PROSTATE CANCER

Introduction:-

Prostate is a glandular organ gift 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’s got five lobes anterior,posterior,two lateral and a median lobe.Since  the first part of the urethra have it any lesion within the prostate can manufacture difficulty in passing urine.

Diseases of the prostate gland:-

1) Prostatitis:-

This can be the inflamation of the prostate gland thanks to bacterial infection.

2) Benign enlargement of the prostate:-

This can be a non cancerous tumour of  the prostate seen after the age of 50. 

3) Cancer of the prostate:-This can be the 4th most typical 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 degree of sex hormone increases the growth rate of cancer additionally increases.It is found that after the removel of testes there is marked reduction in the size of tumour.

Web site of tumour:-

Prostate cancer is seen mainly within the posterior lobe.Non cancerous enlargement is seen in alternative lobes.

Changes within the gland in cancer:-

The gland becomes hard with irregular surface with loss of traditional lobulation .Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells in the gland)

Growth :-

Growth rate is terribly quick in prostate cancer .The tumour compresses the urethra and manufacture difficulty in urination.

Unfold of tumour:-

Metastasis in cancer of prostate is terribly early.

1) Native spread:-

From the posterior lobe the cancer cells visit the lateral lobes and seminal vesicles.Tumour cells conjointly move to the neck and base of the urinary bladder.

2) Lymphatic unfold:-

Through the lymph vessels cancer cells reach the interior 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 rely upon the stage of the cancer. The following 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 can be frequent urge for urination with troublesome urination.

3) When the tumour spread 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 totally compressed there can be retention of urine.This will lead to hydronephrosis, renal failure ect.In this condition patient may get convulsions thanks to renal failure and finally coma.

5) Signs of metastasis:-

Some patients come with the signs and symptoms of metastasis.

a) Lumbo sacral pain thanks to spread of cancer cells to lumbar and sacral vertebrae.

b) Fracture of spine thanks to cancerous growth in the spine.

c) Swelling, pain and fluid assortment within the abdomen because of lesion in the abdomen.

d) Respiratory complaints due to cancer of mediastinal lymphnodes and lungs.

e) General weakness thanks to unfold of cancer to completely different elements of the body.

f) Anaemia because of 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;-

Provides plan regarding prostate,bladder,kidney ect.

7) C T scan:-

A lot of detailed information regarding organs and tumour.

MRI of the spine:-

Offers detailed data regarding spine ,disc and nearby soft tissues.

9) Lymphangiography:-

Gives plan concerning lymphatic unfold of cancer.

10) Biopsy to substantiate cancer:-

Biopsy is taken from the tumour and is send for histopathological examination beneath 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 very 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 reduce tumour growth.Since this treatement will increase the prospect for cardiovascular disease phosphorylated diethyle stilbesterol is used nowadays.

6) Chemotherapy:-Drugs like cyclophosphamide, cisoplatim ect are given.

7) Radiotherapy is also done for a few cases.

Homoeopathy:-

Homoeopathic drugs like carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur ect will be given consistent with symptoms.Constitutional homoeopathic drugs will provide nice relief and will increase the life span.

9) Yoga and meditation is additionally healpful.