Prostate cancer: symptoms and signs. The first signs of prostate cancer in men: alarming symptoms of a dangerous disease

Prostate cancer (prostate carcinoma)- a malignant tumor that develops from the cells of the prostate gland. This internal genital organ is only in the representatives of the stronger sex. He is deservedly called the second male heart for playing a big role in the sexual sphere. A malignant tumor of the prostate grows relatively slowly. It can remain small for years, but, like other types of cancer, it is dangerous and forms metastases.

Prostate cancer is the most common malignant tumor in men and has become more common in recent decades. Every year, 14,000 Russians are diagnosed with prostate cancer by a doctor. But our compatriots are relatively lucky, because this disease often affects representatives of the Negroid race. But the Japanese and South Asians get sick several times less often than Europeans.

A neoplasm may occur after 35 years in 1 in 10,000, but with age, the risk of getting sick increases hundreds of times. Among men over 60 years old, one in a hundred is sick. And in old age, after 75 years, prostate cancer is found in one in eight men. Therefore, after 50 years, you need to be especially attentive to your health and take special blood tests that will indicate that there are problems with the prostate.

Anatomy of the prostate

The prostate gland is located in the small pelvis. It is located below the bladder, between the rectum and the pubis. The prostate surrounds the urethra (urethra) with a wide open ring. Therefore, its increase causes problems with the excretion of urine.

The prostate does a lot functions that provide "male strength":

1. Supports sperm production
2. Increases their activity
3. Liquefies semen with her secret
4. Helps to get rid of it
5. Increases sex drive
6. Participates in orgasm
7. Blocks the exit from the bladder during an erection

The structure of the prostate

• prostatic glands, they can be from 30 to 50 - this is the main part of the prostate. They consist of glandular epithelium and look like tubules surrounded by vesicles. Their task is to produce prostatic juice, which makes up a third of the sperm.
• Smooth muscles contract and remove prostatic juice from the gland. Its stagnation in the prostate can cause inflammation.
• Connective tissue capsule covers the gland from the outside. Inside, elastic partitions depart from it, between which the glands are located.
  The prostate can be felt through the rectum. It is located at a depth of 5 cm from the anus. Normally, the gland is resilient and elastic to the touch, without compacted areas and nodules.

Causes of Prostate Cancer

Most often, the appearance of a tumor is preceded by:

• Hormonal disbalance. The cause of the appearance of a cancerous tumor may be an increase in the concentration of male sex hormones: testosterone, dihydrotestosterone and androstenedione. They cause the growth of the gland and the multiplication of tumor cells. In connection with this feature, prostate cancer is called a hormone-dependent tumor.
• BPH and other benign changes cause the growth of cells that should not be in the gland. They mutate more often than healthy cells of the glandular epithelium.
• Prostatitis. Chronic inflammation in the prostate causes poor circulation and lack of oxygen.

Precancerous conditions

There are also precancerous conditions . They are more likely than others to lead to the appearance of a cancerous tumor. These changes may be congenital or develop in adulthood. These include:

• Atypical adenosis(atypical prostatic hyperplasia). Nodules appear in the central part of the gland, in which cells grow and multiply more actively than the surrounding ones. In addition, they change their structure. Their large nuclei indicate that the cells are in a borderline state between the norm and the tumor. It is considered an optional precancerous condition - this means that cancer can occur in its place if mutagenic factors act on the body.
• Hyperplasia with malignancy(intraepithelial neoplasia of the prostate gland). Cells in individual foci of the prostate begin to multiply actively. Gradually, they become less like typical cells of the prostate gland, and acquire the properties and signs of a malignant tumor. It is considered an obligate precancer - this means that the likelihood of a malignant tumor is very high.

1. Improper diet: the predominance of fatty foods and red meat.
2. Bad habits: alcoholism and smoking.
3. Exposure to cadmium: in rubber, textile, printing and welding shops.
4. Age over 50 years.
5. Sexually transmitted infections.
6. Stagnation in the prostate with irregular sexual activity.
7. The fall of the body's defenses, caused by prolonged stress, chronic diseases.
8. Heredity: specific BRCA 1 and BRCA2 genes have been identified that cause tumor development. Cancer in the father increases the risk of the disease in the son by 2-3 times.
9. Infection with viruses: XMRV (retrovirus), herpes type 2, cytomegalovirus.

Signs of prostate cancer

Therefore, doctors discover prostate cancer by chance when a man is being examined for another disease. Symptoms of the disease appear when the tumor has affected neighboring organs: the bladder and intestines.

1. The first signs of the disease are associated with the fact that the prostate gland increases in size. It presses on the sensitive wall of the bladder and irritates it. It causes these symptoms:
   • at night you have to get up 2-3 times to empty your bladder (normally 1 time)
   • urination during the day becomes more frequent up to 15-20 times
   • there is a strong urge to urinate that is difficult to endure
   • severe pain and burning during urination
   • pain in the perineum and pubis
2. In the event that the prostate compresses the urethra and blocks the outflow of urine from the bladder, the following signs of the disease appear:
   • difficulty starting to urinate
   • intermittent urine stream
   • at the end of urination, urine does not flow, but is excreted in drops
   • after going to the toilet, there is a feeling that the bladder is still full
3. Low bladder tone leads to the fact that you have to strain your abdominal muscles to urinate. And all the same, urine comes out slowly, with little pressure and a sluggish stream.
4. Lower back pain and the appearance of kidney stones are due to the fact that when the bladder overflows, urine rises in the opposite direction. It causes dilation of the ureter and renal pelvis.
5. In difficult cases, the exit from the bladder is blocked completely. A man cannot urinate on his own. Then you need to urgently seek medical help so that the doctor puts a catheter. This is a thin flexible and soft tube that is inserted into the bladder through the opening of the urethra.
6. The appearance of blood in the urine and semen indicates that the tumor has damaged the vessels in the urethra, bladder or seminal vesicles.
7. The appearance of metastases in the inguinal lymph nodes causes swelling of the scrotum, penis and lower extremities.
8. If the tumor has damaged the sensory nerves that lead to the genitals, then the man may suffer from problems with potency.
9. Constipation and pain during a bowel movement may indicate that cancer has affected the rectum.
10. Pain in the bones of the pelvis and spine appear in the later stages with bone metastases.
11. Secondary tumors in the liver cause heaviness in the right hypochondrium and jaundice, and dry cough indicates metastases in the lungs.

Grades and stages of prostate cancer

In order to determine the stage of prostate cancer, you need to conduct an examination. For this, different diagnostic methods .

1. Determination of the level of specific prostate antigen(PSA) in the blood.
2. Finger examination: the doctor examines the gland through the anus. So you can determine the increase in its size, elasticity, the appearance of seals.
3. Ultrasound examination of the prostate a rectal probe that is inserted into the rectum. With it, the doctor can identify seals, nodes and tumors, their size and location.
4. prostate biopsy needed when there are tumors and elevated prostatic antigen. In this case, the doctor determines whether the tumor is benign or cancerous. The study is carried out under ultrasound control. With a special needle, several pieces of tissue are taken from different areas. In the laboratory, the samples are stained and the features of the cells are studied under a microscope.
5. Computed tomography and magnetic resonance imaging needed when a biopsy has confirmed the presence of cancer. These studies help to clarify the size of the tumor and identify metastases.

I stage The tumor is microscopic in size. It cannot be felt or seen on ultrasound. It is indicated only by an elevated level of prostate specific antigen (PSA).
At this stage, the patient does not notice any signs of the disease.

II stage - the tumor grows, but does not go beyond the boundaries of the organ. It is limited to the prostate capsule. Cancer of the second degree can be felt with a digital examination in the form of dense nodes and detected by ultrasound.
With second-degree prostate cancer, urination disorders may appear, which are associated with the fact that the prostate squeezes the urethra. At the same time, the urine stream becomes sluggish, cramps and pains appear in the perineum. The need to go to the toilet makes a man wake up 3-4 times at night.

III stage - the cancerous tumor extends beyond the prostate and grows into neighboring organs. The seminal vesicles, bladder and rectum are the first to be affected. Tumor metastases do not penetrate into distant organs.
Prostate cancer of the third degree is manifested by a violation of potency, pain in the pubis and lower back. There is blood in the urine and a strong burning sensation when emptying the bladder.

IV stage - The tumor grows in size. Metastases form in distant organs: bones, liver, lungs and lymph nodes.

With cancer of the fourth degree, severe intoxication, weakness, loss of strength appear. When emptying the bladder and intestines, there are difficulties and severe pain. Often a man cannot urinate on his own and a catheter must be placed.

Treatment of prostate cancer

Expectant tactics. The advanced age of a man (over 70 years), severe chronic diseases of the heart, blood vessels and lungs can become contraindications to the treatment of prostate cancer. It can be more life-threatening than the disease itself. If the tumor is small, does not go beyond the boundaries of the gland and has stopped its development, then the doctor will suggest postponing the treatment. In this case, you will have to do an ultrasound of the prostate every 6-12 months and take a PSA test.

Operation

The surgeon makes a small incision in the lower abdomen or perineum. Through it, the gland is completely removed. The doctor also dissects the surrounding tissue and, if necessary, the lymph nodes. The operation lasts 2-4 hours. The man is currently under general anesthesia. Sometimes they do regional anesthesia (epidural anesthesia) when there is no sensitivity below the belt.

If the tumor has not gone beyond the connective capsule, then it is possible to defeat the disease in 100% of cases. But if the tumor has grown into neighboring organs, then it can also be removed, but the prognosis for recovery worsens. Additional chemotherapy or radiotherapy may be required.

Modern clinics offer treatment with the help of a special Da Vinci robotic surgeon. The doctor controls all the actions of the robotic system, which rids the body of the tumor with high accuracy. The operation is performed through small punctures, which then heal quickly. New technologies can reduce the risk of complications to a minimum. Side effects such as urinary incontinence and impotence are avoided.

Chemotherapy

Chemotherapy is used instead of surgery in stages III and IV, when the tumor has grown and metastases have appeared. Toxins are carried by the blood throughout the body, find cancer cells and destroy them. The drugs are administered intravenously in courses (Paclitaxel), sometimes they are taken in the form of tablets. In total, the treatment lasts six months.

Prostate cancer is sensitive to chemotherapy, but it is rarely given in the early stages. The reason is that chemotherapy drugs also affect healthy cells and cause many side effects (baldness, weakness, nausea).

Radiotherapy

In the treatment of prostate cancer, irradiation is carried out using special equipment - a linear accelerator. This method is called remote radiation therapy.

The doctor will advise remote irradiation if the neoplasm is large and metastases have appeared in other organs. In this case, it is necessary to irradiate not only the tumor itself, but also the lymph nodes. The course of treatment lasts about 2 months, 5 days a week. Irradiation lasts 15 minutes and is absolutely painless. After the procedure, you need to rest for 1-2 hours and you can return home the same day.

But it will be more effective to inject radioactive particles directly into the prostate. The method is called - brachytherapy. For this purpose, iridium or radioactive iodine is used. As a result of such exposure, the cancerous tumor dies off, and healthy tissues are irradiated minimally. This avoids serious side effects.

The procedure is carried out under anesthesia. There are methods when radioactive granules remain in the gland. There are also those when needles with irradiating material are inserted for a while and removed on the same day.

Radiation therapy is used to treat cancer in the early stages, and in advanced cases, when the operation can no longer be done.

Fewer complications occur if prostate cancer is cauterized with a thin beam of high frequency ultrasound (HIFU therapy). Under its influence, the protein in cancer cells is destroyed, and they die. HIFU therapy is widely used in foreign clinics.

Medication treatment

Hormone treatment

For the treatment of prostate cancer without surgery, use:

• Gonadotropin-releasing hormone antagonists: Firmagon, Fosfestrol, Diethylstilbestrol. Drugs lower testosterone levels. They inhibit tumor growth, help its cells become more differentiated (similar to other prostate cells).
• Pituitary hormone analogues: Diphereline, Lucrin, Decapeptyl. Injections of these hormones provide "medicated castration." The level of male hormones after 2-3 weeks drops as much as if a man had his testicles removed. But this phenomenon is temporary, and gradually the concentration of testosterone in the blood rises again.
• Antiandrogens: Casodex, Flucinom, Anandron. These drugs prevent tumor cells from interacting with hormones that are secreted by the adrenal glands. They are used in conjunction with analogues of the pituitary hormone. This combination is called "maximum androgen blockade" and allows you to achieve the best result in the treatment of cancer.

In men under 60, hormone treatment is combined with cryotherapy - freezing the tumor with low temperatures. Ice crystals that form in cancer cells destroy their membranes. The combined use of hormones and radiation therapy has a good effect.

If hormone treatment does not work, then the doctor will advise you to have an operation to remove the testicles. After it, testosterone levels fall and tumor growth stops. But men have a hard time undergoing surgical castration psychologically.

Monoclonal antibodies

Virotherapy

In the event that cancer is detected at stage 4, the doctor prescribes treatment that is aimed at relieving pain and improving the condition. In this case, the tumor is not removed, but they try to stop the spread of metastases.

An operation or the right treatment helps a man live 15 years or more. Research is ongoing in this area and new drugs are being tested. This gives hope that in a few years, doctors will be able to cope with the disease in the later stages.

Prognosis for prostate cancer

With the diagnosis of "prostate cancer" stage II or III, more complex and lengthy treatment will be required. Its success depends not only on the skill of the doctor, but also on the age of the man and his state of health. Life expectancy in most patients with stage II is more than 15-20 years. Patients with stage III who have successfully completed a course of treatment can live 5-10 years.

It is believed that with stage IV prostate cancer, the prognosis for recovery is unfavorable. The average life expectancy is 3 years. But a combination of treatment and the will to live can work wonders. And some men manage to live longer than 5-7 years.

Doctors have a “five-year survival rate”. He talks about what percentage of patients after treatment live five or more years. This allows you to judge what are the chances of a successful cure in patients with different stages of cancer.

Prevention of prostate cancer

1. Eat right. It is advisable not to eat fatty meats, and include a lot of fresh fruits and vegetables in the menu.
2. Avoid Carcinogens. These substances that cause cell mutation are found in tobacco smoke, nitrates, food additives, and hazardous industries.
3. Lead an active lifestyle. 15 minutes of morning exercises and 40 minutes of walking help strengthen blood vessels and the heart, and boost immunity.
4. get enough sleep. During sleep, the body releases the hormone melatonin, which protects against tumor development.
5. Avoid congestion in the prostate. Regular sex life and physical activity are especially important for people who have a sedentary job. These measures ensure the outflow of prostatic juice and help to avoid inflammation.
6. Get tested regularly. After age 50, screening for prostate cancer should be done every two years. It is necessary to take a blood test for a specific prostatic antigen and do an ultrasound of the prostate. Those who suffer from adenoma or prostatitis should be examined once a year.

Age is the main cause of prostate cancer. Over time, changes in the hormonal background occur in the male body. Such changes are especially intense in middle and old age. As a rule, prostate cancer manifests itself in the body of a man over the age of 45 years.

Treatment of prostate cancer at an early stage allows you to build an optimistic prognosis - a man can be completely cured. However, even in cases of treatment of an advanced stage of the tumor, a man's life can be significantly extended.

Prostate cancer is a tumor dependent on the level of hormones (testosterone) in a man's blood: the more testosterone in a man's body, the higher the risk of progressive tumor development.

Men with prostate cancer most often have the following symptoms of the disease:

• bloody discharge in the urine;
• problems with urination;

Most often, the signs of prostate cancer appear when the disease is already in a neglected state. The asymptomatic course of prostate cancer can also be detected if you turn to a urologist or therapist once a year for a preventive examination.

Currently, medical research has not established the causes of prostate cancer, which would have a direct impact on the development of this malignant tumor in the male body.

Nonetheless, There are quite a few potential causes of prostate cancer:

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• Negative environmental factors: for example, there is a certain risk of illness as a result of moving to a region with different climatic conditions. The new environment affects the body of a man, including his hormonal background.
• genetic predisposition factor: if one of the relatives of a man has previously been diagnosed with an oncological disease, then there is a possibility that this man will also have a dangerous neoplasm, including prostate cancer.
• Occupational causes of prostate cancer: if in the course of work a man works a lot with hazardous substances, then the risk of developing a tumor increases significantly. One of the causes of prostate cancer in this case is the interaction with cadmium: welders, electroplaters, workers in the printing house and various industries (including rubber production) are most at risk.
• Improper nutrition: if a man's diet is too low in fiber and too high in fat, then the level of testosterone in the blood becomes extremely high, which subsequently leads to the development of prostate cancer. It should be noted that overweight is not a cause of prostate cancer, that is, it cannot be the cause of this disease, however, obesity increases the risk of death from prostate cancer if the disease is already developing.
• : a factor such as ultraviolet radiation also affects the formation of a cancerous tumor in men. As a result of insufficient amounts of vitamin D in the body, the risk of prostate cancer increases. Studies have shown that the highest number of deaths from prostate cancer is observed in the northern regions, where solar ultraviolet is not enough.
• Smoking: it is definitely impossible to say that smoking is a direct cause of prostate cancer, however, all toxic substances and nicotine enter the cells and tissues of the male body, poisoning them more and more with age. Even if smoking does not become the main cause of prostate cancer, this factor will only aggravate the course of the disease.

What causes prostate cancer: we understand the etiology of prostate cancer

The etiology of prostate cancer (or adenocarcinoma) is currently considered to be not fully understood.

It is believed that the tumor develops rather slowly: the last stage of prostate cancer occurs on average 10-15 years after the onset of the tumor in the male body.

Prostate cancer can be accompanied by metastases, when tumor formations appear in other organs.: in this case, the disease can no longer be stopped, since the surgeon will no longer be able to identify absolutely all the foci of neoplasms.

Asymptomatic development is characteristic of prostate cancer, therefore, only annual diagnostics in a medical institution will help to detect the disease in the early stages.

It is worth noting

A man's age remains the main factor influencing the development of prostate cancer. According to the results of many studies, it was found that the incidence of prostate cancer in 65% -70% of cases is found in elderly men - from 60 years and older. The diagnosis of prostate cancer is quite rare for men under 45: the incidence in this age group is almost zero.

As mentioned earlier, prostate cancer comes from genetic predisposition, poor diet, lack of vitamin D, smoking, and excessive alcohol consumption. A man's profession and place of residence also play an important role.

Questions about prostate cancer

• Can penester increase the risk of prostate cancer?
  Yes maybe. Penester is popular in the treatment of benign prostatic hyperplasia. The composition of the drug includes finasteride, which promotes the breakdown of testosterone, as a result of which the transformation of the hormone into dihydrotesterone is prevented and, as a result, the growth of prostate tissue is inhibited.
  As a result of long-term use of the substance finasteride (also found in Proscar and Finast), the likelihood of developing an aggressive tumor that is difficult to treat increases significantly.
  The drug Penester has a number of side effects: libido may decrease, a decrease in the amount of sperm is observed, impotence may appear. Also, in some cases, breast enlargement (intensive growth of the mammary glands as a result of estrogen synthesis) was noted. When the first signs of side effects appear, Penester should be discontinued.
  For patients with severe urination disorders, additional monitoring should be prescribed.
• What is a PSA blood test?
  Most often, the only indicator for detecting prostate cancer is a blood test for PSA (prostate specific antigen). In the body of a healthy man, this protein is present in small amounts, and an excess of the norm may indicate the development of prostate cancer.
• What should be a normal PSA level?
  At the age of 49 years, the PSA level should be equal to 2.5 ng / ml, from 50 to 59 - no more than 3.5 ng / ml, from 60 to 69 - approximately 4.5 ng / ml. 6.5 ng / ml is the limit of normal for men aged 70 to 79 years.

Prostate cancer or prostate carcinoma is a dangerous oncological disease most often diagnosed in older and middle-aged men. Currently, the disease occupies the third position in the list of oncological diseases among the representatives of the strong half of humanity and is detected in every eighth man, regardless of his social status.

Over the past decade, there has been a trend of cancer rejuvenation, which is due to the mass exposure of the population to maintaining an unhealthy lifestyle and refusing timely diagnostic procedures. Diseases that affect the prostate gland, including oncology, prostatitis, are quite easy to treat if diagnosed in the early stages of development. When cancer of the third and fourth degree is detected, the prognosis, as a rule, is not favorable.

General characteristics of the disease

The prostate gland is an unpaired multifunctional organ consisting of glandular and muscular tissues. The list of functions of the gland includes the production of a specific sexual secretion, participation in the processes of spermatogenesis, urinary retention, and maintaining the hormonal background at an optimal level.

Any disruption in the activity of the prostate can cause a deterioration in the general well-being of a man and a decrease in the quality of life in general. This issue is especially relevant if the patient suffers from a disease of oncological pathogenesis.

Cancer or carcinoma of the prostate is a common disease associated with the development of malignancy in the tissues of the prostate gland. Due to the functional characteristics of this organ, cancer cells can metastasize and spread to other organs and tissues through the systemic circulation.

Despite the high level of development of modern medicine, an effective cure for prostatitis, cancer does not currently exist. As well as the nature of the occurrence of a malignant formation has not been studied in full. However, doctors call the following causes of prostate cancer in men as factors provoking the growth of tumor-like formation:

• hereditary predisposition. Diseases such as prostatitis, cancer, are more often detected in men who have a genetic predisposition to their development.
• Racial affiliation. According to the results of scientific research, representatives of the African nationality are especially predisposed to the development of cancerous tumors, while the incidence rate among Asians is quite low.
• Irrational nutrition. The use of excessive amounts of animal fats, starchy foods and alcohol can become a kind of impetus for starting the processes of formation of a malignant tumor.
• Age features. Mostly the disease affects men who have reached the age mark of thirty to thirty-five years.
• Bad habits. Alcohol consumption, harmful substances that affect the body when smoking, can also cause the development of cancer.

Of course, the above reasons, which can play the role of a kind of catalyst for the mechanism of triggering the growth of a cancerous tumor in the prostate, are conditional. However, the exclusion or reduction of their influence, the maintenance of a healthy lifestyle, the rejection of addictions may well delay or exclude the development of a malignant neoplasm, as well as improve the quality of life in general.

Stages of the disease

The difficulties that a patient will have to face in the process of carrying out therapeutic measures aimed at treating prostate cancer are directly proportional to the stage of development of a cancerous neoplasm. There are four main stages, each of which is characterized by a certain size of the tumor, the presence or absence of metastases.

The fourth stage of prostate cancer is determined by the development of irreversible processes, the growth of extensive metastases of a malignant tumor that affects almost all organs and tissues of the abdominal cavity. Identification of the disease at this stage of development is not associated with favorable prognosis. The probability of a fatal outcome in this case is more than 90 percent.

Important! It is possible to cure cancer and prevent its irreversible consequences only if you consult a doctor in a timely manner. It is necessary to undergo diagnostic procedures when even the most insignificant disturbing signs appear.

Clinical picture

The main feature of prostate cancer is a latent course, which can last for several years. At this stage, the detection of the disease occurs more often by chance, for example, as a result of a preventive medical examination. Signs of growth of prostate cancer, as a rule, are erased, the tumor itself is of small size and does not lead to disruption of the functioning of the prostate gland.

Quite common clinical cases are those in which a cancerous neoplasm, even having a small size, leads to the growth of metastases that affect other organs and tissues. It is the spread of cancer cells that is one of the reasons for the appearance of non-specific symptoms of oncology. The main signs of prostate cancer:

• Rapid weight loss while maintaining the usual diet.
• Complete or partial lack of appetite.
• Malaise, general weakness, fatigue.
• The appearance of streaks of hemolymph and particles of purulent masses in the excreted urine.
• Painful sensations, burning sensation and pain that appear during sexual intercourse or the act of urination.
• Constant urge to visit the toilet, while often a man notes a feeling of incomplete emptying of the bladder.
• Increasing pain that can occur in the groin, abdomen, lower back, genitals. As a rule, the causes of their appearance are the growth of metastases and cancer of the organs and systems of the abdominal cavity.
• Excretion of urine in small portions.

In the most severe and advanced cases, an increase in a cancerous neoplasm can lead to compression of the urinary tract, disruption of the outflow of urine, impotence, loss of sensation, and paralysis of the lower extremities.

Diagnostic measures

The list of diagnostic measures, through the use of which it is possible to identify a malignant formation and the stage of cancer development, is quite extensive. Depending on the primary results of the patient's examination, procedures that are not necessary are removed from the list. General examination of the patient includes the following diagnostic options:

• A blood test that reveals the value of a prostate-specific antigen, carried out in a laboratory. Through the use of this technique, it is possible to detect the presence of cancer even in the early stages of development.
• Ultrasound examination of the prostate. Depending on the size and localization of the neoplasm, various methods of ultrasound diagnostics are used.
• Palpation. Or literally probing the prostate gland and the primary determination of the size of the tumor and pathological changes in the prostate.
• Biopsy. The study of tissue particles of a malignant neoplasm, necessary for the selection of the most optimal variant of drug or other types of therapy.

When a cancerous tumor is detected, it is often practiced to use additional research methods that allow determining the size of the neoplasm, the intensity of its growth, the localization and prevalence of metastases.

Important! For the timely detection of oncological formation, men over the age of forty are recommended to undergo a complete examination using the methods given above at least once a year.

Treatment

The need for treatment of prostate cancer is determined solely by a specialist. For example, against the background of the patient's diseases of the heart muscle, pathologies of the respiratory system, as well as when the patient reaches the age of seventy, treatment can lead to a significant deterioration in the patient's condition.

Intensive therapy is not carried out if the cancer is small, does not leave the prostate capsule, does not progress and does not cause the growth of metastases. Why? This is due to the fact that tumor treatment methods can have a negative impact on the patient's condition and lead to its deterioration. In such situations, the patient is charged only with regular visits to the doctor to monitor the progression of the disease.

Cancer treatment stage 1 and 2

The first and second stages of cancer are not associated, as a rule, with the growth of metastases, and therefore the treatment used at this stage of oncology is limited to the use of tools and methods aimed at removing the tumor or stopping its further growth. Most often, in this case, the following methods are used:

• Radiation therapy. Today, the most common method of treating oncological diseases, which involves the exposure of radioactive rays to the tissues of a malignant neoplasm. Permissible and equally popular are methods of exposure to rays both from the outside and through the introduction of certain drugs into the tissues of the prostate.
• Hormonal preparations. The technique can be used only as an element of complex treatment. Taking drugs in this category can reduce the production of certain hormones, thereby stopping the development of a malignant neoplasm.
• Virotherapy. One of the innovative methods of treatment, which is currently not yet widely practiced. The method involves the introduction of certain viruses into the tissues of the prostate gland, which have a detrimental effect on the cells of the tumor formation.
• Brachytherapy. It involves the introduction of radioactive substances into the tumor tissue, which have a destructive effect on the cells of the neoplasm. The method has a number of disadvantages, since there is a risk of damage to healthy tissues.
• Chemotherapy. It implies the use of various drugs of a special category, which have a detrimental effect on foreign cells. The method, despite its prevalence, has a lot of contraindications and side effects.

Also among the common methods of treatment is a radical method of getting rid of the neoplasm, called prostatectomy, which involves the complete removal of the prostate gland, as well as, if necessary, parts of the organs located in the immediate vicinity. The method has a lot of side effects, including urinary incontinence, impotence, and a number of others.

Cancer treatment stage 3 and 4

Treatment of cancer in the third and fourth stages of development rarely involves the use of radical methods. Most often, in this case, methods are used that allow you to stop the growth of education, the spread of metastases, improve the general well-being of the patient and improve the quality and overall life expectancy. The limited number of methods used in this situation is due to the fact that a complete cure for advanced forms of cancer is not possible.

To stop the growth of the tumor and eliminate the symptoms of oncological disease, methods such as chemotherapy and radiation therapy are most often used. Additional methods and methods are also used to eliminate disturbing symptoms, increase the body's immune forces and strengthen it.

Elderly patients are often offered a method of so-called watchful waiting. According to this method, treatment aimed at stopping the cancerous tumor is not used, since its use is fraught with the development of multiple side effects. Nevertheless, a man is recommended to undergo regular medical examinations to identify trends in tumor growth and the spread of metastases. However, the use of this option is possible only in cases where tumor growth is slowed down due to natural causes and characteristics of the body.

Forecasting

According to the data obtained as a result of many years of research, a favorable prognosis of prostate cancer is possible only if the diagnosis is made in time and appropriate treatment is prescribed. When a tumor is detected in the early stages of development, a complete cure of patients occurs in nine cases out of ten.

In the second and third stages of the development of prostate cancer, the prognosis is less optimistic. In this case, an important role is played by such factors as the correctness of the selected drugs and methods used in the treatment process, the characteristics of the patient's body, symptomatic manifestations, patient compliance with medical recommendations, the degree of damage to organs located in the immediate vicinity of the prostate gland.

As for the fourth stage, in this case, the forecasts are not favorable. The maximum survival rate for patients with an appropriate diagnosis is no more than three years. In exceptional cases, this mark is increased to five years. In this case, there is a significant decrease in the quality of life of the patient.

Unfortunately, there are currently no truly effective methods for preventing prostate cancer. However, compliance with such rules as, for example, rational nutrition, giving up bad habits, following a healthy lifestyle, general strengthening of the body, will significantly reduce the risk of developing the disease, and will also help improve the quality of life in general.

In recent years, there has been a significant increase in the incidence of prostate cancer (PCa). Among oncological diagnoses in men, it occupies a leading position. Despite improvements in early detection of PCa, detection of advanced cases and mortality remain high. In 22% of patients, the disease is first diagnosed already at the 4th stage, in 35% - at the 3rd.

Despite the fact that prostate cancer in the early stages is most often asymptomatic, there are a number of non-specific signs by which this pathology can be suspected.

Changes in the prostate in the presence of cancer

The prostate gland is a small organ located in the pelvis. It consists of two lobes connected by an isthmus. Behind it adjoins the rectum, on top is the neck of the bladder, on the posterolateral surfaces - the seminal vesicles.

The prostate covers the initial section of the urethra, through its thickness pass the seminal ducts. Conventionally, the entire prostate gland is divided into 3 zones: central (closer to the bladder), transitional (middle) and peripheral, where the vast majority of malignant tumors occur.

Normally, the prostate has dimensions of 3x4x2.5 cm, its volume and shape are compared with a walnut.

With prostate cancer, it can significantly increase in size and compress the urethra. Violation of urination is the main local symptom.

With the progression of the process, general signs of the influence of cancer on the whole body (paraneoplastic symptoms) may appear.

Metastasis of the primary tumor forms a picture of damage to other organs, sometimes prostate cancer is initially manifested precisely by the influence of distant metastases.

local signs

The first symptoms of prostate cancer in men appear when the tumor is already large enough or located in the central or transitional zones.

Clinical view of the lower urinary tract

• Weakening and/or splashing of the urine stream.
• Intermittent urination.
• Increased urge to go to the toilet. Imperative urge - a sudden, strong desire to urinate, up to incontinence.
• The need to wake up at night to empty the bladder.
• Dissatisfaction after urination, feeling of incomplete emptying of the bladder.
• Urinary incontinence.
• It is difficult to start the act of urination, the need to strain. This is especially noticeable in the morning hours.
• Discomfort and burning during urination.
• Pain of a constant nature in the suprapubic region, back, perineum.

As a result of partial obstruction (blockage) of the urethra, the bladder may not empty completely, leaving a residual volume in it. If the patient ignores these symptoms and does not consult a doctor, chronic urinary retention may develop. This condition manifests itself with the following symptoms:

• Paradoxical ischuria - constant leakage of urine.
• Heaviness in the lower abdomen.
• Enlargement of the abdomen by stretching the bladder (sometimes it can reach the navel).
• Pain in the lumbar region due to distension of the renal pelvis.
• Attachment of infection and pyelonephritis.
• The development of renal failure (increased pressure, weakness, nausea, itching, swelling of the whole body).

Symptoms of sexual dysfunction

• Sexual intercourse is incomplete, does not end with ejaculation.
• Hemospermia is an admixture of blood in the semen.
• Pain during ejaculation.
• Impotence.

The defeat of the pelvic lymph nodes and the germination of the tumor in nearby organs

• Swelling of one or both legs.
• Pain of a constant nature in the lower abdomen, in the perineum.
• Hematuria is an admixture of blood in the urine with germination in the bladder or urethra.
• Constipation, false urge to defecate, mucus and blood in the feces when germinating into the rectum.

General symptoms

A growing malignant tumor tends to affect the entire body. This is due to the release of toxic metabolic products, as well as the release into the blood of biologically active substances produced by carcinoma cells.
Common and paraneoplastic symptoms of prostate cancer include:

• Decreased hemoglobin.
• Weakness, fatigue, poor appetite.
• Weight loss.
• Skin itching.
• Inflammation of the joints.
• Increase in body temperature.
• Dermatitis.
• Polyneuropathy - numbness in the limbs, weakness.

Signs of PCa metastases to other organs

Skeleton

Prostate cancer most often metastasizes to the bones (50 to 70% of all metastases). And in half of the cases - these are the lumbar and thoracic vertebrae, less often - the bones of the pelvis or thigh, there may be multiple lesions of the skeleton.

It is severe back pain that usually forces a patient with stage 4 PCa to see a doctor.

Pain in metastatic bone lesions gradually increasing, worse at night. Conventional painkillers are of little help. In the presence of screenings in the vertebrae, they are compressed, the nerve roots are squeezed, and walking function is impaired. Such patients often get pathological fractures at the slightest awkward movement.

Vertebral deformities can cause a picture of spinal cord compression. Gradually, such patients stop walking without assistance, and pelvic dysfunction may occur (control of urination and defecation is lost).

With the destruction of bones in the blood, the level of calcium rises, which can cause disturbances in the functioning of the heart (blockade, arrhythmias), from the gastrointestinal tract - constipation, abdominal pain, nausea, vomiting.

Liver

In second place in the frequency of formation of tumor screenings.

Single lesions in this organ may not give any symptoms. If there is a multiple lesion, then the following are determined:

• Yellowness of the skin.
• Pain and heaviness in the right hypochondrium with an enlarged liver.
• Expansion of veins on the anterior abdominal wall.
• Enlargement of the abdomen (ascites).
• Bleeding (nasal, rectal, gastroesophageal).

Metastases in the bronchopulmonary system

In the presence of tumor screenings in the lungs, the following signs of prostate cancer in men are possible:

• Hacking, refractory cough.
• Hemoptysis.
• Increasing dyspnea.
• Constant pain in the chest.

Brain damage

Metastases to the brain are always accompanied by neurological symptoms. Depending on the size of the foci, the number and localization, the following can be observed:

• Headaches of a bursting nature, with nausea.
• Seizures.
• Speech disorders.
• Complete (plegia) or partial (paresis) paralysis of the limbs on one side.
• Dizziness, unsteady gait.
• Mental disorders.

Dynamics of symptoms depending on the stage

Prostate cancer is conditionally divided by oncologists into:

1. localized form (limited to the organ capsule);
2. locally advanced (with regional metastases to lymph nodes or surrounding tissues);
3. generalized (with spread to other organs remote from the primary focus).

The initial form of prostate cancer (stages 1-2), especially coming from the peripheral zone, is most often asymptomatic. But sometimes, even at the first stage, there may be signs of urination disorders or erectile dysfunction.

However, these symptoms in prostate cancer at an early stage are nonspecific, they are also characteristic of benign prostate adenoma, which occurs in 50% of men over 50 years of age. It is possible to identify prostate cancer against the background of adenoma only by a special examination.

Cancer of the 3rd stage (locally advanced) is characterized by more pronounced signs of urination disorders, there may be an admixture of blood in the urine or semen, pain in the pelvis, in the perineum, general and neoplastic symptoms join.

Generalized prostate cancer gives a very vivid clinical picture with metastases to the bones and brain. Increased signs of cancer intoxication (weakness, weight loss, anemia). In this case, local symptoms may fade into the background.

Conclusion

Most variants of prostate cancer are slow-growing tumors. In the early stages, there are no specific symptoms of prostate cancer, which is why it is so difficult to recognize. But we must remember that every third man over 70 years old has a chance to get RP and 3% risk dying from it.

Even with minor urination disorders, you need to contact a urologist. Most likely, a benign pancreatic adenoma will be diagnosed and treatment will be prescribed. But this does not mean that you need to calm down and no longer go to the doctor.

Benign prostatic hyperplasia does not rule out cancer. For the timely detection of a malignant neoplasm, it is necessary to undergo regular examinations (PSA level in dynamics, transrectal ultrasound, if necessary, an MRI of the small pelvis and a biopsy of the gland can be prescribed).

Prostate cancer, detected in the initial stages, has every chance of being cured. And a big role in its identification is assigned to the patient himself.

This type of cancer pathology is inherent exclusively in the male sex, since the organ in which the tumor grows - the prostate, is only in men. In the list of male oncological diseases, this one consistently ranks first and, unfortunately, is being detected more and more often over time.

Prostate cancer can develop at any age, but most often it affects men who have reached the age of 35-40, and with increasing age, the risks increase significantly. So, for example, among 35-year-old men, prostate cancer is detected in 10 cases per 10,000, upon reaching the age of 60, this figure increases 10 times, and in men older than 7 years, pathology occurs in every eighth.

A distinctive feature of prostate cancer is the long and asymptomatic development of the disease. It seems to a man that everything is in order and he leads a normal life, and when noticeable problems begin (usually already at stage 3), a complete cure may no longer be possible.

In view of such insidiousness of the disease, men, especially those who have reached the age of 40, should be regularly examined by a urologist, and preferably by an oncologist-urologist.

Functions of the prostate

The prostate is the main gonad of a man, has a small size - about 4 cm in diameter and consists of 2 equal lobes. Located in the cavity of the small pelvis, under the bladder, it encircles the urethra with a horseshoe, which causes problems with urination in case of inflammation of the prostate. Increasing, it presses on the ureter and blocks it.

The prostate is arranged as follows - from its outer shell, the capsule, partitions diverge, between which the prostate glands are located. Their tissue is formed by glandular epithelium, and in shape they are small tubes separated by vesicular formations. The glands are of paramount importance because they are responsible for the production of prostatic juice, one of the main components of the seed. These tubules are surrounded by smooth muscle tissue, serve to remove excess juice and prevent congestion.

With regards to the functions performed by the gland, the main ones are:

• Production of seminal fluid;
• Secretion of semen-releasing and liquefying substances;
• Provides natural sex drive.

In addition, the prostate gland is the main supplier of the main male hormone - testosterone and some others.

What can lead to prostate cancer?

Despite all the efforts of medicine, it still cannot unequivocally answer the question why, however, the accumulated experience and statistics quite definitely indicate the reasons that significantly increase the risk of this disease.

An unequivocal risk factor is chronic inflammation of the prostate. They may be of an infectious nature or be the result of hormonal disorders. Constant irritation of cells can cause them to mutate and cause a tumor. In addition, inflammation leads to the activation of immune cells, which can disrupt the DNA structure of gland cells.

Most prostate tumors are sensitive to hormones produced by the gland - androstenedione, testosterone and dihydrotestosterone, so it is logical to assume that the causes of prostate cancer may be hidden in the imbalance of these hormones, or rather, in their hypersecretion.

Very high risk in men with prostate adenoma. Despite the safety of this tumor, it has a habit of mutating and becoming malignant. Therefore, if an adenoma is found, it should definitely be removed.

Along with adenoma, there are a number of conditions - congenital and acquired, that need to be constantly monitored, since their development, with a high probability, ends with prostate cancer:

• prostate neoplasia. For some reason, the gland cell division program fails, and they begin to multiply at an accelerated pace. Over time, these cells become atypical and often become malignant;
• Atypical hyperplasia. The condition is characterized by the appearance of nodular foci, the tissues of which change their nature and begin to grow. Cell nuclei gradually enlarge and over time, tumor foci appear in the nodules, initially benign. Gradually, it can change its nature.

Fortunately, such borderline conditions do not always lead to cancer, but the disease becomes almost inevitable when exposed to additional factors:

• Old age - over 40 years;
• Unhealthy diet. For the prostate, a large amount of fatty foods and meat of animal origin, especially beef, is harmful;
• Prolonged contact with carcinogens and their derivatives. This is true for men involved in hazardous industries associated with phenols, cadmium, and other aggressive substances;
• Lack of regular sex is especially true for young men. Their semen production is very active and its untimely excretion leads to stagnation - prostatitis and adenoma, and this is a borderline, precancerous condition;
• Prolonged chronic diseases of the gland and other urinary organs;
• Viral infections - herpes, retrovirus, cytomegalovirus.

Increase the risk of developing cancer cells and bad habits that men often sin - smoking, excess alcohol, excessive coffee and spicy food.

Particular attention should be paid to men whose close relatives suffered from this disease at a young age - up to 35 years.

Stages of the disease

The stage is determined based on the size of the tumor, the degree of damage to neighboring tissues, the presence and number of secondary foci. Any cancer, including prostate cancer, for the convenience of describing the condition, is usually divided into 4 stages:

• 1 stage. Visible symptoms are completely absent. The size of the tumor is miniature, barely noticeable, palpation and ultrasound do not reveal the disease. At this stage, diagnosis is possible only by the PSA test - a specific antigen. The discovery of such a tumor is a rare stroke of luck;
• 2 stage. The tumor grows to a size that can be detected by palpation and ultrasound, while its body does not penetrate beyond the capsule of the gland. There are no metastases yet, but symptoms appear and intensify - difficult, intermittent and frequent urination, sometimes painful. Symptoms worse at night. Often you have to walk on the small 4, or even 5 times. A growing tumor compresses the urethral canal, which causes the described symptoms;
• 3 stage. The tumor becomes large, easily diagnosed by any method. There is a clear, specific symptomatology - severe pain in the pubic part, perineum and lumbar girdle, painful, burning, urination, hematuria develops - blood in the urine. This is due to the tumor leaving the prostate with damage to neighboring organs, primarily the bladder and urethra. At this stage, metastases often occur, but only in a regional location;
• 4 is the final stage. The growth of the tumor becomes aggressive, its cells, spread through the blood and lymphatic system, are fixed in remote corners of the body and produce secondary foci - metastases.

The last stage is characterized by severe pain, intoxication of the body with the waste products of cancer cells, a sharp decrease in body weight, interest in life and the rapid extinction of the patient. Treatment of this phase of cancer is impossible, therefore, they resort to palliative therapy, which, if possible, reduces the suffering of the patient and somewhat prolongs his life.

Symptomatic manifestations

In addition to natural causes, primarily associated with age-related changes, there are a number of others that provoke the occurrence of prostate cancer. Unfortunately, both groups of these disease-provoking factors do not manifest themselves as obvious and specific symptoms for a long time, and if they do, they are very similar to manifestations of other, less dangerous diseases and do not cause proper concern.

All this leads to the fact that the vast majority of men suffering from this disease learn about it at best at the 2nd stage of the disease, and often at the advanced stage - the third. The stage of active cell division of a malignant tumor is characterized by:

• Various disorders of the urinary system - from difficulty urinating to complete blockage of the ureter, this requires immediate catheterization, otherwise the resulting stagnation not only activates the disease, but can also complicate it with kidney problems. Sometimes the reverse picture is observed - partial and even complete incontinence;
• When the tumor grows through the capsule of the gland, the affected tissues and organs adjacent to it acquire atypical dysfunction, trophic processes are disturbed. This is expressed by discomfort and pain, problems with erection and the appearance of blood impurities in the ejaculate;
• The growth of the tumor and the occurrence of metastases also cause pain, usually in the lumbar and bone tissues, while their intensity is quite high, especially at night. Further development of the process leads to a sharp decrease in the concentration of hemoglobin in the blood, a strong weight loss, swelling of the legs, and with compression (compressing the spinal cord) metastases in the spine, partial or complete paralysis is possible.

In the event that a cancerous tumor consists of cells of an undifferentiated nature, the described symptoms proceed as severely as possible, and the survival prognosis is extremely negative.

In view of the foregoing, early diagnosis of the disease is of particular importance, and it is impossible without regular examination by a specialist. Men who have reached the age of 35 should consult a specialist annually, and those who have crossed this line every six months. Of great importance is also the understanding of risk factors and disease prevention, especially for people who are genetically predisposed.

Prevention

Unfortunately, it is impossible to protect yourself with 100% probability by any measures, but if you follow a number of simple rules, possible risks will be minimized. Here are the rules:

• Balance your diet towards fresh vegetables and fruits, reducing your intake of animal fats and red meat as much as possible. It can be replaced with fish. Completely refuse semi-finished products and products with nitrates, food additives and artificial colors;
• Try to limit contact with carcinogens as much as possible;
• To avoid congestion, avoid delays in emptying the bladder and prolonged sexual abstinence;
• Activate physical activity - sports or physical education, even a simple walk in the fresh air significantly improves both general blood circulation and the prostate in particular, and this is a guarantee of health;
• Healthy full sleep also has a very beneficial effect on the state of the gland, since during sleep the production of melatonin, a hormone that prevents the mutation of glandular cells of the prostate, is activated.

And of course, a mandatory factor in prevention is regular examination:

• Tumor marker PSA;
• Palpation of the prostate;

And a group of people with chronic prostatitis or identified adenoma should be especially careful - regardless of age, a detailed examination should be carried out twice a year.

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