Prostate cancer

Prostate cancer is a type of cancer that occurs in the prostate gland, which is a small walnut-shaped gland in men that produces seminal fluid. Prostate cancer typically develops slowly and may not cause symptoms in its early stages. However, as the cancer grows, it may cause symptoms such as difficulty urinating, blood in the urine or semen, pain in the hips, back, or chest, or erectile dysfunction. Prostate cancer is the second most common type of cancer in men worldwide, and the risk of developing prostate cancer increases with age. Prostate cancer is the most commonly diagnosed male malignancy worldwide. In 2018, 1,276,106 new cases of prostate cancer were registered worldwide, representing 7.1% of all cancers in men. The incidence and mortality rates for prostate cancer vary by race and ethnicity. Hispanic men have a lower incidence and mortality rate than non-Hispanic white men, but a higher incidence and mortality rate than non-Hispanic black men.

Risk factor

Prostate cancer is a complex disease, and its exact causes are not yet fully understood. However, researchers have identified several risk factors that may increase a man's chances of developing prostate cancer. Some of the most common risk factors for prostate cancer include:

  •  Age The risk of prostate cancer increases as men get older, with the majority of cases occurring in men over the age of 65
  • Family history Men with a family history of prostate cancer, particularly in a father or brother, are at increased risk of developing the disease themselves.
  • Genetics Some inherited genetic mutations, such as the BRCA1 and BRCA2 genes, have been linked to an increased risk of prostate cancer.
  • Race and ethnicity Prostate cancer is more common in African American and Caribbean men than in men of other races and ethnicities.
  • Exposure to certain chemicals Exposure to certain chemicals, such as cadmium, may increase the risk of developing prostate cancer.
  • Inflammation of the prostate Chronic inflammation of the prostate gland, a condition known as prostatitis, may increase the risk of developing prostate cancer.

It's important to note that having one or more of these risk factors does not necessarily mean that a man will develop prostate cancer. Conversely, some men without any of these risk factors may still develop the disease. If you have any concerns about your risk of prostate cancer, it's best to speak with your healthcare provider.

Diagnosis

The diagnosis of prostate cancer typically begins with a physical exam and a blood test called prostate-specific antigen (PSA) test. If the PSA level is elevated, a doctor may recommend a biopsy of the prostate gland. During a biopsy, a small piece of tissue is removed from the prostate gland and examined under a microscope to look for cancer cells.

  • ዲጂታል የፊንጢጣ ምርመራ (DRE) ዶክተሩ በፕሮስቴት እጢውስጥ ለሚከሰት ማንኛውም አይነት መዛባት ለመሰማት የጓንት ጣትን ወደ ፊንጢጣ ያስገባል።
  • ፕሮስቴት-ስፔሲፊክ አንቲጅን (PSA) ምርመራ በደም ውስጥ ያለውን የ PSA መጠን የሚለካ የደም ምርመራ. ከፍ ያለ የ PSA ደረጃ የፕሮስቴት ካንሰር መኖሩን ሊያመለክት ይችላል, ነገር ግን ምርመራው ትክክለኛ አይደለም እና በሌሎች ካንሰር ያልሆኑ ሁኔታዎችም ከፍ ሊል ይችላል፡፡
  • Biopsy በDRE ወይም PSA ምርመራ ወቅት ያልተለመዱ ነገሮች ከተገኙ ባዮፕሲ ሊመከር ይችላል። በዚህ ሂደት ውስጥ ለምርመራ የሚሆን  ከፕሮስቴት እጢ ውስጥ ትንሽ ቲሹ ይወጣል፡፡
  • የኢሜጅ ምርመራ እንደ ማግኔቲክ ሬዞናንስ ኢሜጂንግ (ኤምአርአይ) ወይም ኮምፕዩትድ ቶሞግራፊ (ሲቲ) ስካን ያሉ የምስል ሙከራዎች በፕሮስቴት እጢውስጥ ያሉ አሳሳቢ ቦታዎችን ለመለየት ይረዳሉ።

ለፕሮስቴት ካንሰር ስላላቸው ተጋላጭነት ለወንዶች ከጤና ባለሙያጋር መነጋገር እና የፕሮስቴት ካንሰርን የመመርመር ጥቅማ ጥቅሞችን እና አደጋዎችን መወያየት አስፈላጊ ነው። የአሜሪካ የካንሰር ሶሳይቲ ወንዶች የፕሮስቴት ካንሰር ምርመራን በተመለከተ ከጤና ባለሙያ ጋር በመሆን ከጤና አጠባበቅ አቅራቢያቸው ጋር እንዲወያዩ  እና የሚመቻቸው የምርመራ ምርጫዎች ላይ ተመርኩዘው Diagnosis እንዲደረግላቸው በመረጃ ላይ የተመሰረተ ውሳኔ እንዲያደርጉ ይመክራል። 

Staging for prostate cancer

Stage I Cancer in this early stage is usually slow growing. The tumor cannot be felt and involves one-half of 1 side of the prostate or even less than that. PSA levels are low. The cancer cells look like healthy cells.

Stage II The tumor is found only in the prostate. PSA levels are medium or low. Stage II prostate cancer is small but may have an increasing risk of growing and spreading.

Stage II A The tumor cannot be felt and involves half of 1 side of the prostate or even less than that. PSA levels are medium, and the cancer cells are well differentiated. This stage also includes larger tumors found only in the prostate, as long as the cancer cells are still well differentiated.

Stage IIB The tumor is found only inside the prostate, and it may be large enough to be felt during a DRE. The PSA level is medium. The cancer cells are moderately differentiated.

Stage IIC The tumor is found only inside the prostate, and it may be large enough to be felt during a DRE. The PSA level is medium. The cancer cells may be moderately or poorly differentiated.

Stage III PSA levels are high, the tumor is growing, or the cancer is high grade. These all indicate a locally advanced cancer that is likely to grow and spread.

Stage IIIA The cancer has spread beyond the outer layer of the prostate into nearby tissues. It may also have spread to the seminal vesicles. The PSA level is high.

Stage IIIB The tumor has grown outside of the prostate gland and may have invaded nearby structures, such as the bladder or rectum.

Stage IIIC The cancer cells across the tumor are poorly differentiated, meaning they look very different from healthy cells.

Stage IV The cancer has spread beyond the prostate.

Stage IVA The cancer has spread to the regional lymph nodes. 

Stage IVB The cancer has spread to distant lymph nodes, other parts of the body, or to the bones.

Treatment

The treatment of prostate cancer depends on several factors, including the stage of the cancer, the individual's age and overall health, and their personal preferences.

For early-stage prostate cancer that has not spread beyond the prostate gland, treatment options may include

  • Active surveillance This involves closely monitoring the cancer with regular checkups and tests, but not treating it immediately. Treatment may be started later if the cancer grows or causes symptoms.
  • Surgery This involves removing the prostate gland and some surrounding tissue. This is called a radical prostatectomy.
  • Radiation therapy This uses high-energy radiation to kill cancer cells. It can be done externally or internally (brachytherapy).
For more advanced prostate cancer that has spread beyond the prostate gland, treatment options may include:
  • Hormone therapy This involves blocking or reducing the amount of testosterone in the body, which can help slow the growth of prostate cancer cells.
  • Chemotherapy This uses drugs to kill cancer cells throughout the body.
  • Immunotherapy This uses drugs that help the immune system to recognize and attack cancer cells.
  • Targeted therapy This uses drugs that target specific molecules or pathways involved in the growth and spread of cancer cells.

In some cases, a combination of treatments may be used. It's important for individuals with prostate cancer to talk with their healthcare provider about the benefits and risks of each treatment option and to make an informed decision based on their individual needs and preferences.

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