Prostate cancer in detail


Prostate cancer affects the prostate gland, the gland that produces some of the fluid in semen and plays a role in urine control in men.

The prostate gland is located below the bladder and in front of the rectum.

In the United States (U.S.), it is the most common cancer in men, but it is also treatable if found in the early stages.

In 2017, the American Cancer Society predicts that there will be around 161,360 new diagnoses of prostate cancer, and that around 26,730 fatalities will occur because of it.

Regular testing is crucial as the cancer needs to be diagnosed before metastasis.

Fast facts on prostate cancer:

Here are some key points about the prostate cancer. More detail is in the main article.

  • The prostate gland is part of the male reproductive system.
  • Prostate cancer is the most common cancer in men.
  • It is treatable if diagnosed early, before it spreads.
  • If symptoms appear, they include problems with urination.
  • Regular screening Is the best way to detect it in good time.

Symptoms

There are usually no symptoms during the early stages of prostate cancer. However, if symptoms do appear, they usually involve one or more of the following:

Advanced Prostate Cancer – Learn About Treatment Options

Get Details on Treatment Options for a Specific Type of Prostate Cancer.

treat-small-subset-cancers.com

  • frequent urges to urinate, including at night
  • difficulty commencing and maintaining urination
  • blood in the urine
  • painful urination and, less commonly, ejaculation
  • difficulty achieving or maintaining an erection may be difficult

Advanced prostate cancer can involve the following symptoms:

  • bone pain, often in the spine, femur, pelvis, or ribs
  • bone fractures

If the cancer spreads to the spine and compresses the spinal cord, there may be:

  • leg weakness
  • urinary incontinence
  • fecal incontinence

Treatment

Treatment is different for early and advanced prostate cancers.

Early stage prostate cancer

If the cancer is small and localized, it is usually managed by one of the following treatments:

Watchful waiting or monitoring: PSA blood levels are regularly checked, but there is no immediate action. The risk of side-effects sometimes outweighs the need for immediate treatment for this slow-developing cancer.

Radical prostatectomy: The prostate is surgically removed. Traditional surgery requires a hospital stay of up to 10 days, with a recovery time of up to 3 months. Robotic keyhole surgery involves a shorter hospitalization and recovery period, but it can be more expensive. Patients should speak to their insurer about coverage.

Brachytherapy: Radioactive seeds are implanted into the prostate to deliver targeted radiation treatment.

Conformal radiation therapy: Radiation beams are shaped so that the region where they overlap is as close to the same shape as the organ or region that requires treatment. This minimizes healthy tissue exposure to radiation.

Intensity modulated radiation therapy: Beams with variable intensity are used. This is an advanced form of conformal radiation therapy.

In the early stages, patients may receive radiation therapy combined with hormone therapy for 4 to 6 months.

Treatment recommendations depend on individual cases. The patient should discuss all available options with their urologist or oncologist.

Advanced prostate cancer

Advanced cancer is more aggressive and will have spread further throughout the body.

Chemotherapy may be recommended, as it can kill cancer cells around the body.

Androgen deprivation therapy (ADT), or androgen suppression therapy, is a hormone treatment that reduces the effect of androgen. Androgens are male hormones that can stimulate cancer growth. ADT can slow down and even stop cancer growth by reducing androgen levels.

The patient will likely need long-term hormone therapy.

Even if the hormone therapy stops working after a while, there may be other options. Participation in clinical trials is one option that a patient may wish to discuss with the doctor.

Radical prostatectomy is not currently an option for advanced cases, as it does not treat the cancer that has spread to other parts of the body.

Fertility

As the prostate is directly involved with sexual reproduction, removing it affects semen production and fertility.

Radiation therapy affects the prostate tissue and often reduces the ability to father children. The sperm can be damaged and the semen insufficient for transporting sperm.

Non-surgical options, too, can severely inhibit a man’s reproductive capacity.

Options for preserving these functions can include donating to a sperm bank before surgery, or having sperm extracted directly from the testicles for artificial insemination into an egg. However, the success of these options is never guaranteed.

Patients with prostate cancer can speak to a fertility doctor if they still intend to father children.

What causes prostate cancer?

The prostate is a walnut-sized exocrine gland. This means that its fluids and secretions are intended for use outside of the body.

The prostate produces the fluid that nourishes and transports sperm on their journey to fuse with a female ovum, or egg, and produce human life. The prostate contracts and forces these fluids out during orgasm.

The protein excreted by the prostate, prostate-specific antigen (PSA), helps semen retain its liquid state. An excess of this protein in the blood is one of the first signs of prostate cancer.

The urethra is tube through which sperm and urine exit the body. It also passes through the prostate.

As such, the prostate is also responsible for urine control. It can tighten and restrict the flow of urine through the urethra using thousands of tiny muscle fibers.

How does it start?

It usually starts in the glandular cells. This is known as adenocarcinoma. Tiny changes occur in the shape and size of the prostate gland cells, known as prostatic intraepithelial neoplasia (PIN). This tends to happen slowly and does not show symptoms until further into the progression.

Nearly 50 percent of all men over the age of 50 years have PIN. High-grade PIN is considered pre-cancerous, and it requires further investigation. Low-grade PIN is not a cause for concern.

Prostate cancer can be successfully treated if it is diagnosed before metastasis, but if it spreads, it is more dangerous. It most commonly spreads to the bones.

Stages

Staging takes into account the size and extent of the tumor and the scale of the metastasis (whether it has traveled to other organs and tissues).

At Stage 0, the tumor has neither spread from the prostate gland nor invaded deeply into it. At Stage 4, the cancer has spread to distant sites and organs.

Diagnosis

A doctor will carry out a physical examination and enquire about any ongoing medical history. If the patient has symptoms, or if a routine blood test shows abnormally high PSA levels, further examinations may be requested.

Tests may include:

  • a digital rectal examination (DRE), in which a doctor will manually check for any abnormalities of the prostate with their finger
  • a biomarker test checking the blood, urine, or body tissues of a person with cancer for chemicals unique to individuals with cancer

If these tests show abnormal results, further tests will include:

  • a PCA3 test examining the urine for the PCA3 gene only found in prostate cancer cells
  • a transrectal ultrasound scan providing imaging of the affected region using a probe that emits sounds
  • a biopsy, or the removal of 12 to 14 small pieces of tissue from several areas of the prostate for examination under a microscope

These will help confirm the stage of the cancer, whether it has spread, and what treatment is appropriate.

To track any spread, or metastasis, doctors may use a bone, CT scan, or MRI scan.

Outlook

If the disease is found before it spreads to other organs in a process known as metastasis, the 5-year survival rate is 99 percent. After fifteen years, this decreases to 96 percent. Once the cancer metastasizes, or spreads, the 5-year survival rate is 29 percent.

Regular screening can help detect prostate cancer while it is still treatable.

Risk factors

The exact cause of prostate cancer is unclear, but there are many possible risk factors.

Age

Prostate cancer is rare among men under the age of 45 years, but more common after the age of 50 years.

Geography

Prostate cancer occurs most frequently in North America, northwestern Europe, on the Caribbean islands, and in Australia. The reasons remain unclear.

Genetic factors

Certain genetic and ethnic groups have an increased risk of prostate cancer.

In the U.S., prostate cancer is at least 60 percent more common and 2 to 3 times more deadly among black men than non-Hispanic white men.

A man also has a much higher risk of developing cancer if his identical twin has it, and a man whose brother or father had prostate cancer has twice the risk of developing it compared to other men. Having a brother who has or has had prostate cancer is more of a genetic risk than having a father with the disease.

Diet

Studies have suggested that a diet high in red meat or high-fat dairy products may increase a person’s chances of developing prostate cancer, but the link is neither confirmed nor clear.

Medication

Some research has suggested that non-steroidal anti-inflammatory drug (NSAID) use may reduce the risk of prostate cancer. Others have linked NSAID use with a higher risk of death from the disease. This is a controversial area, and results have not been confirmed.

There has also been some investigation into whether statins might slow the progression of prostate cancer. One 2016 study concluded that results were “weak and inconsistent.”

Obesity

It is often believed that obesity is linked to the development of prostate cancer, but the American Cancer Society maintains that there is no clear link.

Some studies have found that obesity increases the risk of death in advanced cancers. Studies have also concluded that obesity decreases the risk that a cancer will be low-grade if it does occur.

Agent Orange

Exposure to Agent Orange, a chemical weapon used in the Vietnam war, may possibly be linked to the development of more aggressive types of cancer, but the extent of this has not been confirmed.

What to know about blood in urine (hematuria) in females


Hematuria refers to the presence of blood in the urine. Some causes are specific to, or more likely to affect, females.

Blood in the urine is often due to infections, kidney problems, or injuries.

In this article, we discuss the possible causes of blood in the urine in females. We also discuss when to visit a doctor, diagnosis, treatment options, and what blood in the urine can mean for children.

Causes

Hematuria can occur when part of the urinary tract, which includes the kidneys, bladder, and ureters, sustains damage or becomes irritated.

However, blood that appears in the urine does not always come from the urinary tract. In females, blood from the vagina, cervix, or uterus may appear in the urine, giving the false appearance of hematuria.

Types of hematuria include:

  • Gross hematuria, where a person can see blood in their urine. The urine can appear pink, red, or brown.
  • Microscopic hematuria, in which the urine contains trace amounts of blood that are invisible to the naked eye. Microscopic hematuria accounts for 13% to 20% of urology referrals.

Causes of blood in the urine in females can include:

Living with Type 2 Diabetes? – Get Meal Ideas Here

Visit Today to Read About Healthy Meal Ideas & Food Choices Here.

www.how2type2.com

Urinary tract infections

Females have a higher risk of developing urinary tract infections (UTIs) due to the location of their urethras.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), at least 40–60% of women experience a UTI in their lifetime.

UTIs occur when bacteria from the bowels enter the urethra, the tube that carries urine out of the body. A UTI can travel up the urethra and infect the ureters, kidneys, or bladder.

A UTI can cause people to feel a frequent and urgent need to urinate.

Other symptoms of a UTI can include:

  • painful urination
  • cloudy or foul-smelling urine
  • blood in the urine
  • pressure or pain in the lower back, abdomen, or pelvic area

Stones

Excess minerals can form hard deposits or stones in the bladder and kidneys.

Stones may tear or scratch the lining of the urinary tract and its associated organs. Blood from these tears can mix with the urine, resulting in either gross or microscopic hematuria.

Stones in the urinary tract can cause the following symptoms, according to the NIDDK:

  • pink, red, or brown urine
  • frequent urination
  • incontinence, or involuntary urination
  • painful urination
  • cloudy or foul-smelling urine

The following factors may increase a person’s risk of developing stones, according to the Urology Care Foundation:

  • dehydration
  • consuming large quantities of salt
  • gastrointestinal conditions, such as Crohn’s disease or ulcerative colitis
  • thyroid problems
  • being overweight or having obesity

Endometriosis

Blood in the urine that accompanies severe lower back pain may indicate endometriosis, a common health condition that occurs in more than 11% of adolescent and adult females in the United States.

Endometriosis occurs when tissue similar to the endometrium — the lining of the uterus — grows in areas of the body outside of the uterus.

Although endometriosis can affect any part of the body, the Office on Women’s Health state that it commonly involves the following areas:

  • outer lining of the uterus
  • ovaries
  • fallopian tubes

Without treatment, endometriosis can affect fertility.

Cancer

Although it does so less commonly than infections and stones, cancer of the kidney or bladder can also cause hematuria.

The urine may contain blood one day and appear clear the next. A person should not wait for the blood to reappear before contacting a doctor.

Bladder cancer can cause a person to urinate more or less frequently. Kidney cancer does not typically affect a person’s urination habits, but it can cause lower back pain.

Diagnosis

Treating blood in the urine requires an accurate diagnosis of the underlying cause. A doctor may start the diagnosis process by reviewing a person’s medical and family history for any contributing risk factors.

They are likely to ask females when their last menstrual period occurred. The presence of menstrual blood in the urine can result in a false positive hematuria diagnosis.

Doctors use the following tools to diagnose blood in the urine:

Pelvic exam

During a pelvic exam, a doctor will assess the condition of the female reproductive organs, including the:

  • vulva
  • vagina
  • cervix
  • uterus
  • ovaries

Depending on the reason for the evaluation, the doctor may examine the bladder and rectum as well.

Urinalysis

A urinalysis tests for protein, blood cells, and waste products in the urine. It can identify a range of medical conditions that affect the urinary tract, such as kidney disease and UTIs.

Imaging tests

Imaging tests can detect stones, endometriosis growths, and cysts in the urinary tract and pelvis.

Imaging tests can include:

  • ultrasound tests
  • MRI scans
  • CT scans
  • cystoscopy

When to see a doctor

People should not wait to see a doctor if they notice blood in their urine. They should speak with a doctor even if the blood clears on its own.

Females should speak with their doctor if they see blood in their urine outside of their regular menstrual period, especially if it occurs alongside the following symptoms:

  • severe pain in the lower back, intestines, or pelvis
  • gastrointestinal problems, such as constipation, diarrhea, or nausea
  • painful urination
  • cloudy or abnormally colored urine
  • foul-smelling urine
  • fever
  • chills
  • fatigue

Blood in urine in children

UTIs, stones, injuries, and some inherited diseases, such as polycystic kidney disease, can cause hematuria in children. In general, hematuria will not cause further complications in children. It may resolve on its own without treatment.

However, parents or caregivers should still take the child to see a doctor.

In most cases, a doctor will use a physical exam and urinalysis results to diagnose the underlying cause of hematuria in a child.

The presence of blood and protein in the urine may indicate an issue relating to the kidneys. In this case, it may be best to take the child to see a nephrologist, a healthcare professional who specializes in treating kidney conditions.

Treatment

Treatments for hematuria will address the underlying cause.

UTIs

A doctor may prescribe a course of antibiotics to treat hematuria that is due to a bacterial UTI.

Stones

People who have kidney stones can expect an improvement in their symptoms after they pass the stone. Large stones may require either medication, a special procedure to break the stone into smaller pieces, or surgical removal to relieve the symptoms.

Cancers

If a doctor finds that a person has kidney or bladder cancer, they will usually refer the individual to an oncologist, a healthcare professional who specializes in treating people who have cancer.

Treatment options for kidney and bladder cancer include surgery, chemotherapy, and radiation. Treatment programs will vary from person to person, depending on the stage of cancer and whether it involves other organs.

Summary

A doctor can help diagnose the cause of blood in the urine. Some causes, such as endometriosis, are specific to females, and females are more likely than males to experience UTIs.

The treatment for blood in the urine will depend on the cause.

Treating UTIs usually involves antibiotic therapy. Stones in the urinary tract can pass on their own without treatment. Large stones may require medication to break them up or surgical removal.

People should contact their doctor if they experience severe symptoms that interfere with their daily lives.