วิธีตรวจมะเร็งต่อมลูกหมากและการรักษา มะเร็งต่อมลูกหมาก - Prostate cancer

Prostate Cancer

Prostate cancer that is detected early has a better chance of successful treatment.

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Prostate Cancer

Cancer in the prostate is called prostate cancer. The male prostate has a walnut-shaped gland that produces the seminal fluid that feeds and carries sperm. One of the most common types of cancer in men is prostate cancer. Normally it grows slowly and starts in the prostate gland, which may still cause no harm.

Some types of prostate cancer grow slowly, which may need small treatments or may not need one at all. Some types are severe and can grow quickly. Prostate cancer that is detected early has a better chance of successful treatment.

What are the signs and symptoms of prostate cancer?

Signs and symptoms of prostate cancer may not be shown in its early stages. However, the signs and symptoms will be shown during its advanced stages as follows:

You have difficulty passing your urine.

  • You have a weak urine stream.
  • There is blood in semen.
  • You have a slight pain in the pelvic area.
  • You have pain in your bones.
  • You have sexual dysfunction in men.

When to see a doctor

If you have any signs or symptoms or don't have signs or symptoms but want to undergo a screening check, you are advised to make an appointment with your doctor. Each hospital may give different opinions about the risks and benefits of prostate cancer screening. Therefore, it is best to meet your doctor to discuss the screening. And then you can decide which screening is best for you.

What are the causes of prostate cancer?

The causes of prostate cancer remain unclear. What doctors understand is cancer starts when some cells turn abnormal. DNA in abnormal cells is mutated, which also expands more rapidly than those in normal cells do. While other cells are dying, these abnormal cells remain alive and continue living.  Later on, the growing abnormal cells that are accumulating from a tumor can expand to invade other tissues nearby. This means the abnormal cells can also metastasize to other parts of the body.

What are the risk factors of prostate cancer?

Some factors increase your risk of prostate cancer, such as:

  • Age: You have a higher risk of getting prostate cancer when you are older.
  • Race: People of color are said to have a greater risk of prostate cancer, compared to men of other races. However, why these black men tend to have a higher risk of having cancer has not yet been determined. Cancer in black men is also said to be aggressive and advanced among the men in this race.
  • Family history: If your male family members have had prostate cancer, you have a higher risk of having cancer. If your family members have a history of genes BRCA1 or BRCA2, which are breast cancer genes, or have had breast cancer, you may have a higher risk of having prostate cancer.
  • Obesity or overweight: If you are diagnosed with prostate cancer, and at the same time you are overweight, your cancer is more advanced and it may be more difficult to treat.

How do doctors diagnose prostate cancer?

Screen for prostate cancer

You may not be aware of the fact that you have prostate cancer until you have it. And if you are healthy, doctors will not ask you to opt for any tests to screen for cancer. Moreover, no hospitals or doctors can claim if screening for cancer has benefits. However, some hospitals or doctors may recommend you have a prostate cancer screening test if you are 50 or older. If you have risk factors for prostate cancer, your doctor will advise you to have the screening. When meeting your doctor, he or she will discuss your particular situations and benefits as well as the risks of screening for prostate cancer. Together with your doctor, you can decide if the screening is right for you. In this connection, prostate cancer screening may include:

  • Digital rectal exam (DRE): Your doctor inserts a gloved and lubricated finger into your rectum to inspect your prostate. Your prostate is located near your rectum. If any irregularities are found any irregulars in your prostate; for instance, the texture, shape, or size of the gland are abnormal, you may need more tests.
  • Prostate-specific antigen (PSA) test: Your doctor may want to inspect a substance that is produced from your prostate gland, which is called prostate-specific antigen (PSA). With a small amount of PSA, your condition is normal. But if you have a higher than normal level, it can indicate that you are having a prostate infection, redden and swollen tissues, enlarged prostate, or even cancer.

Your doctor may use PSA testing in combination with DRE to help identify prostate cancer, especially at its earliest stage. However, different doctors may use different methods to screen for cancer.

Diagnose

Once a DRE or PSA test confirms abnormal, your doctor may suggest you have further tests to see if you are having cancer. The additional tests include:

  • Transrectal ultrasound: Your doctor may use transrectal ultrasound for further evaluation. A blunt-ended surgical instrument with the size and shape of a cigar is inserted into your rectum. This device uses sound waves to create pictures of your prostate gland for diagnosis.
  • Multiparametric-magnetic resonance imaging (mp-MRI): This method may be recommended if you have continuous use of PSA or DRE and find abnormal areas. A good expert for MRI can detect prostate cancer up to 60-80%.
  • Prostate-specific membrane antigen for Positron Emission Tomography (PSMA PET) PET/CT Scan: Nowadays is the most sensitive test to detect prostate cancer and help move for proper and adequate treatment for prostate cancer.
  • Prostate biopsy: Your doctor may collect some samples of prostate tissue for further diagnosis once the first test results suggest you have cancer. Your doctor uses a thin needle to insert into your prostate to collect tissue for further analysis. The sample will be analyzed in a lab to determine if cancer can be confirmed.
  • MRI fusion: Doctors nowadays use MRI fusion to assist in prostate biopsy, which has a higher prostate cancer detection rate.

Determine if prostate cancer is aggressive

Once the biopsy confirms that you have cancer, your doctor may next want to determine how aggressive or what grade your cancer is. In this process, your doctor examines the collected sample tissue to determine how much cancer cells are different from other healthy cells. A higher grade means more aggressive cancer and may spread quickly. In this evaluation, a Gleason score will be used to grade your prostate cancer cells. The scores range from 2, which means nonaggressive cancer, to 10, which means very aggressive cancer. Most scores normally stand between 6 to 10. While a score of 6 means less aggressive, a score of 7 means medium-grade cancer. Scores from 8 to 10 mean high-grade cancers.

Moreover, genomic testing is used more and more to evaluate the risks of having cancer and detect the aggressive ones.

Determine how much the cancer has grown

Your doctor will try to determine the stage of the prostate cancer you have following the completion of the diagnosis. Moreover, if your doctor suspects that it has expanded to other nearby parts and organs, you may be advised to:

  • Undergo a bone scan.
  • Opt for an ultrasound.
  • Undergo a computerized tomography (CT) scan.
  • Opt for magnetic resonance imaging (MRI).
  • Undergo a Prostate-specific membrane antigen for Positron Emission Tomography (PSMA PET) Scan.

With the information from these tests, your doctor can determine the stage of your cancer. Each stage of the cancer is normally assigned with Roman numerals, which is from I to IV. The lowest stages refer to cancer remaining in the prostate. At stage IV, cancer has spread beyond the prostate and may have spread to other parts of the body. It is necessary to know what stage your cancer is so that your doctor can choose the right treatments for your condition.

Published: 04 Oct 2020

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