Prostate enlargement, defined as a natural part of the aging process, does not occur with the same intensity in all men. And not all of them, despite the passage of years, suffer from ailments due to prostatic enlargement. That is why it is worth examining the prostate, because its enlargement can turn into prostate cancer.
Prostateis located just below the bladder and surrounds the urethra. When mature, it is 3-3.5 cm wide and can weigh 15-20 g depending on the male's build.
The prostate needs testosterone, a hormone produced by the testes, to develop and function properly.
The prostate itself produces a fluid that contains glucose - a substance that nourishes and protects sperm. So the prostate is responsible for the quality of the sperm, and thus - for male fertility.
Around the age of 45-50, the male body begins a cycle of hormonal changes. Probably under their influencethe prostate glandbegins to enlarge again. An enlarged prostate is called an adenoma or benign prostatic hyperplasiaprostatic hyperplasia(from Englishbenign prostatic hyperplasia -BPH).
Doctors even say that an enlarged prostate is a disease that you die from, not one that you die of. This is confirmed by medical statistics. Half of men over 50 suffer from prostate disease, 75 percent. in their eighties and 90 percent over ninety.
Symptoms of an enlarged prostate
Hypertrophy of the prostate is slow and men are not always aware that it is happening. But the enlarging prostate tightens more and more around the urethra, and trouble urinating begins.
As the condition worsens, it becomes more and more difficult to start urinating, and towards the end the flow of urine simply stops. Sometimes, after leaving the toilet, he experiences an embarrassing letting go, and the man has a feeling that despite his efforts, his bladder has not completely emptied.
- more frequent use of the toilet, also at night (even 3-4 times)
- feeling of constant pressure on the bladder
- longer time to start emptying the bladder
- low force of urine flow
- having to strain to empty the bladder completely
- appearance inurine, even trace amounts of blood
- total urinary retention
TOWIDEO What are the symptoms of prostate cancer?
Prostate Cancer - Important Rapid Diagnosis
Few men know what may portend an illness. They are ashamed to even talk to the doctor about it. This is a mistake. The earlier the disease is diagnosed, the more effective the treatment will be.
Any irregularity related to urination should prompt you to visit a urologist. There is nothing to wait for. If a man drops out of control and the prostate grows larger, it is likely that he will develop cancer.
The cancer that develops in the prostate is called primary cancer. This means that it comes from prostate tissue and is not a metastasis of cancer cells from a tumor in another organ.
It also means that it can be completely removed along with the gland before it invades other organs or bones. If detected early, it gives you a chance to heal completely.
Prostate examination
A visit to the urologist begins with an interview. Then the doctor performs a rectal examination , which is a finger through the anus. It is not pleasant for the patient, but it is important - this way you can get the closest to the prostate and check if there are any changes on its lobes, i.e. lumps or hardness. A he althy prostate is smooth and flexible, so you can easily feel any abnormalities this way. Usually, the doctor will also order blood and urine tests.
If cancer is suspected, further diagnosis is required. The core needle biopsy is the most reliable test. They are performed under ultrasound control using a special head that is inserted into the anus. Then, material is collected from the changed places for analysis (histopathological examination). In this way, the presence of cancer cells is confirmed or excluded, and their type and degree of malignancy are determined.
Fine-needle biopsy is performed when, following a rectal examination, the doctor is confident that cancer has developed and only needs confirmation of the diagnosis. The test is minimally invasive, and after cytology of the collected sample, it is known if the patient has cancer.
Performed Ultrasound of the prostate through the abdominal wall doesn't really make much sense unless the urologist sees the results. Only he can use them to assess the condition of the bladder and determine whether the size of the prostate is a threat to your he alth. Recently, a blood test has become fashionable to determine the level of PSA (from Englishprostate specific antigen- prostate specific antigen), a protein produced by epithelial cells prostate gland.
PSA is performed at the earliest48 hours after the rectal examination, because all manipulations in the area of the gland (including inflammation) increase the antigen result. The concentration of PSA antigen should not exceed 4 ng / ml of blood. An increase in PSA levels means that cancer can develop, even if the tumor is so small that it is difficult to detect on an rectal examination. Unfortunately, the measurement of PSA concentration is not reliable. As much as 25 percent men with normal results have prostate cancer, and more than half of men with elevated PSA levels have a he althy prostate gland.
If cancer is suspected, an enzyme in the blood is also measured - prostatic acid phosphorase (PAP), which tells you that the cancer has spread to other organs.
Treatment of an enlarged prostate
Benign gland hyperplasia can be treated pharmacologically or surgically. At the first symptoms of BPH, preparations are taken to alleviate urological ailments. They reduce the tension of the smooth muscles of the urinary tract, reduce swelling and congestion in the bladder neck, and improve the elasticity of the prostate gland and bladder patency. The urologist may also recommend drugs to reduce the volume of prostate adenoma and alpha-blockers to improve the flow of urine through the urethra.
ImportantNobody knows the reasons for the formation of prostate adenoma, although scientists more and more often blame male hormones for its development. It is not known why some men develop a slow prostate without problems, while others develop cancer within a few years. It is suspected that blood type, coronary heart disease, celibacy, high blood pressure, alcohol abuse, smoking and a polluted environment may be responsible for the development of the disease. Prostate cancer runs in families. Gentlemen, whose relatives were ill, should be especially vigilant and start to be examined after forty. Those who do not have such burdens should start regular examinations around the age of 50.
Prostate surgery
With a large adenoma, surgery is sometimes necessary. Usually, the decision about it is made when urine remains in the bladder, urinary tract infections often occur or bladder stones have been diagnosed. Then transurethral electroresection is used.
The surgeon uses micro tools (more and more often with a laser) to reach the prostate through the urethra and remove a part of the gland, usually only the enlarged internal fragment, to allow urine to drain freely. If the adenoma is significantly enlarged, it is reached through the abdominal wall and the bladder. The procedure is performed under anesthesia.
Other methods are used to treat cancer. The more the tumor is developed, the less surgery is performed. Usually it is aimed at such radical treatmentpatients whose disease is confined to the gland itself. The entire gland is then removed (this operation is called a prostectomy).
After the operation, urinary incontinence may occur as the removal of the gland adversely affects the muscles of the bladder sphincter. But this complication should disappear after about half a year.
Another problem is erectile dysfunction. The nerves that are needed to induce it run past the prostate and can be damaged during the procedure. You have to take this into account - although currently the treatments are carried out very precisely.
You must do it
Radiotherapy
Radiation can completely destroy a small tumor and hence heal the tumor as effectively as with prostectomy. This is a good solution for men who, for various reasons, e.g. with a sick heart, cannot be given anesthesia.
Radiotherapy is also used in men whose cancer has spread beyond the prostate, but this procedure does not completely cure. However, it allows you to live, sometimes even for many years, without pain and maintaining independence. Irradiation is unlikely to cause urinary incontinence, but erectile dysfunction is common. The bladder and rectum may also malfunction.
In the treatment of the disease, brachytherapy is also used. It consists in placing an implant in the prostate gland containing radioactive material that destroys cancer cells.
It aims to reduce the size of the tumor. It is believed to make surgery or radiotherapy more effective, but should not be used as the sole treatment. Thanks to hormones, PSA results and fitness at the same time improve quicklyurinating, because the tumor is putting less pressure on the urethra. Some men are satisfied with this and give up further treatment. When they come back for help after a few years, it is too late for it.
Recognizing it does not necessarily mean a dead end. Most cancers belong to a group of adenocarcinomas that grow slowly and usually attack other organs and bones after many years. Hormone castration is an effective method of treatment in such cases. It can be either by removing the testicles (all or just the hormone-producing part) or by administering female sex hormones. Both methods are equally effective because the prostate does not enlarge without androgens.
Hormone treatment
Tumor growth is also stopped by drugs that create a barrier between the tumor and male sex hormones, but they do not affect the level of androgens in the blood. The injection is given once a month. Side effects of the treatment are low sex drive and difficulty in getting an erection. Another problem is hot flashes - the same ones that women experience during the menopause. There is severe sweating at night. This is the result of hormonal treatment, and not, as some people believe, the progression of the neoplastic disease.
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