The good news is that many tumors are not very aggressive, remain confined to the prostate and have a rather slow course; this means that patients can live with cancer for years without undergoing specific treatments and without suffering negative consequences for their health. Furthermore, when necessary, the therapeutic options are multiple and quite effective. Unfortunately, alongside the very slow-growing forms, there are also more aggressive prostate cancers, with a tendency to metastasize. These types of cancer grow rapidly and can spread to other parts of the body (through the blood or the lymphatic system), where cancer cells can form secondary tumors (metastasize). In such circumstances, the chances of curing the disease are very low.
Data in hand, it is estimated that every Italian over 65 has about 3% chance of dying from prostate cancer. For this reason, it is good not to let your guard down: intervening in time means greater chances of eradicating or containing the disease.(lower abdomen), just below the bladder and in front of the rectum, surrounding the first portion of the urethra. The parenchyma consists of a cluster of tubuloalveolar glands, surrounded by a rather thick layer of smooth muscle fibers.
The main function of the prostate is to help produce sperm, as it secretes part of the seminal fluid released during ejaculation (note: seminal fluid together with sperm constitutes sperm).Symptoms Prostate cancer
In the early stages, prostate cancer is often asymptomatic; this means that the patient does not experience any symptoms, remaining unaware of the condition. In recent years, thanks to the growing awareness of the dangers of the disease, most prostate cancers are diagnosed in these early stages. A urological examination accompanied by a check of the PSA (prostate specific antigen), by means of a blood test, allows to identify the subjects at risk in which to carry out further tests.
If the tumor is ignored, the increase in its size is associated with problems associated with urination, as the organ surrounds the prostatic urethra. The changes within the gland therefore directly affect urinary function. Symptoms of prostate cancer can include:
- Difficulty urinating (hesitation);
- Frequent urge to urinate, especially at night (nocturia);
- Difficulty maintaining a steady stream of urine (the flow is weak, intermittent, or a feeling of not being able to empty your bladder completely)
- Pain or burning when urinating
- Blood in the urine or semen
- Erectile dysfunction (impotence);
- Painful ejaculation;
- Discomfort in the pelvic area;
- Fatigue, loss of appetite and general malaise
- Generalized pain in the back, hips or pelvis.
PLEASE NOTE: The urinary symptoms described are manifested in a similar way to other benign prostatic problems, such as prostatic hyperplasia (BPH). For this reason, if one or more of these manifestations occur, it is advisable to undergo specific medical examinations without panicking, it could in fact be a "simple" benign enlargement of the prostate. Again, the appearance of these symptoms in an acute form could indicate a "generally bacterial" inflammation of the prostate: prostatitis.
Malignant prostate cancer can metastasize to the lymph nodes in the pelvis and progressively spread to other parts of the body. Prostate cancer tends to metastasize mainly to the bones of the spine, pelvis, ribs and femur. Bone pain, therefore, can be a symptom of advanced prostate cancer. If the metastasis compresses the spinal cord, it can cause weakness or numbness in the lower limbs, urinary and fecal incontinence.
Benign prostatic problems
Benign prostatic pathologies are more common than neoplasms, especially after the age of 50; often, these conditions cause symptoms that could be confused with those of the tumor.
Under normal conditions, the prostate is approximately the size of a walnut, but due to advancing age, or due to certain pathologies, it can enlarge and cause problems, especially urinary ones.
Enlarged prostate (benign prostatic hyperplasia). The prostate is very sensitive to the action of hormones, such as testosterone. Over the years, an enlargement of the gland occurs spontaneously, following the hormonal changes that occur in the testicle (the production of androgens decreases and the release of small amounts of estrogen hormones.) Benign prostatic hyperplasia can compress the urethra and cause problems in passing urine.
Inflammation (prostatitis). Prostatitis is an "inflammation of the prostate. Usually, the main cause is a" bacterial infection, but it can also arise in the absence of pathogens. Symptoms consist of pain in the lower abdomen, often accompanied by dysuria, and loss of mucous secretions.they are characterized by small alterations in shape and size, which make them anomalous. Many men may have mild dysplasia (PIN1, low grade) even at a young age, but they will not necessarily develop prostate cancer. A high-grade intraepithelial prostatic neoplasm, on the other hand, correlates with a significantly higher risk. For this reason, physicians must carefully monitor each patient in which it is found and possibly perform another "biopsy of the prostate."
An adenocarcinoma arises when the normal cells, making up one of the secretory glands, become cancerous. During the initial stages, the lesions remain confined. Over time, the cancer cells begin to multiply and spread into the surrounding tissue (stroma), forming a tumor mass. This causes a swelling of the surface of the prostate, which can be seen during palpation of the gland through the rectal wall. In the later stages, the tumor can increase in size and invade neighboring organs, such as the seminal vesicles or the rectum. Cancer cells can develop the ability to migrate from the site of origin to another part of the body, through the bloodstream and the lymphatic system. These can proliferate and form secondary tumors. Prostate cancer metastasizes more frequently to the bones, lymph nodes and can invade the rectum, bladder and ureters by means of a local diffusion mechanism.
Malignant tumors (prostate cancer)
- They do not invade neighboring tissues;
- They do not metastasize to other parts of the body;
- They can be treated and usually do not tend to come back.
- They can invade nearby organs and tissues (such as the bladder or rectum);
- They can give rise to metastases in other parts of the organism;
- They can be treated, but they can come back.
Adenocarcinoma is the most frequent histotype among prostate neoplasms (it represents about 95% of malignant tumors).
However, there are other cancers, which differ in clinical presentation and course, including:
- Small cell carcinoma (originates from neuroendocrine cells);
- Ductal adenocarcinoma (originates from the cells of the prostatic ducts);
- Mucinous carcinoma (characterized by the production of mucus);
- Adenosquamous or squamous carcinoma;
- Mesenchymal neoplasms (such as sarcomas or liposarcomas);
- Primary lymphoma of the prostate.
Once the type of cancer has been diagnosed, the doctor will also need to consider:
- The grade of the tumor (how the abnormal cancer cells behave);
- The stage of the cancer, including whether it has spread (metastasized) and where it has spread
- Prognostic factors (particular characteristics that could influence the course of the disease);
- Survival statistics for the particular type and stage of cancer.
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