malignant one and responds well to treatment. For this reason, the prognosis for such an ailment is in most cases positive. A moderately differentiated tumor is diagnosed by palpation and a PSA test.

Low-differentiated

This is a serious oncological disease that is not amenable to either medical or surgical treatment. The mortality rate for this disease is almost 100%, since the tumor quickly metastasizes to neighboring organs.

Highly differentiated

This is a malignant formation that can be mucinous, mucus-forming, papillary, and so on.

The tumor grows slowly, so specialists, subject to timely treatment of the patient, can quickly take control of the disease and stop dangerous changes with the help of surgical intervention.

In addition to the characteristics listed above, adenocarcinoma can also be:

• clear cell (during histology, the cells of such a formation have a pale shade);
• dark cell (due to the absorption of pigment by the tumor cells, they stain in dark shades).

Glisson grades and stages

For the accuracy of diagnosis and prediction of survival, specialists use the Glisson scale, according to which oncological lesions can be divided into 4 stages:

• Stage 1. Up to 5 points on the scale. Cancer affects only one lobe of the gland. At this stage, the disease almost never makes itself felt;
• Stage 2. The cancer has affected both lobes and is visible on ultrasound;
• Stage 3. The neoplasm has managed to grow beyond the boundaries of the capsule;
• 4th stage. 8-10 points on the Glisson scale. At this stage, metastases spread to the tissues of the scrotum, testicles, and pelvic muscles.

Characteristic symptoms and signs

At the initial stages, adenocarcinoma proceeds without any symptoms. Therefore, men do not even know about the course of dangerous processes in their body.

In later stages, when the nodes begin to compress adjacent organs, the following symptoms may occur:

Symptoms can appear as a group or separately from each other.

Diagnostic methods

Timely diagnosis is the key to early detection of pathology and timely control of the disease.

To diagnose a tumor and determine its nature, it is necessary to undergo the following types of procedures:

The results of diagnostic procedures will allow the doctor to form an objective opinion about the patient's health status.

Treatment of adenocarcinoma of the prostate

Therapy of adenocarcinoma must be comprehensive. Otherwise, it will not be possible to achieve a positive result in the treatment.

To get a good effect, specialists can use the following methods:

• taking hormonal drugs. It is used to stop the process of neoplasm growth due to changes in the hormonal background. For medicinal purposes, drugs are used in tablets and injections, with the help of which androgen blockade occurs;
• Chemotherapy and medication after a course of treatment. In this case, chemicals are injected into the patient's blood. Their aggressive components inhibit the activity of any cells, including malignant ones. This method can give a good result, but at the same time it has many side effects;
• radiotherapy. Adenocarcinoma cells are extremely sensitive to radiation exposure, which makes radiation therapy effective for this disease. During irradiation, specialists act on the tumor with ionizing radiation. In some cases, several courses of radiation are carried out to achieve a positive result;
• surgical operations to remove the affected organ or parts thereof. It is used when the neoplasm has significantly increased in size. In this case, the doctor makes a small incision through which the tumor is removed along with the prostate or individual parts of the organ and neoplasms. However, such manipulations do not exclude relapse;
• other treatments. In modern medicine, there are other ways to deal with adenocarcinoma. However, they are used an order of magnitude less frequently than the methods listed above, and more often they simply act as an addition to complex therapy. Depending on the characteristics of the course of the disease, the patient may be recommended to undergo cryotherapy, ultrasound ablation, herbal medicine and other procedures. However, the listed measures, even with long-term treatment, will not give a result without more serious medical measures.

How long a person will live: forecast

Prognosis regarding the life expectancy of a patient who has been diagnosed with adenocarcinoma of the prostate may be different.

This indicator depends on the type of tumor, the rate of its growth, the time the patient seeks help from specialists, and many other points.

The life expectancy of a man after undergoing treatment can range from several months to many years without relapse.

Related video

About what is acinar adenocarcinoma of the prostate, in the video:

Timely access to a doctor is the key to timely taking the disease under control and effective treatment. The disease, detected at an early stage, in most cases responds well to treatment and does not relapse in the future.