The prostate is a gland in the male reproductive system that produces the majority of the fluid that makes up the semen, the thick fluid that carries sperm. The walnut-sized gland is located beneath a man’s bladder and surrounds the upper part of the urethra. The tube that carries urine from the bladder. Prostate function is regulated by testosterone, a male sex hormone produced mainly in the testicles. Prostate cancer is a major health concern for American men. Although the disease is rare before age of 50, experts believe that most elderly men have at least traces of it. More than 200,000 new cases and about 30,000 deaths are attributed to prostate cancer each year in the U.S. for reasons not fully understood; African- American men have the highest frequency of prostate cancer in the world and highest death rate from the disease. In other parts of the world – notably Asia, Africa and Latin America- prostate cancer is rare.
Prostate cancer cells do not follow the usual cancer growth patterns, which are to grow uncontrollably and spread to other tissues. Prostate cancer is typically a very slow growing tumor, often causing no symptoms until advanced stages. Most men with prostate cancer die of other causes, many without ever realizing that they have the disease. Prostate cancer in its early stage can be cured. Fortunately, about 85% of American men with prostate cancer are diagnosed in the early stages.
But one prostate cancer begins to grow more rapidly or spreads outside the prostate. It is dangerous. This aggressive type of prostate cancer can occur at any age. Although the disease tends to progress slowly, it is generally fatal if it spreads beyond the prostate gland itself.
Cancer that has spread beyond the prostate to distant tissues ( such as bones, lymph nodes and lungs) is not curable, but it often can be controlled for many years. Because of the many advances in available treatments, the majority of men whose prostate cancer becomes widespread can expect to live five years or more.
Sign and symptoms of enlarged prostate
- Getting up at night to urinate more often than one time per night
- Urinating more frequently than every two hours during the daytime
- Feeling that you have to urinate, but when you attempt to, finding that it takes a while for the urine to come out
- Straining or pushing to get your urine stream started and/ or to maintain your stream
- Dribbling urine near the completion of voiding
- A urine stream that stops and starts during voiding
- Feeling of incomplete emptying after voiding such that you feel that you could void again shortly.
Screening and diagnostic test for prostate cancer
In an attempt to detect prostate cancer at its earliest stage, it is recommended that the digital rectal examination and prostate specific antigen (PSA) test be performed during routine annual examinations starting at the age of 5o. However, if there is a family history of prostate cancer or if the man is African-American, then annual testing should begin at age 45. Screening can also be performed in response to a patient exhibiting one or more of the symptoms mentioned previously.
1% of men with prostate cancer that does not produce an elevated PSA level. Conversely, the PSA test may indicate the presence of the disease when it cannot be palpated.
It should be kept in mind that an elevated PSA level is not synonymous with prostate cancer. There are a number of conditions other than cancer that can result in this elevation. For example, PSA level normally increases with age or with an enlarged prostate that is either the result of normal growth as a men ages (benign prostate hyperplasia) or due to infection or inflammation (prostatitis). And for a day or two after ejaculation, It is also possible for certain prescribed medication (e.g., finasteride) and herbal supplements (e.g., Saw Palmetto) that are advertised for prostate health to decrease PSA levels, potentially masking any elevation that may occur in the PSA level. A patient should notify his healthcare provider of all medications, vitamins, and dietary supplements being taken because they may have an effect on test results.
A Varity of the tests are available to determine the stage of the disease
The diagnosis of cancer by a prostate biopsy is typically followed up by one or more tests in order to stage the disease within the gland but also to determine whether it has spread to surrounding tissue. A localized stage of prostate cancer is confirmed to the prostate whereas a regional stage has spread to nearby tissues such as the seminal vesicles or bladder, but not to distant sites.
Prostate cancer ahs tendency to metastasize to the bones accounting for persistent pain and stiffness. A particular type of radionuclide bone scan can be used to locate areas in the skeleton that contain very active cells which may be sites where metastatic cancer cells reside. This procedure entails the injection of a small amount of low – level of radioactive material in to the patient’s bloodstream that travels throughout the body. Cells that are very metabolically active, such as cancer cells, will take up more radioactive material than will less active cells.
It is possible with very detailed 2-D images or 3-D models created by MAGNATIC RESONANCE IMAGING, to distinguish between healthy and diseased tissue.
Benign hypertrophic and cancerous prostate cells produce a prostate – specific membrane glycoprotein (PSMG), which is a carbohydrate -linked protein locate only in cellular membranes of these types of cells. Normal prostate cells do not produce PSMG or produce very small quantities of it. During a prostataScint scan, a radioactive monoclonal antibody with a binding specificity for PSMG is injected in to the patient and a body scan is taken to detect where the radioactive antibody is located. A prostate scan is useful in determining the exact location of cancer cells within the prostate as well as in local lymph nodes or nearby tissues.