PROSTATE CANCER
Introduction:- Prostate may be a glandular organ gift only in males. It surrounds the neck of bladder & the first part of urethra and condribut...
Introduction:-
Prostate may be a glandular organ gift only in males. It surrounds the neck of bladder & the first part of urethra and condributes a secretion to the semen. The gland is conical in form and measures 3 cm in vertical diameter and 4 cm in transverse diameter.It has got five lobes anterior,posterior,two lateral and a median lobe.Since the first part of the urethra go through it any lesion in the prostate can produce issue in passing urine.
Diseases of the prostate gland:-
1) Prostatitis:-
This is the inflamation of the prostate gland thanks to bacterial infection.
2) Benign enlargement of the prostate:-
This is often a non cancerous tumour of the prostate seen after the age of 50.
3) Cancer of the prostate:-This is often the 4th commonest reason behind death from malignant diseases in males.
Cancer of the prostate.
Cancer of the prostate is directly linked with the male sex hormones(androgens).If the levels of sex hormone will increase the growth rate of cancer additionally increases.It’s found that after the removel of testes there’s marked reduction in the size of tumour.
Website of tumour:-
Prostate cancer is seen mainly within the posterior lobe.Non cancerous enlargement is seen in other lobes.
Changes in the gland in cancer:-
The gland becomes laborious with irregular surface with loss of traditional lobulation .Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells within the gland)
Growth :-
Growth rate is terribly quick in prostate cancer .The tumour compresses the urethra and manufacture problem in urination.
Spread of tumour:-
Metastasis in cancer of prostate is very early.
1) Native spread:-
From the posterior lobe the cancer cells go to the lateral lobes and seminal vesicles.Tumour cells also move to the neck and base of the urinary bladder.
2) Lymphatic unfold:-
Through the lymph vessels cancer cells reach the inner and external illiac group of lymph nodes.From there cells move to retroperitonial(Behind the peritonium) and mediastinal lymph nodes(within the chest)
3) Unfold through the blood:-
Spread of cancer cells takeplace through the periprostatic venous plexus and reaches the vertebral veins whereas coughing and sneezing and eventually enders the vertebral bodies of the lumbar vertebrae.
Signs and symptoms of prostate cancer:–
Signs and symptoms rely upon the stage of the cancer. The following symptoms could be seen.
1) No symptoms:-
Tumour is small and solely in the posterior lobe. This is often diagnosed accidentely.
2) Slight problem in urination:-
Here the tumour is enlarged and urethra is slightly compressed.Shortly there will be frequent urge for urination with difficult urination.
3) When the tumour spread to all or any nearby areas together with neck of bladder and urethra there will be painful urination with bleeding.Urine comes drop by drop.
4) Retention of urine:-
When the urethra is completely compressed there will be retention of urine.This may result in hydronephrosis, renal failure ect.In this condition patient may get convulsions due to renal failure and eventually coma.
5) Signs of metastasis:-
Some patients come with the signs and symptoms of metastasis.
a) Lumbo sacral pain thanks to unfold of cancer cells to lumbar and sacral vertebrae.
b) Fracture of spine due to cancerous growth in the spine.
c) Swelling, pain and fluid assortment within the abdomen due to lesion in the abdomen.
d) Respiratory complaints due to cancer of mediastinal lymphnodes and lungs.
e) General weakness because of spread of cancer to different parts of the body.
f) Anaemia thanks to involment of bone marrow and increased destruction of RBCs.
Clinical examination :-
Includes per rectal examination to feel the prostate gland,palpation of abdomen to feel the swelling in kidneys and any tumours.Patient is examined from head to foot to find out any lesions.
Investigations:-
1) Complete blood investigations;-
RBC,WBC,Platlets,ESR,bleeding time ,clotting time ect.
2) Urine analysis:-
Microscopic examination to detect pus cells,occult blood,casts,Crystals ect.
3) Renal perform tests:-
Blood urea level,serum creatinine level,electrolyte level ect.
4) Serum acid phosphatase:-
Increased in cancer of prostate.
5) x-ray of the spine:-
To detect any tumour or fracture.
6) Ultra sonography;-
Offers idea regarding prostate,bladder,kidney ect.
7) C T scan:-
A lot of detailed information regarding organs and tumour.
MRI of the spine:-
Offers detailed information regarding spine ,disc and nearby soft tissues.
9) Lymphangiography:-
Gives plan concerning lymphatic spread of cancer.
10) Biopsy to substantiate cancer:-
Biopsy is taken from the tumour and is send for histopathological examination underneath the microscope.This can detect the presence of cancer cells.
Treatment:-
1) If there is retention of urine catheterisation is needed.
2) Dialysis if kidney failure.
3) If there’s coma monitoring of all important functions along with parentral nutrition and electolyte supply.
4) Specific treatment is prostatectomy(removal of prostate)
Partial prostatectomy :-
Here only the affected lobe is removed.
Radical prostatectomy :-
Total removal of prostate together with nearby lymphnodes.
5, Hormone therapy :-
Stilbestrol is given to cut back tumour growth.Since this treatement increases the chance for cardiovascular disease phosphorylated diethyle stilbesterol is employed nowadays.
6) Chemotherapy:-Medication like cyclophosphamide, cisoplatim ect are given.
7) Radiotherapy is additionally done for some cases.
Homoeopathy:-
Homoeopathic drugs like carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur ect will be given consistent with symptoms.Constitutional homoeopathic medicine will offer great relief and will increase the life span.
9) Yoga and meditation is additionally healpful.
