PROSTATE CANCER
Introduction:- Prostate is a glandular organ present solely in males. It surrounds the neck of bladder & the first half of urethra and condribu...
Introduction:-
Prostate is a glandular organ present solely in males. It surrounds the neck of bladder & the first half of urethra and condributes a secretion to the semen. The gland is conical in shape and measures three cm in vertical diameter and 4 cm in transverse diameter.It has got five lobes anterior,posterior,2 lateral and a median lobe.Since the first half of the urethra meet up with it any lesion within the prostate will manufacture problem in passing urine.
Diseases of the prostate gland:-
1) Prostatitis:-
This is the inflamation of the prostate gland because of bacterial infection.
2) Benign enlargement of the prostate:-
This is a non cancerous tumour of the prostate seen after the age of 50.
3) Cancer of the prostate:-This is the 4th commonest reason for 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 increases the growth rate of cancer conjointly increases.It’s found that once the removel of testes there’s marked reduction in the scale of tumour.
Site of tumour:-
Prostate cancer is seen mainly in the posterior lobe.Non cancerous enlargement is seen in other lobes.
Changes in the gland in cancer:-
The gland becomes exhausting with irregular surface with loss of normal lobulation .Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells within the gland)
Growth :-
Growth rate is very fast in prostate cancer .The tumour compresses the urethra and manufacture difficulty in urination.
Spread of tumour:-
Metastasis in cancer of prostate is terribly early.
1) Local unfold:-
From the posterior lobe the cancer cells attend 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 internal and external illiac cluster of lymph nodes.From there cells move to retroperitonial(Behind the peritonium) and mediastinal lymph nodes(within the chest)
3) Unfold through the blood:-
Unfold of cancer cells takeplace through the periprostatic venous plexus and reaches the vertebral veins whereas coughing and sneezing and finally enders the vertebral bodies of the lumbar vertebrae.
Signs and symptoms of prostate cancer:–
Signs and symptoms depend upon the stage of the cancer. The subsequent symptoms may be seen.
1) No symptoms:-
Tumour is small and solely within the posterior lobe. This can be diagnosed accidentely.
2) Slight difficulty 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 unfold to all or any nearby areas including 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 can be retention of urine.This may cause hydronephrosis, renal failure ect.During this condition patient could get convulsions due to renal failure and eventually coma.
5) Signs of metastasis:-
Some patients come back with the signs and symptoms of metastasis.
a) Lumbo sacral pain because of 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 in the abdomen due to lesion within the abdomen.
d) Respiratory complaints thanks to cancer of mediastinal lymphnodes and lungs.
e) General weakness because of unfold of cancer to totally different components 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 search out 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 function 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;-
Provides plan concerning prostate,bladder,kidney ect.
7) C T scan:-
Additional detailed info regarding organs and tumour.
MRI of the spine:-
Gives detailed information regarding spine ,disc and nearby soft tissues.
9) Lymphangiography:-
Gives idea about lymphatic spread of cancer.
10) Biopsy to verify cancer:-
Biopsy is taken from the tumour and is send for histopathological examination below the microscope.This will 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 is coma monitoring of all important functions along with parentral nutrition and electolyte supply.
4) Specific treatment is prostatectomy(removal of prostate)
Partial prostatectomy :-
Here solely the affected lobe is removed.
Radical prostatectomy :-
Total removal of prostate along with nearby lymphnodes.
5, Hormone therapy :-
Stilbestrol is given to cut back tumour growth.Since this treatement increases the prospect for cardiovascular disease phosphorylated diethyle stilbesterol is used nowadays.
6) Chemotherapy:-Medication like cyclophosphamide, cisoplatim ect are given.
7) Radiotherapy is additionally done for some cases.
Homoeopathy:-
Homoeopathic medicine like carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur ect will be given per symptoms.Constitutional homoeopathic drugs will give nice relief and will increase the life span.
9) Yoga and meditation is also healpful.
