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oncology1

Prostate Cancer

Prostate cancer, also known as carcinoma of the prostate, is the development of cancer in the prostate, a gland in the male reproductive system.

Signs & Symptoms:

  • Problems urinating, including a slow or weak urinary stream or the need to urinate more often, especially at night.
  • Blood in the urine
  • Trouble getting an erection (erectile dysfunction)
  • Pain in the hips, back (spine), chest (ribs), or other areas from cancer spread to bones
  • Weakness or numbness in the legs or feet, or even loss of bladder or bowel control from cancer pressing on the spinal cord.

Risk Factors:

  • Age
  • Race/ethnicity
  • Geography
  • Family history
  • Gene changes
  • Diet
  • Obesity
  • Smoking
  • Workplace exposures
  • Inflammation of the prostate
  • Sexually transmitted infections
  • Vasectomy

Common Types:

  • Ductal adenocarcinoma
  • Transitional cell (or urothelial) cancer
  • Squamous cell cancer
  • Carcinoid
  • Small cell cancer
  • Sarcomas and sarcomatoid cancers

Diagnosis:

  • Medical history and physical exam
  • Prostate-specific antigen (PSA) blood test
  • Transrectal ultrasound (TRUS)
  • Prostate biopsy
  • CT Scan / MRI
  • PET Scan

Stages:

  • Stage 1
    In stage 1, prostate cancer is found in the prostate only. Stage I prostate cancer is microscopic; it can’t be felt on a digital rectal exam (DRE), and it isn’t seen on imaging of the prostate.
  • Stage 2
    In stage 2, the tumor has grown inside the prostate but hasn’t extended beyond it.
  • Stage 3
    In stage 3, prostate cancer has spread outside the prostate, but only barely. Prostate cancer in stage 3 may involve nearby tissues, like the seminal vesicles.
  • Stage 4
    In stage 4, the cancer has spread (metastasized) outside the prostate to other tissues. Stage 4 prostate cancer commonly spreads to lymph nodes, the bones, liver, or lungs.

Prevention:

  • Reduce consumption of meat, eggs and dairy
  • Eat lots of tomatoes, especially cooked
  • Eat plenty of yellow and orange vegetables
  • Confirm adequate vitamin D levels with a blood test
  • Avoid supplemental folic acid
  • Avoid fried foods
  • Exercise at least 3 hours a week
  • Supplement with a conservative amount of zinc

Management:

  • Surgery
    Surgery for prostate cancer involves removing the prostate gland (radical prostatectomy), some surrounding tissue and a few lymph nodes. Ways the radical prostatectomy procedure can be performed include:

    • Using a robot to assist with surgery
    • Making an incision in your abdomen
    • Making an incision between your anus and scrotum
    • Laparoscopic prostatectomy
  • Radiation Therapy
    Radiation therapy uses high-powered energy to kill cancer cells. Prostate cancer radiation therapy can be delivered in two ways – Radiation that comes from outside of your body (external beam radiation) or Radiation placed inside your body (brachytherapy)
    Hormone Therapy
    Hormone therapy is treatment to stop your body from producing the male hormone testosterone. Prostate cancer cells rely on testosterone to help them grow. Cutting off the supply of hormones may cause cancer cells to die or to grow more slowly. Hormone therapy options include – Medications that stop your body from producing testosterone or medications that block testosterone from reaching cancer cells or surgery to remove the testicles (orchiectomy).
  • Freezing prostate tissue
    Cryosurgery or cryoablation involves freezing tissue to kill cancer cells. During cryosurgery for prostate cancer, small needles are inserted in the prostate using ultrasound images as guidance. A very cold gas is placed in the needles, which causes the surrounding tissue to freeze. A second gas is then placed in the needles to reheat the tissue.
  • Chemotherapy
    Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form or both.

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