PROSTATE CANCER

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	PROSTATE CANCER
	*PROSTATE CANCER*

PROSTATE CANCER

Cancer of prostate

It is the most frequent cancer in the man.

Very related to the age, it appears in the autopsies of more of 40% of men of fifty years, to increase his frecuensia until a 67% (one of each three) between 80 and 89 years.

In spite of it, the appearance of symptoms of the same one in life much more is reduced (around a one percent).

The risk of developing a cancer of prostate in a Spanish of 50 years throughout its life approaches 40%, but from this that produces clinical symptoms it does not arrive at 10%, and the possibility that it produces muetre to him is inferior to 3%.

Complications

It depends on estadío evolutionary in which one is.

The located disease can cure without affectation of the hope or quality of the life.

The hormonal treatment reduces the quality of the life, when annulling the sexual function and the líbido one.

The disease locally outpost can be cured, but most frequent it is than it less falls to than three years, reducing the life expectancy.

The metastásica disease reduces the life expectancy, although initially usually it stops with the treatment.

Causes

The basic cause is not known, although diverse theories and data aim at a traumatismo like leading factor.

Signs and symptoms

Initially they produce few symptoms.

The presence of obstructivos symptoms:

Delay in the beginning of the micción,

Spurt of tinkles little powerful, with pauses,

Sensation of incomplete evacuating,

Dripping after finalizing.

he is much more frequent in the Benign Hipertrofia of Pro'stata (HBP)

The cancers already very advanced cause:

Circulatory difficulties in legs, with swelling,

Dolores of bones, mainly vertebrales, or

neurological symptoms (impotence, lack of evacuating of vejiga with retention of tinkles)

Factors of risk

The age.

One assumes that environmental or dietetic factors exist that influence in their advance, but they have still not been possible to make specific.

Prevention

Urinary obstruction, with repercussion in the kidneys.

Pathological fractures of spine, by the metástasis.

Neurological affectations caused by the previous ones.

Diagnosis and treatment

The habitual procedure of diagnosis comes as it follows:

Rectal tacts of cribaje are made in the asintomática population.

In the cases in which is the enlarged and hard gland, it is come to a determination of tumorlike markers in the blood (PSA).

His result must to interpret with much caution in this context, since this test produces many false positives (say that a person heals is ill) and negative (they say that a patient is healthy), reason why are much more useful for the pursuit of the disease that stops its initial diagnosis. Also other parameters in the blood, indicative of remote development of the disease study (acid Fosfatasa).

He is advisable, if there are obstructivos symptoms, to make studies of the renal function.

Immediately afterwards, to confirm or to assure the diagnosis, obtaining of a weave sample is come to a transrectal puncio'n-biopsy (by means of the introduction of a needle from the rectum; he is little annoying).

From here, one goes to the visualization techniques, to value the surgical possibilities (to do before produces it confused results):

Transrectal Prostate Ecografia: It allows to detect if the cancer is confined to the prostate or it has overflowed it. Also one is used to guide the needle in the previous procedure of puncio'n-biopsy.

RMN (Resonancia Magne'tica Nuclear): It allows to value the pelvic lymphatic ganglia (that are affected soon, and whose affectation influences in the therapeutic decision).

T.A.C. (Tomografia, Escáner): little is used, surpassed by the RMN.

Bony Gammagrafía: One is used to detect metástasis in bones.

Once made all these tests, one determines the degree of volución of the tumor and the suitable therapeutic intervention more.

Treatment of the located disease

Three possibilities exist:

Surgical extirpation of the gland. Very effective in selected patients, usually it conserves the urinary function (the continencia) in most of patients, and the eréctil function in selected cases.

X-ray. Effective alternative in selected cases, avoids the necessity of an intervention. Executed well, it facilitates the conservation of the urinary and eréctil function.

Monitoring: In some selected cases, it can be the best option, but the treatment by some of the previous methods prolongs the survival in general, reason why it is not the first option.

Treatment of the disease locally outpost

In these cases the optimal treatment is being investigated intensely.

The techniques are combined the previous techniques with hormonal treatment:

When depending the prostate weave on masculine hormones, its cancellation causes its disappearance, at least partial.

Today in day the election agents are the antagonists of the LHRH (Leuprolida, etc.), so effective that they avoid the necessity of surgical castration (necessary previously to avoid a masculine hormone source), or other similar measures.

Usually they are accompanied, so that the blockade is complete, by antagonists of the androgénicos receivers (Flutamida, etc.).

They produce cancellation of the sexual function and the líbido one.

Treatment of the Metastásica disease

In these cases the treatment is limited the hormonal modalities.

For some bony metástasis that cause symptoms, X-ray can be applied locally.

The palliative cares are very important (treatment of the pain, bony incontinencia, injuries...)

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