A prostate carcinoma, commonly referred to as prostate cancer, is a cancer that originates in the epithelial cells of the prostate gland. Considered one of the most frequently diagnosed cancers in men, the prognosis associated with a prostate carcinoma is dependent on when the cancer is discovered. Treatment for a prostate carcinoma depends on the extent, or staging, of the carcinoma and the overall health of the individual.
Symptoms rarely manifest during the early stages of prostate cancer development. Men with an undiagnosed prostate cancer may experience a variety of symptoms as the carcinoma matures. Those who experience difficulty urinating, a swelling in the legs, or pelvic discomfort may be symptomatic. The presence of blood in either semen or urine may also be indicative of the presence of prostate cancer. Additional symptoms may include bone discomfort and a decreased flow when urinating.
There is no known, single cause for the abnormal cell development associated with prostate cancer. In most cases, a prostate carcinoma grows slowly and remains noninvasive to surrounding tissues. As with nearly every cancer, the early detection of a prostate carcinoma is the key to successful treatment. Most prostate cancers may be detected early through routine screening, which is recommended for men 50 years of age and older.
A prostate-specific antigen (PSA) test is a blood test that evaluates a man's PSA levels. As a naturally occurring substance produced by the prostate, PSA levels are normally low and the presence of higher levels in the blood stream may be indicative of a carcinoma. A digital rectal exam (DRE) is a physical examination conducted by a physician that assesses the size and texture of the prostate gland. Any abnormalities discovered during the screening process generally prompt the administration of further testing.
A transrectal ultrasound is usually conducted to assess the condition of the prostate gland. The test involves the insertion of a small transducer into the rectum that emits sound waves, which are transmitted to a video monitor to produce a clear image of the prostate. If the pictures from the ultrasound indicate the presence of an abnormality a biopsy may be conducted. A slender, hollow needle is generally used to obtain the tissue sample, which is sent to a laboratory for further analysis. When biopsy results support a diagnosis of prostate cancer a grading of the carcinoma is performed.
Grading is utilized to determine the aggressiveness of the carcinoma. The growth rate of the abnormal cells compared to that of healthy cells is used to establish the grading of the cancer. The Gleason score is the most commonly employed scale used to evaluate prostate cancer and ranges numerically from a two to a ten. A grade two cancer is considered to be the least aggressive and a ten is the most aggressive. Once the cancer is assigned a grade, further testing may be conducted to determine the staging, or extent, of the cancer.
An individual with a prostate carcinoma that has a grading of three or higher may undergo additional testing that may include a computerized tomography (CT) scan, magnetic resonance imaging (MRI), and a bone scan. Imaging testing is employed to aid with evaluating whether or not the cancer has spread to surrounding tissues and, if so, to what extent. Results from the imaging tests are used to determine the stage of the cancer, which ranges from one to four.
A stage one prostate cancer is in the earliest stage of development and only detectable on a cellular level. When the cancer remains confined to the prostate gland it is given a staging of two. Stages three and four indicate that the cancer has spread to the surrounding tissues, the lymph nodes, and major organs respectively.
Treatment for prostate cancer is dependent on the individual’s overall health and the grade and staging of the cancer. When the carcinoma is discovered very early, treatment may not be immediately necessary, in which case, a wait-and-see approach is taken. In instances where the cancer is advanced, the individual may undergo a treatment regimen that includes radiation and chemotherapy, hormone therapy, or the use of extreme temperature to target and eradicate the cancer cells. A radical prostatectomy may be necessary, which is the surgical removal of the prostate gland.
Complications associated with prostate cancer include urinary incontinence and erectile dysfunction. Men of advanced age or those who have a family history of prostate cancer may be at a greater risk for developing a prostate carcinoma. Obesity often hinders the early diagnosis of a prostate carcinoma, which may complicate treatment. Men may reduce their risk for prostate cancer by exercising regularly, eating healthy, maintaining a healthy body weight, and refraining from unhealthy habits, such as smoking and excessive alcohol consumption.
