Prostrate Problems

25 November 2020, Wednesday

Prostrate Symptoms does not always mean “Prostrate Problems”, but one must bear in mind, that anything related to the prostrate is extremely hard to diagnose.

Prostatitis, is an infection of the prostrate, and doctors usually treat this with antibiotics.

Many men who are told they have prostatitis are misdiagnosed. Often inflammation may be centred in the bladder, and this condition is known as interstitial cystitis (IC), which may cause frequent, painful urination

 

WHAT THEN IS PROSTRATE CANCER?

Prostate cancer is a form of cancer that develops in the prostrate, a gland in the male reproductive system. Prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize (spread) from the prostate to other parts of the body, particularly the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, problems during sexual intercourse, or erectile dysfunction. Other symptoms can potentially develop during later stages of the disease.

Prostate cancer tends to develop in men over the age of fifty and although it is one of the most prevalent types of cancer in men, many never have symptoms. This is because cancer of the prostate is, in most cases, slow-growing, symptom-free, and since men with the condition are older they often die of causes unrelated to the prostate cancer, such as heart/circulatory disease.

Many factors, including genetics and diet, have been implicated in the development of prostate cancer. The presence of prostate cancer may be indicated by symptoms, physical examination, prostrate-specific antigen (PSA), or biopsy. The PSA test increases cancer detection but does not decrease mortality. Nonetheless, suspected prostate cancer is typically confirmed by taking a biopsy of the prostate and examining it under a microscope. Further tests, such as CT scans and bone scans, may be performed to determine whether prostate cancer has spread.

Management strategies for prostate cancer should be guided by the severity of the disease. Many low-risk tumors can be safely followed with active surveillance. Curative treatment generally involves surgery, various forms of radiation therapy, or less commonly, cryosurgery; hormonal therapy and chemotherapy are generally reserved for cases of advanced disease (although hormonal therapy may be given with radiation in some cases).

The specific causes of prostate cancer remain unknown. The primary risk factors are age and family history. Prostate cancer is very uncommon in men younger than 45, but becomes more common with advancing age. The average age at the time of diagnosis is 70. However, many men never know they have prostate cancer. Men who have first degree family members with prostate cancer appear to have double the risk of getting the disease compared to men without prostate cancer in the family. This risk appears to be greater for men with an affected brother than for men with an affected father. Men with high blood pressure are more likely to develop prostate cancer. There is a small increased risk of prostate cancer associated with lack of exercise.

Genetic

Genetic background may contribute to prostate cancer risk. Men who have a first-degree relative (father or brother) with prostate cancer have twice the risk of developing prostate cancer, and those with two first-degree relatives affected have a fivefold greater risk compared with men with no family history.

While a number of dietary factors have been linked to prostate cancer the evidence is still tentative. Evidence supports little role for dietary fruits and vegetables in prostate cancer occurrence. Red meat and processed meat also appear to have little effect. Lower blood levels of vitamin D may increase the risk of developing prostate cancer. This may be linked to lower exposure to Ultraviolet (UV) light, since UV light exposure can increase vitamin D in the body.

Green Tea may be protective (due to its catechins); although the most comprehensive clinical study indicates that it has no protective effect. Other holistic methods are also studied.

High alcohol intake may increase the risk of prostate cancer and interfere with folate metabolism. Low folate intake and high alcohol intake may increase the risk of prostate cancer to a greater extent than the sole effect of either one by itself.

Medication exposure

There are also some links between prostate cancer and medications, medical procedures, and medical conditions. Use of the cholesterol-lowering drugs known as statins may also decrease prostate cancer risk.

Infection or inflammation of the prostate (prostatis) may increase the chance for prostate cancer while another study shows infection may help prevent prostate cancer by increasing blood to the area. In particular, infection with the sexually transmitted infections Chlamydia, gonorrhoea, or syphilis seems to increase risk. Finally, obesity and elevated blood levels of testosterone may increase the risk for prostate cancer. There is an association between vasectomy and prostate cancer however more research is needed to determine if this is a causative relationship.

The prostate is a part of the male reproductive system that helps make and store seminal fluid. In adult men, a typical prostate is about three centimeters long and weighs about twenty grams. It is located in the pelvis, under the urinary bladder and in front of the rectum. The prostate surrounds part of the urethra, the tube that carries urine from the bladder during urination and semen during ejaculation. Because of its location, prostate diseases often affect urination, ejaculation, and rarely defecation.

The prostate contains many small glands which make about twenty percent of the fluid constituting semen. In prostate cancer, the cells of these prostate glands mutate into cancer cells. The prostate glands require male hormones, known as androgens, to work properly. Androgens include testosterone, which is made in the testes; dehydroepiandrosterone, made in the adrenal glands; and dihydrotestosterone, which is converted from testosterone within the prostate itself. Androgens are also responsible for secondary sex characteristics such as facial hair and increased muscle mass.

 

 

 

 

 

 

 

Prostate imaging

Ultrasound (US) and Magnetic Resonance Imaging (MRI) are the two main imaging methods used for prostate cancer detection. Urologists use transrectal ultrasound during prostate biopsy and can sometimes see a hypoechoic area. But US have poor tissue resolution and thus, are generally not clinically used. In contrast, prostate MRI has superior soft tissue resolution. MRI is a type of imaging that uses magnetic fields to locate and characterize prostate cancer.

 

Biopsy

If cancer is suspected, a biopsy is offered expediently. During a biopsy a urologist or radiologist obtains tissue samples from the prostate via the rectum. A biopsy gun inserts and removes special hollow-core needles (usually three to six on each side of the prostate) in less than a second. Prostate biopsies are routinely done on an outpatient basis and rarely require hospitalization. Fifty-five percent of men report discomfort during prostate biopsy.

Prostate cancer screening is an attempt to find unsuspected cancers, and may lead to more specific follow-up tests such as a biopsy, with cell samples taken for closer study. Options include the digital rectal exam (DRE) and the prostate-specific antigen (PSA) blood test. Such screening is controversial and, in some patients, may lead to unnecessary, even harmful, consequences. Modern screening tests have found cancers that might never have developed into serious disease, and that “the slight reduction of risk by surgically removing the prostate or treating it with radiation may not outweigh the substantial side effects of these treatments,” an opinion also shared by the CDC.

Prevention

There is a significant relation between lifestyle (including food consumption) and cancer prevention.

 

Diet

Consuming fish appears to lower prostate cancer deaths but not the occurrence of prostate cancer. Omega-3 fatty acids are unlikely to prevent prostate cancer. There is no evidence that vitamin supplements affect risk. Trans fats may be associated with an increased risk of cancer but the evidence is still limited. The American Dietetic Association and Dieticians of Canada report a decreased incidence of prostate cancer for those following a vegetarian diet. Selenium is believed to be able to reduce the risk of contracting prostate cancer.

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LATEST RESEARCH NEWS ON PROSTRATE CANCER

 

A new prostate cancer treatment using high frequency sound waves may be a viable alternative to surgery and radiotherapy with less chance of incontinence or impotence according to the latest research.

 

A clinical trial funded by Britain’s Medical Research Council examined the efficacy of a new treatment known as high-intensity focused ultrasound (HIFU) that can target areas just a few millimetres in size.

 

“The results show that 12 months after treatment, none of the 41 men in the trial had incontinence of urine and just 1 in 10 suffered from poor erections – both common side effects of conventional treatment,” said a statement.

 

“The majority of men (95 per cent) were also cancer-free after a year.” The findings were published in the journal Lancet Oncology.

 

Treatment involves radiotherapy or removing the prostate surgically — both methods that can damage surrounding healthy tissue, in some cases leading to incontinence or erectile dysfunction.

 

HIFU targets a small area affected by cancer — the sound waves causing the tissue to vibrate and heat up, killing the cancer cells. The procedure is done under general anaesthetic and most patients are back home within 24 hours, said the statement.

 

“Our results are very encouraging,” said Dr Hashim Ahmed, who led the study.

“We’re optimistic that men diagnosed with prostate cancer may soon be able to undergo a day case surgical procedure, which can be safely repeated once or twice, to treat their condition with very few side-effects. That could mean a significant improvement in their quality of life.”

 

There will be a larger trial to examine whether the new therapy, already in use in hospitals for several years, was as effective as the standard treatment.