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Prostate cancer symptoms and treatment. Prostate cancer. In the early stages

A malignant neoplasm that has formed in the male genital area is prostate cancer. Medical statistics convincingly show that the disease is rapidly "getting younger". And if earlier pathology was considered the lot of men after 65-75 years old, today it is diagnosed in people 45-50 years old.

Many people who are faced with a similar situation - the detection of a malignant node in the tissues of the prostate, are primarily concerned about the issue of predicting survival. Oncologists take into account many factors, but special attention is paid to the stage of prostate cancer at which the oncological process is. So, people with stage 1-2 cancer have a high chance of recovery. Less bright prospects in people with stage 2-3 metaplasia. Be sure to take into account the prevalence of the primary tumor, and the presence of metastases, and the severity of negative symptoms.

TNM classification

As a rule, specialists all over the world are guided by the generally accepted system of gradation of oncoprocesses "tumor-node-metastasis", in which it is customary to indicate:

• with the symbol "T" the prevalence of the tumor process - from zero, when the focus as such has not yet formed, to 4 - neoplasia has already spread not only to neighboring tissues and organs, but also to higher structures;
• the symbol "N" describes regional lymph nodes - the severity of their involvement in the cancer process, as a rule, 1 indicates the absence of metastases, the number 2 - the diagnosis of damage to regional lymph structures;
• the symbol "M" denotes distant metastases, from 0 - the absence of lymphogenous, hematogenous metastasis, to 1C - involvement of even the most distant organs in the oncological process.

However, in addition to determining the categories of TNM, specialists necessarily compare information with the results of PSA in the bloodstream of a man, as well as other laboratory and instrumental diagnostic methods.

Gleason classification

Prostate cancer is usually staged based on a biopsy. In this case, a certain amount of points is calculated on a scale developed by Gleason. The higher the number, the more aggressive the tumor focus is recognized. After all, the differences between atypical elements and healthy prostate tissues are much more significant.

So, if cancer cells are practically indistinguishable from healthy ones, the number 1 is assigned to the tumor focus. The maximum variability of prostate cells is estimated at five points.

However, a neoplasm can capture several areas of the organ at once. If, as a result of diagnostic procedures, 2 nodes were identified, and both turned out to be malignant, then the total amount on the Gleason scale can reach 7 points. Tumor foci with a number of 6 or less are recognized as less threatening to men's health. Whereas 8-10 points give the most unfavorable prognosis of survival.

But in this case, you should not give up, in any case. Achievements of modern anticancer medicine make it possible to prolong the life of patients many times over, and sometimes achieve recovery even with medium-high and high scores on the Gleason scale.

Classification according to the Juite-Whitemore system

As in other classification systems, in this case they are guided by the severity of differentiation of oncocells, the prevalence of the tumor process, and damage to neighboring tissues and organs.

The earliest stage in the formation of an atypia focus is called "A". At A1, a good differentiation of oncoelements is observed, but at A2, cancer cells are not so similar in different areas of the prostate tissue.

The stage when the cancer focus has not yet gone beyond the organ, but is palpated by a specialist during physical examination, and the PSA parameters are already elevated, is called the "B" stage. The numbers from 0 to 2 indicate the severity of the oncological process - from the minimum, when the focus is diagnosed in only one lobule of the organ, to the capture of the entire prostate tissue.

In stage C prostate cancer, metaplasia extends beyond the capsule of the organ, affecting both the spermatic cords and adjacent organs. At C1, the focus of atypia has just gone beyond the prostate. But at C2, there is already an overlap of the lumen of the urethra, or the exit to the bladder.

Diagnosis of metastasis indicates the transition of the oncoprocess to stage "D". Numbers 0-3 indicate the severity of damage to regional lymph structures and distant organs. The higher it is, the worse the prognosis.

Cancer symptoms by stage

The danger of pathology is that at the initial stage of prostate cancer, negative symptoms are completely absent. A man does not feel any discomfort or difficulty with urination or sexual desire.

The first signs of the disease begin to manifest themselves only with a significant increase in the size of the tumor focus. In some cases, a man learns about his diagnosis only at the stage of the oncological process leaving the prostate.

The alarming manifestations of the disease include, first of all, an unnaturally rapid urge to empty the bladder, especially at night, as well as the difficulty of the process of excretion of urine. Pain may not always be observed. Urine contains elements of blood and semen.

However, such symptoms are often referred by men to age-related changes in the prostate - adenoma, prostatitis, and are simply ignored. And only when the pathology passes to the next stage, when pain impulses become longer and more intense, move to the area of ​​the sacrum, give to the legs, representatives of the strong half of humanity seek medical help.

The subsequent stages of the oncological process proceed with incessant pain sensations not only in the prostate region, but also in the ribs, pelvic bones, and spine. The patient begins to lose weight, he has constant fatigue, increased weakness. Appetite is either significantly reduced, or completely absent, discomfort may be felt in the stomach, there is nausea. Edema is present on the lower extremities, paralysis is less common.

All of the above clinical signs can accompany not only prostate cancer, but also other diseases of the male genitourinary system. Only diagnostic research puts everything in its place.

Symptoms of the first stage of prostate cancer and its treatment

At the initial stage of the formation of the tumor focus, the patient does not notice any changes in his state of health. Performance may deteriorate somewhat, periodically there is a failure with urination - the urine stream becomes weaker, its quantity decreases. Less often there is a moderate burning sensation in the urethra.

When taking a blood test for PSA - a specific antigen for the male part of the population, a deviation from the normal parameters by 18-20% is detected. This result must be compared by a specialist with information from other laboratory and instrumental diagnostic methods.

If prostate cancer is detected at this stage, the chances of recovery are 85-95% after appropriate treatment procedures:

• surgery - the most organ-preserving operation, with excision of the tumor focus within healthy tissues;
• radiation therapy - before and after surgery, in order to reduce the size of the neoplasm, destroy cancer cells;
• hormone therapy - the creation of conditions unfavorable for the growth and reproduction of atypia cells in the prostate.

The optimal set of therapeutic measures is selected by a specialist individually.

Symptoms of stage 2 prostate cancer

Cancer patients at this stage of the disease often feel discomfort and soreness when visiting the toilet room. Unpleasant manifestations accompany the moment of sexual intercourse. Ejaculation is also painful. In the bloodstream, PSA parameters are moderately elevated, which is not always typical, since such a manifestation can also accompany benign processes in the prostate.

Since at the 2nd stage of the oncological process, the focus, as a rule, does not go beyond the organ, although there may already be several nodes, the prognosis for a cure remains quite high - up to 80-90%. With timely and adequate treatment, the five-year survival prognosis reaches 85-95%.

Specialists tend to resort to the most minimally invasive techniques for removing the cancer focus - the laparoscopic prostatectomy technique. In the absence of the possibility of its implementation, for example, in the case of other conditions in a cancer patient that prevent surgical intervention, complex treatment is carried out - radiation therapy, brachytherapy. The essence of the latter is to place a miniature source of radioactivity in the tissues of the prostate. The procedures are repeated several times, with a mandatory evaluation of the treatment and breaks of 6-8 days. Combined treatment is successful in 70-80%.

Brachytherapy allows specialists to select doses of exposure to the tumor on an individual basis, which is almost impossible to achieve with remote irradiation. Therefore, the risk of additional trauma to neighboring tissues and tissue organs is reduced.

Symptoms and tactics of treatment of stage 3 prostate cancer

In the case of high PSA parameters, the Gleason index and information about the exit of the tumor focus beyond the prostate gland, we can already talk about a malignant process at the 3rd stage of its formation.

A cancer patient complains that he is almost constantly pestered by pain impulses in the groin, sacrum, or their movement along the hips, lower back. Visiting the toilet room causes serious difficulties - the need to urinate occurs frequently. But the stream of urine is sluggish, thin, with a small amount of fluid released. Sometimes there is a presence in it of redness, sperm. After going to the toilet, there is no satisfaction, discomfort and incomplete emptying of the bladder persists.

Soreness worries a man during sexual intercourse. The measures taken by him to eliminate discomfort are ineffective, analgesics stop the pain only for a short time. Or they don't work at all.

With the progression of a negative state, appetite worsens, symptoms of exhaustion appear, damage to neighboring organs - intestines, kidneys, temperature fluctuates.

The tactics of treating prostate cancer at this stage are necessarily complex:

• excision of foci of oncoprocess by various methods;
• radiation and chemotherapy;
• cryotherapy, hormone therapy.

However, it is quite difficult to stop the tumor process in stage 3. Most often, therapeutic measures only stop the spread of the tumor, improve the quality of life of patients. It is necessary to constantly monitor the patient's state of health by the attending oncologist, to conduct complex examination methods.

Symptoms and tactics of treatment of stage 4 prostate cancer

At the last, fourth stage of its formation, the oncoprocess in the tissues of the prostate gland is so characteristic that the diagnosis does not cause difficulties for specialists.

Men complain about the following changes in their health:

• false frequent urge to empty the bladder, especially at night;
• excretion of urine in extremely small portions - the jet is intermittent, sluggish;
• episodes of acute urinary retention;
• a feeling of severe discomfort, burning in the urethra, blood in the urine;
• intense and prolonged pain impulses in the groin, radiating to the area of ​​the sacrum, thighs, ribs;
• appetite is almost completely absent, up to anorexia, weight is steadily decreasing.

Conducted instrumental studies reveal multiple metastases in the nearest and distant organs. Rapidly progressing secondary cancer is formed, which further worsens the condition of the person.

The tactics of treatment is aimed at maintaining the basic vital functions:

• infusion therapy;
• plasmaphoresis, hemosorption;
• chemotherapy;
• if a tumor of the kidneys and ureters is affected, surgery is performed to apply a nephrostomy;
• vitamin therapy, a complete balanced diet, taking hepatoprotectors.

Great importance is attached to adequate anesthesia, up to the use of narcotic drugs - strictly under the supervision of a specialist, with correction of doses and multiplicity.

It is currently impossible to completely cure prostate cancer at its terminal stage. However, with properly selected therapeutic measures, it is possible to extend the life of a cancer patient for the maximum possible period of time. In the absence of severe concomitant pathologies and extensive lesions of the prostate tissues by the tumor process, we can talk about 5-7 years of a completely full life. Great importance is attached to compliance with the recommendations issued by the oncologist.

Survival prognosis

In the absence of adequate antitumor treatment tactics and the age of a man after 65-75 years, the five-year survival prognosis at any stage of prostate cancer is extremely unfavorable. A person has to live no more than 2.5-3 years.

However, with timely treatment and the use of modern anti-cancer methods of combating a tumor focus in the prostate, the chances of getting rid of the disease are quite high - they reach 85-95%.

In the case of diagnosing a cancer node within the organ capsule at stage 2, we can talk about a five-year survival rate in 75-85% of cases. A cancer patient will have to undergo a complex multi-stage treatment.

The chances of a man with stage 3 prostate cancer are somewhat lower - only every third of the cancer patients has a chance to recover. The efforts of specialists are aimed at maximizing the life of the patient, maintaining the activity of important functional systems.

The most unfavorable prognosis, of course, is when diagnosing pathology at stage 4. In this case, we are talking only about the implementation of palliative care - to improve the quality of life: pharmacotherapy with pain relief.

Among all types of oncology in men, prostate cancer is considered the most common. At least 400,000 cases of the disease are recorded annually in the world, and in Russia, 6% of mature men suffer from prostate cancer, most of whom have crossed the 60-year mark. The causes of this disease have not been identified, and obvious symptoms and signs appear only in the later stages.

In medicine, prostate cancer is known as prostate carcinoma or cancer. This type of tumor is formed from the alveolar cellular elements of the prostate. In most cases, they form closer to the edges of the gland, in 5-10% of cases, neoplasms are found in the central part of the organ. In 20% of cases, a malignant tumor is located between the lobes of the gland, that is, in the transitional part.

Causes

The main causes of cancer in the prostate are completely unknown. Oncologists tend to assume that the dominant role in the formation is played by hereditary predisposition and age-related changes - more than 2/3 of all cases of prostate cancer are diagnosed in elderly men. According to statistics from the World Health Organization, Native Americans and African Americans are more susceptible to the disease. The smallest number of patients was recorded among Asians.

There are many types of prostate cancer. The main types of tumors, see the figure below.

The following provoking factors or secondary causes of a malignant tumor of the prostate are distinguished:

• age-related hormonal changes;
• the predominance of animal food in the diet - red meat, solid fats;
• deficiency in the diet of foods containing vitamin A and other antioxidants;
• carriage of retroviruses;
• intoxication of the body with cadmium, asbestos, and other chemicals;
• long-term regular exposure to the body of ultraviolet and other types of radiation.

Increase the risk of oncology and bad habits: smoking, alcoholism, and physical inactivity. Obesity can also affect the likelihood of developing a malignant tumor in the prostate gland. None of the above reasons is dominant.

A combination of several unfavorable factors is necessary for the formation of a tumor.

Symptoms

There are no characteristic signs of prostate cancer. The disease is characterized by symptoms that disturb patients with prostate hyperplasia:

• increased urge to urinate;
• weakening and interruption of the stream of urine;
• urinary retention;
• the need to strongly strain the press when emptying the bladder.

The listed symptoms at an early stage are shown at first poorly, and then amplify in process of growth of a tumor. Later, hematuria is added to them - an admixture of blood appears in the urine, it can also be released drop by drop from the urethra.

Later stages of prostate cancer are characterized by severe symptoms with signs of damage to the lymph nodes or bone tissue, most often the pelvic bones.

Interesting fact! It has been established that in prostate cancer, metastases are found only in the lymph nodes or only in the pelvic bones.

In contrast to the symptoms at an early stage, which are limited to a violation of the functions of the urinary system, advanced cancer with metastases is accompanied by general symptoms:

In men, weight loss is observed, body temperature periodically rises, stool is disturbed. Such symptoms indicate the spread of the malignant process to other organs. Most often, the tumor grows in the rectum and large intestine, pelvic floor muscles and urethral sphincter, bladder walls.

stages

There are several classifications that describe the prevalence of the pathological process in prostate cancer:

1. The international TNM system, in which T is the size of the primary tumor, N is the status of regional lymph nodes, and M is the status of distant lymph nodes.
2. The Jewet-Whitemore system, in which the stages of prostate cancer are indicated by the first letters of the alphabet (A, B, C, D), while the first two degrees are considered curable, and the latter, although treatable, have poor prognosis.
3. The level of PSA in the blood. The amount of this specific protein (oncomarker) suggests the size of the tumor and its prevalence.

In general, despite some differences, the classification of stages of prostate cancer is as follows:

• The initial, early stage, in which malignant cells are well differentiated and are located in one or both lobes of the prostate, but the tumor is not palpable. Specific symptoms at an early stage are absent or insignificant. The prognosis for this stage is favorable with timely diagnosis and treatment.
• The second stage, in which the malignant neoplasm is palpated, but, just as in the previous stage, does not go beyond the boundaries of the gland. Symptoms and treatment at this stage are more difficult than at the first, but the outcome is favorable in most cases.

• The third stage, in which the malignant formation goes beyond the boundaries of the prostate capsule, there are pronounced symptoms. Survival prognosis is less favorable, but with adequate treatment, five-year survival rates are good.
• The fourth final stage, in which metastases appear in adjacent and distant organs. Symptoms and treatment at this stage are the most difficult, and the prognosis is poor. Even after several courses of therapy, metastasis continues.

In Russia, unfortunately, prostate cancer is detected in most cases at stages 3 and 4. This is due to the fact that men are in no hurry to find out the causes of unpleasant symptoms, but try to cope with them on their own with the help of folk remedies or completely ignore them.

Diagnostics

For the diagnosis of prostate cancer, a set of procedures is used:

• laboratory blood test for PSA level;

• laboratory examination of urine for specific tumor markers;
• digital examination of the prostate;
• transrectal ultrasound of the prostate;

• laboratory study of a biopsy (material taken with a needle from the prostate gland) for malignant cells and calculation of the "Glisson sum";
• radioisotope research;
• MRI or CT scan of the abdomen and pelvic organs;

• urofluorometry.

During the diagnosis, other pathologies are excluded that are accompanied by the formation of focal seals in the organ (chronic prostatitis, fibrosis, sclerosis, prostate stones, and others). This must be done first of all, since it is necessary to treat these diseases by various methods.

The most informative way to differentiate the diagnosis is histological or cytological examination.

Treatment Methods

The choice of how to treat prostate cancer depends on several factors, including the aggressiveness of the tumor cells and the stage of the disease. At stages 1 and 2, when there are no metastases, the following methods of therapy are used:

• prostatectomy - radical removal of the prostate gland and seminal vesicles;

• radiation therapy - irradiation of the gland and regional lymph nodes with x-rays;
• ultrasonic ablation of the prostate gland - targeted local destruction of the affected cells of the prostate by high-intensity ultrasound;
• interstitial radiation therapy (brachytherapy) - the introduction of grains with radioactive preparations into the prostate;

• cryoablation - local "freezing" with subsequent destruction of the affected tissues of the prostate.

Less often than others, the method of monotherapy with antiandrogens is used, and when an initial stage of a tumor is detected and patients over 60 years of age, expectant tactics are used, since it is not always advisable to treat the disease in them - according to statistics, survival in this group without therapy is equal to the results in the group undergoing full treatment.

At stages 3 and 4, which are characterized by the presence of metastases, treatment involves the use of the following methods:

• hormone therapy in conjunction with external beam radiation therapy;
• monotherapy with antiandrogens or GnRH antagonists;
• medical castration, which involves lifelong use of special drugs;
• intermittent therapy;
• surgical castration.

When the tumor spreads to nearby organs and lymph nodes, ultrasound ablation is used, while advanced forms of cancer are treated symptomatically or palliatively. Relief of symptoms and slowing down of pathological processes is achieved by taking hormonal drugs and potent (often narcotic) analgesics.

Complications

Complications in prostate cancer appear both as a result of pathological processes and as a result of treatment. The most common complications doctors call:

• gross hematuria - a large amount of blood in the urine;
• renal failure resulting from acute urinary retention;
• acute pain in the abdomen due to urinary retention;
• exhaustion of the body and signs of general intoxication - weakness, nausea, stool disorders, fever;
• disruption of the internal organs affected by metastases (liver, kidneys, lungs).

After surgery, radiation, hormonal and chemotherapy, men also experience various complications, including bleeding, intoxication, hair loss and dysfunction of internal organs.

Prevention

There are no specific measures to prevent the occurrence of prostate cancer. The only way to avoid complications is early detection of pathology. For this, men over 40 are recommended to visit a urologist annually and undergo a preventive examination. Men over the age of 45 are recommended to have their PSA tested annually. Any problems with urination should be a reason for examination.

Also, do not ignore the first signs of cancer. For more information about them, see the video:

You can reduce the risk of developing a malignant tumor in the prostate gland if you follow the general principles of cancer prevention. They include giving up alcohol and cigarettes, a full-fledged balanced diet, and an active lifestyle.

A dangerous oncological disease that affects males is considered. The article will give brief information about what kind of disease it is and what signs it has. Also from it, everyone can learn how to get rid of this unpleasant disease.

What is prostate cancer

It is characterized by the formation of a malignant tumor in the prostate gland. This disease affects males over 65 years of age. However, cases have been identified when prostate cancer occurred in young males. The danger of this disease is that the first signs of prostate cancer do not appear.

It is noteworthy that the disease affects only the prostate and does not affect neighboring organs. As a result, almost all men are carriers of this disease. Also, all males should be aware of the symptoms of prostate cancer.

Causes of Prostate Cancer

These include the following manifestations:

• the presence of hormonal disorders in a man;
• heredity;
• eating a small amount of foods rich in fiber, pectins;
• a man has chronic prostatitis;
• overweight and the development of a disease such as diabetes;
• the presence of bad habits and excessive consumption of alcoholic beverages;
• poor ecology in the place of residence;
• work in difficult working conditions, especially with chemical elements;
• male sterilization by vasectomy;
• eating fatty foods;
• advanced age of the patient;
• decreased immunity;
• frequent stress;
• the appearance of inflammation in the prostate.

If a man is thinking about how to determine prostate cancer, you should be well aware of the signs of this disease. This will help to come to the doctor's appointment earlier and prescribe timely treatment.

In addition, there are conditions that indicate prostate cancer in men.

These should include:

• Atypical prostatic hyperplasia. It is characterized by the appearance of nodules. The cells have a modified structure and are actively spreading, an oncological neoplasm occurs at the site of the appearance of the nodule.
• Hyperplasia with malignancy. With it, some cells begin to actively multiply and with an increase in their number, they degenerate into oncology.

It is noteworthy that the development of these diseases indicates the development of prostate cancer at an early stage.

Signs of prostate cancer

Prostate cancer can be detected before the onset of symptoms. For this, a man needs to undergo a comprehensive examination and engage in prevention.

Doctors note that the main symptoms of the development of prostate cancer in the body are:

• The occurrence of disorders during urination. A man begins to visit the toilet very often, especially in the evening and at night. During urination, urine is very difficult to excrete. After going to the toilet, he is not let go by the feeling of overflow in the bladder. Most often this leads to the appearance of impotence.
• The presence of pain and cramps when going to the toilet room.
• The appearance of hematurgy. It is characterized by urinary retention and its discharge with blood clots.
• Having pain in the bladder. Usually, this sign appears when the size of the tumor increases. In addition, a person is concerned about pain in the lower back, perineum, anus and sacrum.
• Kidney failure and aching pain in the back.
• The appearance of bone metastases.

With prostate cancer, a man may be disturbed by the following unpleasant symptoms:

• dryness in the mouth;
• constant feeling of thirst and loss of appetite;
• the appearance of causeless vomiting and nausea;
• confusion;
• the presence of edema and trembling in the legs;
• shortness of breath and chest pain;
• difficulties during physical activity, frequent headaches;
• violation of brain activity and the presence of urinary incontinence;
• the appearance of back pain;
• the presence of blood during bowel movements.

It is noteworthy that the development of all these signs leads to disorders in the urinary system and negatively affects the functioning of the kidneys: this happens when cancer cells are located in the seminal vesicles and have an excessive effect on the ureter. Symptoms of prostate cancer often indicate the development of other diseases.

Many of the signs of prostate in men do not appear at an early stage in the development of the disease. Even the presence of bone metastases manifests itself in the form of aching pain in the pelvis and lower back.

Urinary tract infection, prostate adenoma and prostatitis have slightly different signs than oncology.

Many experts note that a man should not confuse two different concepts: "prostate cancer in men" and "prostate adenoma". The latter concept characterizes the appearance of a benign tumor. In addition, a man should not forget that adenoma can develop both inside and outside. Prostate cancer only develops outward.

If prostate cancer occurs in men with one of the above signs, he should immediately contact a specialist for diagnosis and timely treatment. It is important to remember that the sooner the symptoms are identified and the treatment is carried out, the more effectively and without any consequences you can get rid of the disease.

Diagnostics

Initially, the patient should go to the doctor's office. He will collect the necessary information and test results. Only after that the specialist prescribes competent treatment.

In addition, as additional methods of examining a patient with prostate cancer, the following are used:

• A patient undergoing a digital rectal examination. It is aimed at examining the prostate by internal palpation of the navel and prostate gland;
• The use of transrectal ultrasound. With it, a study of the prostate is carried out by introducing a medical probe into the rectal area of ​​the patient. This method helps to study the size, shape and contours of the prostate gland.

In addition, with prostate cancer, the doctor may refer the patient to take blood and urine tests, as well as undergo a biopsy. In the event that the patient is diagnosed with prostate cancer, then he will also need to undergo the following tests: CT of the lungs, bone scintigraphy and ultrasound of the abdominal cavity.

Treatment

The method of treatment is chosen by a specialist depending on the stage of the disease. For stages 1 and 2 of oncology, the following types of treatment procedures are used:

• Carrying out a radical prostaectomy. It is based on surgical intervention and removal of the prostate and nearby organs. This method has side effects in the form of urinary incontinence and impotence. Currently, the removal of the prostate is performed using da Vinci prostatectomy, which completely eliminates the occurrence of side effects.
• The use of radiation therapy. It is usually used in the absence of metastases to other organs. It is produced by external irradiation of the problem area or the introduction of radioactive substances into the problem area. The drugs have a negative effect on the DNA of cancer cells and contribute to their death.
• The use of cryoablation of the prostate. It is considered the most modern method of getting rid of prostatitis. It is aimed at the destruction of the problem area.
• The use of monotherapy with the use of antiandrogenic drugs. Usually carried out with medical and surgical castration. This method is used extremely rarely, since there is a high probability of side effects: impotence, osteoporosis, gynecomastia.

Severe prostate cancer with the presence of metastases can be treated in slightly different ways. They are aimed at alleviating the patient's condition and reducing the negative impact of the symptoms of the disease. They are also aimed at prolonging the life of the patient, since there is no complete elimination of severe stage prostate cancer.

These methods should include:

• Use of hormone therapy. Usually carried out in conjunction with radiation therapy. It is aimed at reducing the production of male hormones. This helps to reduce the size of the neoplasm and normalize the patient's condition.
• The use of chemotherapy. It is aimed at the patient's use of medications that reduce the activity of cancer cells. The disadvantage of this method is that the drugs also affect healthy human tissues. As a result of this, a person has unpleasant symptoms such as baldness, digestive disorders, and a decrease in immunity.

For older men, the watchful waiting method is usually used. It is based on stopping treatment and monitoring the development of a cancerous tumor. Monitoring is carried out using ultrasound diagnostics. This method is used only in the absence of an excessive increase in the neoplasm.

Currently, there are no standard methods for getting rid of a patient. All methods of treatment are selected for the patient according to an individual scheme.

Prevention of prostate cancer

To avoid the occurrence of this unpleasant disease, the patient should adhere to the following simple rules:

1. Carefully monitor your diet.
2. Reduce the consumption of large amounts of fatty foods.
3. Eat more foods containing phytoestrogens and antioxidants.
4. Stick to a healthy lifestyle.
5. Give up bad habits and excessive alcohol consumption.
6. Do more sports.
7. If necessary, use medications prescribed by a specialist.
8. Undergo a comprehensive examination of the whole body and take tests to determine the level of PSA in the blood, TRUS of the prostate, digital rectal examination of the prostate.

Prostate cancer is considered a very dangerous disease, but following all the necessary recommendations and undergoing a comprehensive examination of the body will help reduce the risk of its occurrence by several times.

Prostate cancer is diagnosed by registering the proliferation of glandular cells of the prostate gland, the presence of which is characteristic only for men. Due to its significant contribution to the sexual life of the body, the prostate is called the "heart" of the masculine principle - the release of androgens (male sex hormones) and the liquid part of the ejaculate, which is necessary for transporting and feeding spermatozoa during fertilization, depend on it.

Just like tumors of the mammary glands, ovaries and uterus in women, prostate carcinoma is the most common malignant neoplasm in men. At the same time, there is a special correlation by race: among Negroids, about one and a half times more often than among Caucasians, and representatives of the Mongoloid race, in particular, the Japanese, are twice as rare.

It has been established that age is a determining risk factor for prostate cancer, since after 35 years it is found only in one out of 10 thousand men, after 60 - already in every hundredth, and among those who have reached 75 years, every eighth man suffers from carcinoma. In connection with this situation, WHO experts recommend that all men who have reached the age of 50 pass all the necessary tests to prevent aggravation of the disease.

What is prostate cancer?

- This is a malignant neoplasm that develops from the cells of the prostate gland.

Anatomy of the prostate. The prostate is an endocrine gland that is located in men in the pelvic area, its average size is 3-4 cm. Due to the fact that the prostate is located around the urethra, its enlargement, provoked by a cancerous tumor, causes urinary dysfunction.

The prostate gland is located inside a capsule of connective tissue, contains elastic septa separating the prostatic glands. Consists of three parts - right, middle, left. In this gland, prostatic juice is produced, it is excreted during the contraction of smooth muscle muscles. The prostate is involved in the production of spermatozoa, increases their activity and vitality, is responsible for the quality of sperm and its excretion. Plays an important role in the implementation of male sexual function.

Functions of the prostate. For a more accurate understanding of the nature of the disease, it is necessary to understand in detail the main functions of the prostate gland. The main features of the functioning of the prostate are that it produces a certain part of the seminal fluid. According to experts, we are talking about more than a third of the total. She is also responsible for participating in the process of eruption of the seed.

Another key function of the prostate is that it has everything to do with any man's ability to retain urine. That is why this gland is of great importance for the health of the male body.

How long do people live with prostate cancer?

In this, as in any other case related to oncology, it is very important to detect the disease as early as possible. However, the prognosis is most often unfavorable due to late detection and the occurrence of a significant number at an early date. Thus, approximately 90% of cases of prostate cancer are detected at the third or fourth stage.

Therefore, answering the question of how long they live with prostate cancer, we can say that everything depends on the stage of the disease at which treatment was started. Radical type prostatectomy, which was carried out at an early stage of oncology in patients under the age of 70, is a guarantee of 10 or even 15 years of survival. In general, after a timely treatment course, the five-year survival rate for the first or second stage is 85%, the third -50%, the fourth - no more than 20%.

Metastases of prostate cancer capture distant areas, due to the spread of cancer cells through the blood and lymphatic vessels. Most often, pain in the pelvis, swelling of the legs in the ankles or feet with prostate cancer means an increase in the number of metastases and the fact that the cancer has become aggressive.

Modern research links the causes of prostate cancer with chronic diseases and inflammatory processes that affect the prostate and provoke pathological changes in its tissues.

Common causes of prostate cancer include:

Hormonal imbalance - since a prostate tumor is hormone-dependent, its occurrence and growth can be triggered by an increase in the level of dihydrotestosterone and androstenedione (male sex hormones).

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  The growth of prostate cancer is influenced by male sex hormones, an increased concentration of which leads to an increase in the size of the neoplasm. This is the reason for the effectiveness of drug therapy - with a decrease in the amount of androgens and a decrease in the susceptibility of tumor cells to their effects, its growth slows down significantly. The result of such treatment is more pronounced if it is applied at an early stage of the disease. But it is possible to slow down the growth of an oncological tumor and increase the patient's life expectancy with the help of drug treatment even at an advanced stage of cancer.

  Hormone treatment

  It is used at the fourth stage of cancer, when surgical treatment is ineffective and can only aggravate the patient's condition, and remains the only available treatment for oncological tumors in elderly people with chronic diseases.

  Hormonal drugs for the medical treatment of prostate cancer:

  Analogues of pituitary hormones- after their use, the level of androgens in the blood of men drops to a state that occurs after surgical castration. But unlike surgery to remove the testicles, this phenomenon is reversible - at the end of hormones, testosterone levels are restored. Preparations of this group - Lyukrin, Diferelin, Decapeptil, are used by injection.

  Antiandrogens - prevent the interaction of pathological cells with adrenal hormones, the combination of antiandrogens with pituitary hormones in medical practice is called maximum androgen blockade and is one of the most effective methods of drug treatment of cancer. The drugs in this group include Flucin, Casodex, Anandron.

  Gonadotropin-rising hormone antagonists, which lower testosterone, slowing down the growth of oncogenic neoplasms, and in addition, stimulate cell differentiation, due to which they turn from pathological into typical cells for prostate tissues. Preparations of this group - Fosfestrol, Firmagon, Diethylstilbestrol.

  They begin treatment with antiandrogens - in some cases, Casodex is enough to slow down the growth of the tumor, while maintaining the male's sexual function.

  Hormone therapy in patients under 60 years of age is carried out in combination with cryotherapy - tumor freezing. When freezing, ice crystals form in pathological cells, which destroy them. Hormones are also prescribed in combination with radiotherapy.

  A radical method of treating prostate cancer as part of hormone therapy is the removal of the testicles, after which the production of testosterone is irreversibly reduced. It is rarely used due to the severe psychological trauma that most men experience after this operation.

  Monoclonal antibodies

  Monoclonal antibodies are classified as methods of cancer immunotherapy, which are rarely used in our country, and were approved in America in 2006. Vaccines are being developed based on these drugs, containing antibodies that the body's own immune system uses to fight cancer cells.

  Virotherapy

  One of the modern methods of treating prostate cancer involves the use of viruses that selectively destroy cancer cells, making it easier for the body to fight cancer. One of the most promising drugs in this group is ECHO 7 Rigvir, which allows you to stop tumor growth and activate the immune system to fight pathological cells. It is prescribed in the early stages of cancer before and after surgical treatment.

  At the fourth stage of cancer, a therapy is prescribed that does not destroy the tumor, but slows down its growth and the spread of cancer cells throughout the body, and also improves the patient's well-being, reducing pain. After surgical treatment, patients can live from fifteen years or more with successful therapy. Treatment of prostate cancer in the later stages is difficult due to the intensive growth and spread of tumor cells, but modern research in this direction will make it possible to overcome the disease in the near future.

  
  
  

  The prognosis for patients with prostate cancer depends on the stage at which treatment was carried out. Experts have the concept of "five-year survival", which allows to assess the success of treatment. So, for patients who went to the doctor at the first stage of cancer, the five-year survival rate is more than 90% - that is, more than 90% of people live 5 years or longer after treatment. For the second stage of cancer, this figure is 80%, for the third and fourth - 40 and 15%, respectively.

  If the patient asked for medical help at the first stage of the disease, then as a result of therapy, he manages to completely restore control over the function of the bladder, sexual function, remove the tumor and return to working capacity. After successful treatment, the negative manifestations of prostate cancer are eliminated, the disease does not reduce life expectancy.

  At the second and third stages, the success of treatment largely depends on the professionalism of the doctor and the patient's health, age and general well-being. Therapy takes longer, the treatment is more complex, but the chances of success are quite high - the life expectancy of most patients after treatment is 15 years or more.

  At the fourth stage of prostate cancer, the prognosis is unfavorable - few of the patients manage to live more than seven years after long-term combination therapy.

  It is important to know! Selenium reduces the risk of prostate cancer by 63%! What foods contain selenium?

  Prevention of prostate cancer

  
  

  To date, medicine cannot offer a 100% way to prevent cancer, but if you follow the general recommendations for maintaining a healthy lifestyle, the risk of cancerous growths is minimized.

  Regular sleep is a necessary condition for maintaining the health of the whole organism, it is in the process of sleep that melatonin is produced, a hormone that prevents the occurrence and growth of tumors.

  Healthy diet - include more fruits and vegetables in the menu, cruciferous, legumes, garlic, onions, citrus fruits, leafy greens and yellow vegetables are especially useful for maintaining the antioxidant defense of the body. Eat lean meats, fish and seafood, prefer vegetable fats and cereals that are rich in dietary fiber, easily digestible protein, vitamin E and phytosterols.

  Avoid carcinogens - carcinogens that provoke the development of tumors can enter the body with food, polluted air or water; tobacco smoke, products with aromatic and flavoring additives contain carcinogenic substances, their concentration is increased at chemical industry enterprises.

  Preventive examination by a specialist - over the age of 50 men are recommended to screen the prostate for cancer at least once every two years and once a year for men with adenoma, prostatitis and other pathologies. Screening includes an ultrasound of the prostate and a blood test for prostate antigen.

  Physical activity helps to avoid congestion in the prostate, strengthens the walls of blood vessels and is the prevention of atherosclerosis and cardiovascular diseases. Gymnastics in the morning and an evening jog or walk for forty minutes allows you to neutralize the harm caused to the body by a sedentary and sedentary lifestyle.

  Regular sex life - prevents congestion and inflammation in the prostate gland, enhances pelvic circulation and metabolic processes in the tissues of the prostate.

  

  Education: completed residency at the Russian Scientific Cancer Center named after N.N. N. N. Blokhin” and received a diploma in the specialty “Oncologist”

Update: December 2018

The prostate gland is a small organ located under the bladder that surrounds the urethra. The function of the prostate is difficult to overestimate, because it is the juice of the prostate gland that supports the vital activity of spermatozoa outside the testicles. In this article, we will look at such an oncological disease as prostate cancer, the symptoms, treatment and causes of this disease.

Disease statistics

Prostate cancer is a tumor localized in the prostate gland, which is malignant in nature and poses a serious threat not only to sexual function, but also to the life of a man. Another name for cancer is carcinoma.

In Europe, this is one of the most serious diseases of the male part of the population, which occurs in 214 people out of 1000 studied. It should be noted that the incidence of prostate cancer in different regions varies. For example, in Sweden, the disease in question accounts for 37 percent of all cancer cases.

Prostate cancer is a disease that has a close relationship with genetics and human age. More often among patients there are men whose age exceeds 40 years.

Some patterns, causes of prostate cancer

The cause of prostate cancer is currently an open question. Scientists have established an unambiguous relationship between the occurrence of prostate cancer and two factors:

• Age

Over the years, hormonal changes occur in the body of a man. Next, there are changes in the prostate gland that can lead to cancer. It was found that prostate cancer directly depends on the level of testosterone in the blood. Therefore, men of middle and advanced age are susceptible to the disease. In young people, cancer is extremely rare and only in the case of a hereditary predisposition or under the influence of serious mutagenic factors.

• Heredity

The risk of the disease doubles if a man has prostate cancer patients among his close relatives. If relatives of the first or more degrees of kinship were sick, the risk is reduced, but there is a place to be. Hereditary prostate cancer differs from other etiological types of the disease only by an earlier date of occurrence (with a difference of 6-7 years).

Other factors by which a person can be classified as a risk group are currently established, but not proven, but they exist:

• Lifestyle

Lifestyle significantly affects the possibility of developing a cancerous process in the prostate gland. The presence of bad habits significantly increases (in unproven proportions) the risk of a tumor: a tendency to drink alcohol, smoke, drugs. The above substances have a powerful mutagenic effect and are able to activate the process of malignant degeneration of an existing prostate tumor.

• Nutrition

Red meat and animal fats can provoke oncology. There is no clear link between diet and cancer. But doctors recommend avoiding eating these foods if there are prerequisites for oncology.

Classification

There are 2 classifications of prostate cancer. The first refers to the standard nomenclature of all cancerous tumors, and the second, more acceptable in the case of prostate cancer, is based on the aggressiveness of the tumor. Aggressiveness is determined by the Gleason index after examining a biopsy of a cancerous tumor. The score (index) is set from 1 to 10, which means, respectively, less and more aggressive tumor.

Prostate Cancer Symptoms

There are too many manifestations of prostate cancer to accurately establish the diagnosis only by the patient's history and palpation.

In general, the symptoms of prostate cancer can be grouped into three broad groups:

• Functional disorders of urine outflow;
• Signs associated with tumor metastases that extend beyond the prostate;
• Symptoms with extensive metastasis of cancer cells far beyond the prostate.

The first group of signs is associated with the fact that the cancerous tumor begins to mechanically compress the urethra, which passes through the prostate. As a result, urination becomes painful, problematic, and irregular. This leads to stagnation of urine in the bladder, nervousness, swelling, stress.

When the tumor penetrates beyond the prostate gland, it causes additional pain to the man. In addition, erectile dysfunction, hematuria and hematospermia can be observed.

With deep and extensive metastases, cancer spreads through the pelvic region, affecting the bones, spinal cord, and nearby organs. In this case, the main symptoms of prostate cancer will be as follows:

• Pain in the pelvis and lower back of bone origin
• Anemia (see)
• Swelling of the body and limbs
• Paralysis

Stages of prostate cancer

The staging of the disease is classified according to the forms of cancer. There are 2 main categories:

TNM- Within the framework of this classification, the degree of growth of a cancerous tumor is considered:

• T - the tumor is in the prostate gland or slightly extends beyond the boundaries of its capsule.
• N - cancer cells grow into regional lymph nodes located below the bifurcation of the iliac artery.
• M - in this paragraph we are talking about distant metastases, in which non-regional lymph nodes, bones and other organs are affected.

Juit-Whitemore system- This classification divides the pathological process into stages A, B, C, D. The first 2 stages are curable, the last 2 carry more sad prospects.

A is the earliest stage., in which the patient may not experience any discomfort, and cancer cells can be single or massively localized in the prostate parenchyma.

Stage B characterizes the growth of the tumor inside the prostate to a palpable size. At the moment, cancer can be detected by a moderate increase in the concentration of the PSA protein.

Next step C, denotes the exit of cancer cells outside the capsule of the prostate gland. The tumor reaches the seminal vesicles, other organs, can block the lumen of the urethra and bladder. At this stage, cancer becomes an incurable disease.

Stage D is the final stage of cancer development. It is characterized by an increase in the number of metastases and tumor growth towards the regional lymph nodes and beyond. Also referred to as stage D and recurrent metastases after surgical treatment of prostate cancer.

It must be remembered that the stages of prostate cancer, the symptoms of which can vary greatly, are allocated conditionally. There are no clear criteria by which a tumor can be attributed to one stage or another.

Diagnostics

The following methods apply:

1. Finger diagnostics or digital rectal examination. The doctor by touch diagnoses the presence / absence of a tumor.
2. PSA (prostate specific antigen). The higher the serum PSA concentration, the more likely it is to have prostate cancer.
3. Transrectal ultrasound. More often it is referred to as TRUS (abbreviation). This is an examination of the prostate using ultrasound by inserting a diagnostic device into the rectum.
4. Biopsy of the prostate.
5. Pathomorphological study of puncture biopsies of the prostate, etc.

The first 3 methods are used as monitoring for prostate cancer. PSA is a great and easy way to monitor your prostate on a regular basis.

Before the appearance of PSA, advanced prostate cancer was detected in 30% of cases, now with regular monitoring of this blood test and examination by a urologist, advanced prostate cancer is detected only in 6% of cases, which improves the prognosis and allows timely radical treatment.

• Rarely, cases are recorded when prostate cancer analysis of the PSA remains within the normal range.
• In the treatment of the prostate, drugs can be used that lead to a decrease in the PSA level (false negative result) against the background of prostate cancer.
• BPH and prostatitis can affect the PSA value, increasing its value in the absence of signs and symptoms of prostate cancer.

Treatment of prostate cancer

The issue of treatment of prostate cancer is very important and relevant today. The decision on treatment is made based on the age of the patient.

If a man is 65 years or older and the cancer does not extend beyond the prostate gland, then there is no point in taking action. To date, mortality at this age is quite high and by no means from prostate cancer.

If the process has gone beyond the prostate gland, then the patient has no more than three years to live without treatment. All currently known methods of treatment can be represented as follows:

• Targeted therapy and chemotherapy
• hormone therapy
• Brachytherapy, radiation techniques
• Surgical interventions

Now the treatment of prostate cancer is as painless as possible.

Targeted treatment and chemotherapy

The action of drugs is aimed at inhibiting the growth of cancer cells. But this action is not specific enough, therefore, it affects healthy cells and harms the body.

As an alternative to chemotherapy, scientists have developed targeted tumor treatments. In this case, cancer cells are attacked by highly specific monoclonal antibodies. This practice allows you to minimize the side effect and greatly facilitates the treatment of prostate cancer.

Hormones

The use of a certain set of hormones can stop or seriously slow down the division of cancer cells. This type of treatment is often used as an accompaniment to surgery or radiation therapy, but can also be used independently.

Beam methods

Exposure to X-ray and other radioactive radiation has always caused fear among patients and many side effects. This is due to the fact that with extensive metastases, it is necessary to irradiate not only the tumor, but also nearby tissues and organs. In the case of a tumor localized in the prostate, this technique is less dangerous, but not advisable.

In modern medicine, less risky treatments have been developed:

• Brachytherapy

It involves inserting a special needle through the rectum, through which an isotope of iodine will be injected into the prostate. The localization of the injection is calculated exactly. The effect of the radioactive substance extends only to cancer cells, without causing systemic harm, as in the case of irradiation by old methods.

• ultrasound therapy

- this is a point effect of ultrasound on tumor cells. It has been proven that cancer cells are completely destroyed by high frequencies.

Modern methods of treatment significantly reduce the risk of side effects, and their effectiveness, on the contrary, is becoming ever higher.

Surgical manipulations

Surgery is the simplest and most effective way to destroy the tumor in the first stages (A and B according to the Jewet-Whitemore classification). As long as the tumor has not begun to grow beyond the prostate, it is really better to remove it. There are two types of operations:

• Prostaectomy

In a prostateectomy, the entire prostate gland is removed through an incision. This is the most traumatic type of surgical treatment for prostate cancer.

• Transurethral resection

Transurethral resection involves partial removal of the prostate through the urethra. Indications for this kind of procedure are the impossibility of complete removal of the prostate or intolerance to operations. It is performed by endoscopic method.

A special Da Vinci robot is widely used abroad. Surgical intervention is reduced to small punctures, all manipulations are performed by a robot controlled by a doctor. On the one hand, this is a non-contact method of treatment for the doctor, on the other hand, it is minimally invasive for the patient.

The most common questions from patients

The doctor does not prescribe treatment, but dynamic observation is shown to me. Does this mean that I have an incurable form of cancer, the treatment will be ineffective and therefore it is not prescribed?

No, this kind of observation means that the tumor is slow growing and may not even manifest itself. With dynamic observation, an examination is shown 2 times a year - digital rectal examination and PSA. Such regular monitoring without treatment allows timely detection of tumor progression and transition from observation to intensive therapy.

Studies in the United States found that men without prostate cancer and patients with a slowly growing tumor (with dynamic observation for 15 years) had the same mortality. To determine who is indicated for dynamic observation, the age of the patient and concomitant diseases are taken into account.

Dynamic observation is carried out in elderly people with an estimated life expectancy of not more than 10 years, in the absence of signs of tumor progression. This is considered more appropriate, since tumor growth is slow, and oncology treatment can worsen the patient's somatic status, having a number of side effects.

However, the choice always remains with the patient, not everyone can take expectant tactics, since this is a serious psychological test that leads to depression and a deterioration in the quality of life. There is also a risk that the tumor will progress faster than expected and then more aggressive treatment will be needed, and the effectiveness of therapy in the later stages is lower.

In what cases can treatment be ineffective?

The reasons why there may be no effect of treatment today are not well understood, but certain facts may contribute to the development of relapse:

• before preparing for treatment or surgery, the stage of the oncological process was not correctly determined due to the imperfection of the examination methods;
• during dynamic observation, the growth of the tumor was more rapid, as a result, the neoplasm went beyond the prostate capsule;
• before treatment, cancer cells had already penetrated into nearby tissues; today there are no methods that determine the spread of single pathological cells throughout the body;
• when tumor cells are insensitive to standard doses of radiation, in a situation where parts of the prostate gland cannot get into the irradiation zone or when the tumor has penetrated beyond the irradiation limits.

How long after treatment can a relapse occur?

It depends on how aggressive the primary tumor was, highly differentiated tumors relapse more slowly, low-differentiated tumors faster, usually recurrence occurs in the first 5 years, but there are cases of relapse after treatment after 15 years.

What are the symptoms of recurrent prostate cancer?

At first (in the early years), a relapse may be asymptomatic, it was previously believed that difficulties with urination, bone pain, swollen lymph nodes indicate a relapse, but this already indicates multiple metastases. Today, the onset of a relapse can be recognized by the rise in PSA. If there are no other manifestations of cancer, and PSA increases, then they speak of a biochemical relapse, and only after a few years, such a patient begins to show signs of tumor growth. Therefore, an important condition after the course of therapy is PSA control, biopsy, digital rectal examination, MRI, CT, bone scintigraphy.

Where can the tumor metastasize?

In prostate cancer, metastases can be local (regional lymph nodes) and distant - these are any organs, most often these are the femurs and humerus, spine, lungs, liver, and brain.

Does a biopsy promote tumor progression and metastases?

There are no grounds for such fears, a biopsy does not affect tumor growth, moreover, it is the most important component of diagnosis, an easy and safe procedure, a reliable method that rejects or confirms the presence of prostate cancer.

Many men are diagnosed with prostate cancer sooner or later, perhaps it would be advisable to remove the gland before cancer cells appear?

The operation cannot be a method of prevention, since this is a serious intervention with a possible complex of complications, such as impotence and urinary incontinence. In addition, prostate cancer progresses rather slowly and in many patients it does not cause death or a sharp deterioration in health, since other diseases can cause death during this time.

Is it possible to cure cancer with folk remedies or alternative medicine methods?

To date, there is not a single folk way or method of alternative medicine that can cure this disease. Moreover, it is dangerous to use only any other methods of treatment and delay effective therapy offered by specialists. Delaying treatment may increase the risk of tumor progression and metastases.

To what extent does lifestyle and nutrition affect the risk of developing cancer?

In countries where there is traditionally a high level of consumption of refined foods and excess animal fats, such as European countries, Canada, the United States, the risk of oncology is much higher than in countries whose population eats soy, rice and seafood. Also, a link was found between an increased risk of prostate cancer in men with obesity, while the risk of not only oncology, but also hypertension, increases.

It should be remembered that timely diagnosis of prostate cancer is the key to a successful recovery! Therefore, with any discomfort, do not delay the trip to a urologist.