Dr Rakshith V
Department of Pathology,
Anand Diagnostics Laboratory
The prostate gland is found exclusively in males and it is a part of the male reproductive system. Its main functions are maintaining urinary continence and fluid secretion that forms part of semen.
Prostate cancer is the second most common cause of cancer and the sixth leading cause of cancer death among men worldwide. On autopsy, up to 60% of 70-year-olds and 80% of 80-year-olds are found to have latent prostate cancer.The number of cases is on the rise in urban India. Prostate cancer is a slow-growing tumor, however, few grow rapidly. It is usually asymptomatic, unless when the cancer grows near the urethra.
Factors that increase the risk of prostate cancer include obesity, older age, a family history of the disease, and race. About 99% of cases occur in those over the age of 50. Having a first-degree relative with the disease increases the risk two to threefold. Other factors that may be involved include a diet high in processed meat, red meat, or milk products or low in certain vegetables.
Symptoms tend to come later, if cancer has grown big enough to change the way you urinate – if, for instance, you have trouble starting your urine flow, or you can barely make it to the bathroom in time. The most common symptoms patients come with complaints of urinary urgency, dribbling, interrupted urination, difficulty in starting to urinate, painful urination, pain in pelvis or blood in urine or semen.
That’s why screening tests are very important– for a doctor to feel a rough or hard spot on your prostate during a physical exam, or for your level of PSA to start going up. This is also why it is very important to get a baseline PSA tests in your fourties.
The gold standard method for diagnosis is a biopsy. Digital rectal examination, cystoscopy, transrectal ultrasonography and MRI are main techniques used in cancer detection. Histopathological examination aided by Gleason score correlates with the aggressive behaviour of the tumor.
The importance of prostate cancer screening- Clinical T1 or incidental prostate cancer is defined as the clinically inapparent tumor that is neither palpable nor visible by imaging. Clinical T1a and T1b prostate cancer are diagnosed most of the times at the time of transurethral resection of the prostate (TURP) for the benign prostatic disease.Prior to the PSA era, up to 27% of prostate cancers were detected incidentally at the time of TURP. In the PSA testing era, an incidental prostate cancer on TURP remains common, occurring in 4.1–16.7% of TURP specimens. But one thing to keep in mind is to remember that PSA is also increased in other non-cancerous conditions of the prostate. The earlier the detection the earlier the cure.
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