Prostate Cancer Chapter 1
Diagnosing Prostate Cancer (VIDEO)
Delve into the prostate, understand this complex disease found in men that is challenging to diagnose, and witness a cutting-edge procedure that may change how prostate cancer is diagnosed in the future.
Medical experts: Dr. Peter Choyke, Dr. Stanley Liauw, Dr. Peter Pinto
Special thanks: National Cancer Institute, National Institute of Health, Dr. Bradley Wood, University of Chicago Medical Center, Dr. Aytekin Oto
Once someone is diagnosed with prostate cancer, the patient and his doctors decide on a course of action and create a treatment plan. Very often that means simply keeping an eye on the progression of the disease. Here, top doctors lay out the most common prostate cancer treatment options and explain the tools and methods used, as well as the risk factors involved. Read more
The vast majority (over 95%) of prostate cancers are adenocarcinomas, cancers that develop in glandular tissue. These tumorous growths develop in the tissue of the prostate gland, which fits tightly into its position behind the base of the penis, underneath the bladder, and in front of the rectum. The prostate produces prostatic fluid, which is a component of semen and helps to nourish and transport sperm. Read more
The prostate gland is found only in males and is an essential part of the male reproductive system. It's about the size and shape of a walnut or a small plum in young men. In older men it normally grows to about the size of a lemon. It fits snugly into its position, sitting about 2 inches above the perineum, the muscular area between the scrotum and anus. The prostate's tissue is both glandular and nonglandular. It is made up of thousands of tiny fluid-producing glands interspersed with blood vessels, within a fibromuscular framework. Read more
The Prostate Gland
The prostate gland is the largest of the male reproductive glands and serves a vital function in the male reproductive system. It secretes a thin, milky-white liquid called prostatic fluid that is rich in zinc, citric acid, choline, and various proteins and hormones. Prostatic fluid contributes about 30% of the volume of seminal fluid. The various components of the prostatic fluid aid the sperm by providing a protective medium for them to move in as they make their way through the vagina. Without this protective medium, most sperm would die soon after ejaculation. Read more
What Is Cancer?
The process of cell growth in the body is normally an orderly one. Cells grow and divide as necessary to produce more cells as they are needed. Cells that are old or damaged die, and are replaced with new cells.
In cancer, something has gone wrong with this process. The cell's DNA has been damaged. DNA is a substance found in every cell in the body that directs the cell's functioning and reproduction. Cell DNA may be damaged by environmental agents, such as radiation (including excessive sunlight), viruses, chemicals, and tobacco smoke. Cells with damaged DNA may also be inherited from one's parents. Read more
Screening is testing someone for a disease when there are no symptoms of the disease present. Screening tests are widely used by clinicians as part of periodic health examinations. The goal of screening for prostate cancer is to catch the disease in its early stages, when it is more easily treated and before it has spread. The most common screening tests for prostate cancer are the prostate specific antigen (PSA) test and the digital rectal exam (DRE). Transrectal ultrasound (TRUS) may also be used, although its usefulness as a screening test is limited. Read more
If the PSA test or the DRE indicate that cancer may be present, then the doctor may recommend biopsy. In a biopsy, tissue samples are taken from the prostate gland and examined by a pathologist under a microscope.The pathologist will look for abnormalities in the tissue architecture and cell structure. Well-differentiated cells are more normal in appearance, while poorly differentiated cells are more abnormal in appearance. Generally speaking, the more abnormal the cells appear, the more aggressive the cancer. Read more
Most cases of prostate cancer grow very slowly, and many prostate cancers never extend beyond the prostatic capsule. Many men die with, rather than from, prostate cancer. This is why active surveillance, in which the prostate is monitored for progress of the disease, is often a viable alternative to treatment. Read more
Unlike for many other cancers, there are no standardized imaging protocols, apart from the use of transrectal ultrasound (TRUS), for the early detection and diagnosis of prostate cancer. This is a critical need. Prostate cancer is a disease for which it is crucial to detect and diagnose cancers early and accurately, both because early prostate cancer is usually without symptoms and because treatment side effects can be severe. Fortunately, new technologies are currently being developed, and even being used in some medical facilities, with promising results. By providing more specific and accurate detection and diagnosis results, these more sophisticated forms of prostate imaging and analysis will help in detecting early cancers, and in making the decision of whether to treat for prostate cancer when abnormalities are detected. Read more
A cancer's stage (how far it has progressed) is a very important factor in deciding on treatment and estimating the patient's prognosis. After biopsy confirms the presence of cancer in the prostate, the cancer is staged, meaning that more tests are done to find out how far the cancer has spread in the prostate and if it has spread outside the gland to adjacent tissues or to other sites in the body. Read more
Prostate cancer patients are likely to have a number of treatment options to choose from. If you have prostate cancer, you may feel pressured to make a decision quickly. But take the time to learn as much as you can about prostate cancer, your prognosis, and the treatments that are appropriate for your case. Talk to your doctor and, preferably, get a second opinion as well. Bear in mind that a surgeon may tend to recommend surgery and a radiation oncologist to recommend radiation therapy. Consider your own feelings about these treatments and their possible side effects. Read more
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