Malignant prostate tumor is one of the most commonly diagnosed cancers in the United States and occurs primarily in men over the age of 65.
The prostate is a gland found only in men; it is located just below the bladder (a chamber that collects urine) and surrounds the urethra (urethra through which urine passes from the bladder for excretion).
After the age of 80, most men have a prostate tumor, but it is asymptomatic, so patients do not even know that they have this tumor mass.
In general, adolescents or men of 30-40 years are not affected.
Causes of prostate tumor
There is no evidence or reasons to explain the exact causes. No explanations have been found as to why one man develops this disease and another does not.
However, there are some risk factors that can cause cancer.
Age is a major factor in prostate cancer.
- It has been found that men who are 65 years or older are at greater risk for this type of cancer.
- Family history is another factor in the formation of prostate cancer.
A man is at greater risk for this condition if the father has already had the same disorder.
- Mortality is higher in men with black skin.
Men with high-grade intraepithelial prostate neoplasia may be more likely to suffer from this type of cancer.
When the prostate gland is viewed microscopically, it appears abnormal.
How does the tumor manifest itself? Symptoms of prostate tumor
- Not being able to urinate
- Difficulty starting or stopping urine flow
- Need for frequent urination, especially at night (nocturia)
- Weak urine stream
- Pain and burning during micturition
- Difficulties and problems with erection
- Painful ejaculation
- Emaciation or weight loss (especially at an advanced stage)
- Blood in the urine or semen
Diagnosis of prostate tumor
Research shows that an image-guided biopsy may be more effective in the early diagnosis of prostate cancer than other traditional examinations such as rectal digital examination or PSA test.
If the cancer is confirmed, further tests (including magnetic resonance imaging and CT) may be done to determine how far the cancer has spread to other parts of the body.
PSA means prostate-specific antigen and is an enzyme produced by the prostate.
PSA levels are elevated in prostate cancer, prostate inflammation and other diseases of the prostate.
Determination of stages in prostate cancer
- Stage I – (T1): At this stage, the cancer cannot normally be detected by echography or rectal-digital examination because the tumor is still too small. The cancer is detected during another surgery or by a biopsy after elevated PSA levels.
- Stage II – (T2): After the tumor becomes larger, it can be detected by rectal-digital examination or echography, but the carcinoma is still limited to the prostate.
- Stage III – (T3): The cancerous cells spread over the area of origin and infiltrate the seminal vesicles.
- Stage IV– (T4 or terminal phase): The cancer passes beyond the seminal vesicles and infiltrates the lymph nodes. The size and number of tumors increase and spread to nearby organs such as the bladder and rectum. In stage IV of prostate cancer, it forms mainly in the bones and other areas of the body such as the lungs and liver.
The Gleason classification includes the Gleason score along with other parameters to evaluate the aggressiveness and spread of the cancer.
In the biopsy, a cylindrical piece of prostate tissue is taken through the rectum.
This sample or a sample taken during surgery is examined under the microscope.
In prostate cancer, the prognosis also depends on histological characteristics (how the cells appear under the microscope).
This classification is called grading.
For prostate cancer, the Gleason score is used.
- A score between 2 and 6 on the Gleason scale is a low grade. Here it is likely that growth is very slow.
- A Gleason value of 7 is moderate, so the tumor grows in a medium
- Rhythm. A Gleason score of 8-10 is a highly developed tumor that threatens to grow very quickly.
The scale value is given with two numbers, for example 3 + 4 = 7 or 3 + 3 = 6
Based on the tissue samples examined, the sum of the lowest and highest values of the examination is drawn.
If the better tissue gives the value 3, while the worse tissue has the value 4, the score on the scale is 3 + 4 = 7.
Once prostate cancer is detected, doctors recommend:
- Prostatectomy (surgical removal of the prostate)
- Radiotherapy (therapy by radiation)
- Attentive monitoring (observation of the carcinoma)
- Hormone therapy
- Other types of therapy
To perform a prostatectomy, the cancer must be detected at the initial stages.
What are the possible treatments for a prostate tumor?
As a rule, therapy includes:
- Observation and attentive waiting
- Hormone therapy
Careful waiting: This is active monitoring of cancer growth without any therapy.
This method is used in older men who cannot be treated with other methods due to possible risks. Careful monitoring can also be recommended for those who are in the first phase of prostate cancer.
When should surgery be performed on prostate tumors?
Surgery: The prostate can be removed during the first phase of the carcinoma or when the gland does not respond to any other therapies.
The removal of the prostate by surgery is called prostatectomy.
If the prostate is removed via an abdominal incision, the operation is called a radical retropubic prostatectomy.
If the gland is removed through an incision in the perineum (skin between the scrotum and anus), it is a radical perineal prostatectomy.
Robotic prostatectomy in laparoscopy (RARP) is a surgical procedure that uses modern technology to remove the prostate.
Unlike other forms of prostatectomy, this method does not provide for a large incision.
Nowadays, RARP is becoming increasingly popular among doctors and patients.
Another surgical procedure istransurethral resection of the prostate (TURP), in which a small portion of the tissue is removed to relieve symptoms. This procedure leads to the removal of that part of the glandular that narrows the urethra and causes discomfort in micturition. A small instrument, a resectoscope, is inserted via the penis.
Cold surgery is another method in which the prostate is iced over metal rods inserted via the peritoneum. The water freezes in the cells surrounding the rods, resulting in cell death.
This method is considered more effective than the other types of therapy. It causes fewer problems during the procedure and the side effects are lower.
Surgical therapy also includes orchiectomy, in which the testicles are removed to reduce the amount of testosterone and thus keep the growth of the prostate cancer under control.
Sometimes prostatectomy can cause nerve damage and complications can occur if surgery is performed after radiation therapy. The most common side effects of surgery are impotence and urinary incontinence.
Some patients also suffer from erection and ejaculation difficulties.
Recovery after surgery for a prostate tumor
Surgery for prostate cancer provides for different discharge periods from the hospital depending on the type of operation performed and the general health of the patient.
As a rule, the patient must remain hospitalized for about 2-5 days after surgery. Patients who have undergone laparoscopic surgery and similar minimally invasive techniques recover faster than others.
Of all the techniques, robotic laparoscopic prostatectomy is the one with the shortest recovery time.
As part of recovery, swelling in the area of the incision decreases within a few weeks or a few months. Also, the patient’s urine control gradually improves. Usually, activities with slow movements are recommended to increase blood circulation and reduce blood clots in the legs. During the recovery period from prostate cancer, the patient is allowed to walk and climb stairs. However, lifting heavy objects and heavy exercises should be avoided for at least 2-6 months.
Hormone therapy: This therapy acts on the male hormone testosterone.
This hormone is responsible for the growth of tumor cells in the prostate and hormone therapy tries to limit testosterone production and thus slow down the growth of cancer cells.
Sometimes the testosterone blockade helps to compact the cells to reduce the size of the malignant portion. Some medications used in this method decrease testosterone production.
Others decrease the body’s ability to use these hormones.
This form of therapy is an important option, especially for inoperable patients.
Radiation therapy: Radiation therapy uses high-energy X-rays or other types of radiation to kill tumor cells.
External radiation therapy directs the radiation emitted from the devices to the cancer cells.
Internal radiotherapy or brachytherapy involves the implantation of small, seed-shaped radioactive substances or needles near or inside the prostate.
The advantages of brachytherapy are the higher dose of radiation administered and the limitation of side effects to the prostate.
These rays destroy the DNA of the tumor cells.
Radiotherapy is the preferred treatment for relapses detected at the initial stages.
This therapy can have some consequences, including:
- Rectal hemorrhage
- Unintentional urination
Other types of therapy include highly focused ultrasound (HIFU) and biologic therapy. In HIFU, ultrasound waves are directed at the tumor cells in order to destroy them. Biological therapy aims to strengthen the immune system, using substances produced in the body to revive the mechanism of natural body protection.
Diet and nutrition for prostate tumor
As with any other disease, diet is important to improve bodily functions and prevent cancer.
A diet high in fish, fruits and vegetables is thought to reduce the risk of prostate cancer.
Natural remedies for prostate cancer
Pomegranate juice and prostate cancer
Would you have come up with the idea of using pomegranate juice for therapy for patients with prostate cancer? Many studies are currently able to show the positive effects of pomegranate juice in many patients with prostate cancer. In addition to conventional therapy, the patient can gain benefits by drinking this juice with antioxidant effects.
One can achieve a delay in the spread of prostate cancer if one drinks pomegranate juice regularly.
According to laboratory studies, various compounds in the juice show the ability to destroy cancer cells.
The pomegranate is rich in almost every type of antioxidant that can lead to the death of cancer cells.
Among the substances for the prevention of prostate cancer is zinc, and in fact, people who suffer from this condition have low levels of zinc in their blood.
Ginger can help fight a cancer that has already been diagnosed.
In one study, 50 patients showed an increase in PSA levels despite having completed conventional therapy (surgery and radiotherapy).
The rate at which PSA levels increase is an important clue to predict the development of prostate cancer.
After cancer therapy, a slow progression of the PSA value means a longer life expectancy.
A study conducted by researchers at the University of California of Los Angeles and published in the journal Clinical Cancer Research compared two groups of people after undergoing prostate cancer therapy.
The first group of patients drank 200 ml of pomegranate juice daily, the second group did not consume this drink.
The results show that the average time to double the PSA value was 54 months in the juice-drinking group, but 15 months in the control group.
How long do you live? Life expectancy in stage IV prostate cancer
The life expectancy in cancer depends on the tumor stage and the therapy the patient undergoes. Early diagnosis of the cancer and rapid treatment help to increase the probability of recovery and thus the remission of the tumor.
Retrospective studies show that the survival rate after 10 years is 83% for patients who have opted for prostatectomy, 75% for radiotherapy and 72% for close monitoring.
If the tumor forms metastases, it is difficult to remove the carcinoma or control tumor growth.
Survival rate and life expectancy for prostate cancer in stage IV (last stage) are therefore not favorable.