Prostate Cancer And It's Diagnosis

The prostate is a gland of the male reproductive system. It is located just under the bladder and, like a ring, it surrounds the urethra, the channel through which urine and sperm come out of the body. The role of the prostate is to produce prostatic fluid, one of the components of sperm with seminal fluid and spermatozoa, to temporarily store sperm before ejaculation, then to contract at the time of ejaculation, thus participating in the expulsion of semen.

Prostate cancer is the most common type of cancer among men: it is estimated that 1 in 7 men will be diagnosed, mostly from the sixties. Although no particular cause has been discovered, there is a genetic predisposition.

Most prostate cancers evolve very slowly. In fact, the vast majority of men diagnosed with this cancer will die from another cause. In many cases, the tumor remains localized in the prostate and has limited health effects, sometimes causing urinary or erectile dysfunction. However, some cancers may evolve and spread more rapidly.

In India, prostate cancer is the most common male cancer and the third leading cause of cancer death in men. The median age of diagnosis is 74 years, and 44% of prostate cancer treatment in Ghaziabad starts after 75 years. The average age of death for prostate cancer is 78. Prostate cancer is a good cancer prognosis: the 5-year relative survival has improved dramatically, from 70% for cases diagnosed in 1990 to 90% in 2002.

Types

Adenocarcinoma is the most common form of prostate cancer. It accounts for about 95% of cases.

The severity of cancer depends on the extent of the tumor (local, with nearby or distant metastases) and the type of cancer cells. There is a score to measure the prognosis of prostate cancer, that is, to say the risks it presents for the person affected. This is the Gleason score.

This score assigns two figures of 3 to 5 during the microscopic examination of the prostate tissue, corresponding to grades 3, 4 or 5. The number 3 corresponding to benign prostatic tissue and the number 5 to the most aggressive.

With these numbers, to obtain a score that can range from 2 to 10, the sum of 2 grades, that of the most frequent cell populations in the prostate and the highest score observed. Thus, a score of 6 (1-1) corresponds to a slightly aggressive cancer, 7 a little more, and the higher the number, the more the aggressiveness of the tumor increases. This figure is important in determining the best choice for prostate cancer treatment in Delhi for each man.

Diagnosis and screening

Blood test: measurement of the prostate antigen level (PSA or PSA). Prostate cancer can be tracked by the finding of an increase in a protein in the blood: prostate specific antigen or PSA. PSA is a substance produced by the prostate. However, a high score on this test does not necessarily mean that there is cancer. Indeed, an amount of more than 4 nanograms/ml of this protein in the blood is associated with prostate cancer in about 25% of cases, and another prostate disorder in 75% of cases. If it is not cancer, high PSA may be benign prostatic hypertrophy, inflammation or infection of the prostate.

On the other hand, the PSA assay does not detect all cases of cancer. In a study evaluating the efficacy of the PSA test, 15% of men who tested negative for this test (from a cohort of 2,950 men aged 62 to 91) had prostate cancer1. Note that PSA is also used to monitor the progression of prostate cancer.

The biopsy is not devoid of undesirable effects. The most common is the presence for a very short time of blood in the urine, stool or sperm, fever and infection of the prostate.

In practice:

- If the prostate is abnormal in the rectal examination and its palpation is suggestive of cancer, the biopsy is performed, even if the PSA is normal.

- If the prostate is normal to palpation and PSA is greater than 4 ng/ml, a biopsy will be performed if PSA increases over time.

• Rectal touch. Its purpose is the palpation of the prostate gland. To do this, the urologist in East Delhi inserts a finger covered with a glove into the rectum and can thus estimate the volume and consistency of the prostate. This gesture allows only a partial appreciation. But it can sometimes detect cancers in people who have a rate of prostate-specific antigen (= PSA or PSA for "Prostatic Specific Antigen") normal.
  • Transrectal ultrasound. It is only performed to perform a prostate biopsy and is not of interest alone.
  • Biopsy during a transrectal ultrasound. During an ultrasound, the urologist in Ghaziabad can guide a needle to the practice of prostate biopsies, that is to say, to take a little prostate tissue to have it examined under the microscope. This allows you to encrypt the Gleason score. Only a biopsy can definitely diagnose prostate cancer. The biopsy is usually performed using a needle inserted into the prostate. From 10 to 12 samples of tissue are performed during a single session, in different areas of the prostate

This technique is used for diagnostic purposes and no screening. This means that it is practiced when a man has a high PSA or when the rectal examination perceives an abnormal prostate.