Treatment of prostate cancer and possible complications of the disease

Consequences of prostate cancer

If you have been diagnosed with prostate cancer, you should learn more about the disease to help you cope with the physical, social, and emotional side effects.

The pathology can occur for a long time without clinical manifestations, but sooner or later the tumor process begins to progress. There are different types of treatment for prostate cancer, all of which can have different effects.

Knowing everything about prostate cancer and the consequences of the disease will make it easier for anyone to cope with problems.

Prostate cancer develops through two stages: androgen-dependent and androgen-resistant. The first stage is treated with antiandrogen drugs - most tumors can eventually become insensitive to hormone therapy.

For hormone-resistant prostate cancer, the treatment results were disappointing for a short time, despite hormonal therapy, the severity of the tumor process increased.

Nowadays, hormone-dependent prostate cancer is treated using progressive therapeutic regimens.

The main consequences of malignant prostate tumors include impotence, urinary incontinence, metastasis, erectile dysfunction, and infertility.

Prostate cancer and erectile dysfunction

Most men experience erectile dysfunction after treatment. The likelihood of the duration of this effect of treatment is determined by age, duration of the disease, lifestyle, various chronic diseases (hypertension, diabetes mellitus). Erectile dysfunction may appear due to taking medications.

Prostate cancer and impotence

Impotence, the inability to achieve or maintain an erection, is one of the consequences of prostate cancer.

About 90% of men experience impotence after orchiectomy for prostate cancer (surgery to remove the testicles). Hormone therapy for prostate cancer also causes impotence in most men.

If it is carried out for a long time, patients cannot restore an erection on their own for a long time.

More often, with prostate cancer, age plays a decisive role in the onset of impotence; in older people, the likelihood of impotence is higher. Treatments to restore erections in these patients include oral medications and penile implants.

Prostate cancer and urinary incontinence

Inability to control urine flow is a common side effect of all prostate treatments. Many patients eventually regain full urinary control.

In severe cases of incontinence, an artificial bladder sphincter is surgically inserted.

Prostate cancer and bone metastases

Prostate cancer can spread to the bones as metastases. They cause pain, weaken bones, and make them prone to fractures. This is often facilitated by endocrine therapy, which is used to slow the spread of prostate cancer. In these cases, doctors prescribe additional treatments to relieve pain and support weakened bones.

How to prevent the effects of prostate cancer with proper nutrition

What you eat can affect your risk of developing prostate cancer, the speed of recovery, and the severity of the consequences. How to improve nutrition for prostate cancer? Patients need to follow a low-calorie diet.

Fatty foods should be avoided and it is better to include fruits, vegetables, whole grains, olive oil, flaxseed and other foods. With the help of a diet prescribed by your doctor, you can stop the progression of prostate cancer!

What are the consequences of prostate cancer with radiation therapy?

Radiation therapy is most often used for prostate cancer. Radiation for prostate cancer can cause side effects:

• fatigue;
• inflammation, dry skin;
• itching;
• frequent urge to urinate;
• weak urinary flow;
• burning, tingling when urinating;
• “heaviness” in the perineum;
• rectal bleeding;
• loose stool.

Some radiation side effects are permanent. Bowel function will never become completely normal, even after stopping treatment. Most symptoms are short-lived and improve after radiation treatment for prostate cancer ends.

After radiation therapy is completed, side effects may last 2-6 weeks, but they will go away soon. Some patients are not bothered by them, so these men can continue normal daily activities. But they should limit physical activity, and lifting any weights is also prohibited.

After radiation therapy, radiation does not remain in the body, so contact with other people may not be limited. Sexual intercourse can be resumed immediately after irradiation; condoms are required.

For most men, erectile dysfunction improves within 2 years after treatment. Irradiation affects the testicles and the sperm count temporarily decreases.

Modern urology treats prostate cancer using different methods, most of which have a positive effect. It is difficult to say which treatment method is better. In any case, serious consequences can arise: the degree of risk, discomfort and time required to restore a normal state are approximately the same.

Source: http://prostatyta.ru/rak-posledstviya

Prostate cancer and its consequences

Prostate cancer is a malignant neoplasm of the prostate gland. This disease is one of the most common malignant processes among male patients. According to statistics, prostate cancer competes only with tumors of the lung and stomach in terms of incidence.

Prostate cancer is currently considered a very big problem, since the disease can most often be diagnosed already at an advanced stage 3 or 4. Therefore, men over 55 years of age, especially with a history of prostatitis and benign hyperplasia, need to be regularly observed by an andrologist for timely diagnosis of a cancerous tumor.

Causes of prostate cancer

Currently, doctors do not name the exact causes of prostate cancer. The disease is caused by various negative factors accompanying pathologies that affect the prostate gland throughout a man’s life. Most often, prostate cancer is diagnosed after 60 years of age, but in recent years there has been a trend towards rejuvenation of the pathology.

The following factors contribute to the development of prostate cancer:

• Hereditary predisposition. If there is oncology in the family, especially prostate cancer in the father or brothers, then the likelihood of developing the disease increases several times.
• Eating fatty foods with carcinogens and animal fats in large quantities.
• Taking testosterone drugs, especially uncontrolled and without strict indications.
• Endocrine disorders.
• Smoking, especially long-term and continuous smoking, in large quantities.
• Alcohol abuse.
• Having excess weight.
• A benign tumor in the prostate is an adenoma.
• Chronic prostatitis.
• Autoimmune reactions in the body.

According to the study, vasectomy, that is, male sterilization, slightly increases the likelihood of prostate cancer.

Symptoms of Prostate Cancer

Like most cancers, prostate cancer develops gradually and secretly, without showing itself in any way. This greatly complicates early diagnosis of the disease, especially if the patient refuses to visit a medical facility for preventive purposes.

Even when the first signs of prostate cancer appear, patients are in no hurry to see a doctor and get examined, because these symptoms are very similar to an exacerbation of prostatitis:

• pain in the groin of varying intensity;
• frequent urge to urinate;
• sluggish stream of urine;
• feeling of incomplete emptying of the bladder;
• urinary incontinence;
• erectile disfunction.

As cancer progresses, pain may increase, blood may appear in the urine, and signs of kidney failure may appear.

Prostate cancer of 3-4 degrees, accompanied by metastasis, is manifested by the following symptoms:

• pain in the ribs, joints, bones;
• swelling of the limbs;
• weight loss;
• pale skin;
• anemia;
• exhaustion of the body.

Diagnosis of prostate cancer

Currently, there is only one test for prostate cancer, which allows one to suspect a malignant process at the first stage, when the tumor is minimal in size. This test is called PSA or prostate-specific antigen test.

This test determines the amount of serine protease that is found in prostatic fluid. When the prostate is damaged, including cancer, the level of PSA in the blood increases. Thus, regular preventive PSA testing helps diagnose prostate cancer in the early stages.

If the PSA level is elevated, it is necessary to determine the reasons for this result, since a negative result does not only occur with cancer. For this, the patient is prescribed:

• examination by an andrologist through the rectum;
• prostate biopsy;
• Ultrasound and Doppler Doppler Doppler.

By palpation, the doctor can determine that some kind of change has occurred in the prostate gland. But with the help of such an examination, it is impossible to say for sure what caused the hardening of the prostate - cancer, adenoma, chronic prostatitis, tuberculosis, stones, so it is very important to conduct a comprehensive examination. The most accurate examination method is a prostate biopsy.

If prostate cancer is confirmed, other studies may be prescribed to clarify it, in particular, scintigraphy of skeletal bones, X-ray of the lungs, MRI.

Classification of neoplasm

The following types of prostate cancer are distinguished:

• Glandular (adenocarcinoma) is the most common form of tumor. It is divided into large and small coacinar, solid, cribriform, and papillary.
• Transitional cell is a very rare form of the disease.
• Squamous cell is one of the rare forms.
• Undifferentiated is a cancer in which various types of prostate cells are involved in the pathological process.

Let's consider the degrees of glandular type prostate cancer (adenocarcinoma), since this form of the disease occurs in most cases:

• Grade 1 is characterized by the absence of any signs. The tumor is so small that it is not palpable and is not visible on ultrasound. As a rule, it is possible to diagnose stage 1 prostate cancer if a biopsy is performed against the background of elevated levels of prostate specific antigen.
• Stage 2 prostate cancer is palpable and visible on a pelvic ultrasound. The tumor does not extend beyond the prostate gland.
• Stage 3 of the disease is characterized by the growth of the neoplasm to the seminal vesicles.
• Stage 4 prostate cancer grows into neighboring organs, that is, the bladder neck, rectum, and abdominal cavity. There is a high probability of systemic spread of metastases.

Accordingly, the earlier prostate cancer is diagnosed, the greater the likelihood of a favorable outcome.

Prostate cancer treatment

Treatment for prostate cancer depends on the extent of the disease and the shape of the tumor. For grades 1 and 2 of pathology, prostatectomy is recommended, in which the prostate gland, bladder neck, seminal vesicles, and lymph nodes are removed. The prognosis in this case is quite favorable, but after prostatectomy there is a high probability of developing urinary incontinence and impotence.

Prostate cancer is a hormone-dependent tumor, so treatment is accompanied by measures to reduce testosterone levels. To achieve this, a subcapsular orchiectomy may be performed.

This is an operation in which the parenchyma of the testicles that produce hormones is removed, but the shell of the glands itself is preserved.

After surgery, the body stops producing endogenous testosterone, due to which the tumor grows more slowly and does not spread to neighboring tissues.

An alternative to subcapsular ochyectomy is currently medical castration. The patient takes a drug, for example, Buserelin, which suppresses testosterone production. In rare cases, treatment is carried out using surgical and medical methods simultaneously.

Lack of testosterone not only reduces the rate of tumor growth, but also has some negative effects on the body. Thus, signs of menopause occur: hot flashes, decreased libido, impotence, osteoporosis, and gynecomastia may develop.

Radiation therapy can be carried out externally, or by introducing a plate with an active component into the organ. This therapy is quite effective, but has its side effects, including:

• radiation cystitis;
• destruction of the intestinal wall;
• urethral injury;
• weakness throughout the body;
• nausea.

Chemotherapy for prostate cancer is prescribed if other treatments are ineffective. As a rule, such therapy is recommended for stage 4 cancer in order to prolong the patient’s life.

Recovery after prostate removal

Radical prostatectomy is an effective method for treating prostate cancer and preventing recurrence in the early stages of the disease. In the first days, rehabilitation measures are aimed at preventing postoperative complications:

• To avoid infection, antibiotics are prescribed.
• To prevent narrowing of the urethra and obstruction of urine flow, a catheter may be installed, and patients are also required to drink plenty of fluids.

Subsequently, prostatectomy almost always causes urinary incontinence and erectile dysfunction. But there are chances to restore normal erection for healthy sexual relationships. To do this, the patient is recommended:

• Try to increase blood flow to the penis using a vacuum pump.
• Take phosphodiesterase 5 inhibitors. These drugs help fill the cavernous bodies with blood and improve erection. But to get the effect of such drugs, you must have a sufficient level of sexual arousal. With reduced libido, PDE-5 will be ineffective.
• Application of vibration stimulation of the penis.
• Injections into the penis to improve blood circulation.
• Penile prosthetics.

To eliminate incontinence and improve blood circulation, it is recommended to perform exercises for the pelvic floor muscles.

Also, after removal of the prostate, the following recommendations must be followed:

• Avoid constipation by eating more vegetables and drinking at least 2 liters of water per day.
• If you have spasms in the bladder, you should consult a specialist.
• If the scrotum is swollen, it is necessary to wear supportive underwear.
• It is recommended to move less for 10 days after surgery, but you should not lie down all the time. A month after removal of the prostate, you need to return to an active life.
• It is better to bathe in the shower; you should not lie in the bathtub or swim in a pool or ponds until you are completely recovered.

A healthy lifestyle and the desire to restore men's health will help get rid of the consequences of prostatectomy. Restoring potency may take several months or years; the most important thing is not to give up and follow all the doctor’s recommendations.

Conclusion

Prostate cancer is a dangerous and fatal disease. The prognosis is favorable only with early diagnosis of the tumor. At stage 4 prostate cancer, the 5-year survival rate does not exceed 10%.

Therefore, all men, especially after 50-55 years, simply need to be examined by an andrologist every 6 months and, for prevention, take a PSA test once a year. This especially applies to men who have at least 1 case of prostate cancer in their family.

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Source: https://prostatits.ru/oslozhneniya/rak-prostaty.html

Complications of brachytherapy for prostate cancer: what to do?

One type of radiotherapy used to deliver radiation into the affected area of ​​an organ as accurately as possible is brachytherapy. Brachytherapy for prostate cancer is used in the initial stages of the disease and is based on an individual approach to the individual case.

Good health to you, dear readers. This is Alexander Burusov, and in this article you will get acquainted with such a method of treatment for prostate cancer as brachytherapy, and you will also find out what complications it can cause.

I would like to note right away that when prescribing this method of treatment, specialists pay attention to the patient’s age, the degree of the disease, as well as the possibility of complications after radiation therapy (classification according to risk level). It is important that such treatment is much easier to tolerate than surgery or external irradiation.

Types of therapy

Brachytherapy in the treatment of prostate cancer (PCa) is a radical treatment method, but even conservative specialists see it as effective and safe. After all, the main advantage is that a large dose of rays is directed directly at the tumor, and undesirable effects on unaffected organs and tissues are minimized.

Mandatory condition : the volume of the prostate should not exceed standard sizes, otherwise the inserted needle will not reach the target, and the risk of complications may increase. It is possible to reduce the volume of the prostate with the help of hormonal therapy, which is carried out for an average of 5 months. Only after reducing the volume of the gland is brachytherapy possible.

The effectiveness of prostate cancer treatment depends on timely detection of the disease, so it is necessary to undergo regular medical examinations.

Procedure

The first stage of brachytherapy is planning. The doctor must, based on ultrasound, MRI or CT readings, establish the most optimal treatment parameters. These include: the dosage of radiation, the number of so-called “grains” with radioactive iodine injected into the prostate, as well as the exact location of their injection.

After this, the treatment method , there are only 2 of them:

• low dose brachytherapy,
• high dose brachytherapy.

In the first case, treatment is carried out by introducing capsules into the prostate. This therapy lasts about 2 hours. The intestines are cleansed in advance, and during the procedure the patient is either under full anesthesia or under incomplete anesthesia, which involves anesthesia of only the lower part of the body.

After this, “grains” are introduced into the prostate through special needles, which are then removed. When using permanent brachytherapy, the injected capsules remain in the body for life.

Then a period of irradiation of cancer cells begins (for 2 months), when the tumor decreases in size and then completely disappears. During this period, constant medical supervision is not required, and the patient can be discharged from the hospital on the same day as brachytherapy.

In the second case, the principle of action is the same, but the capsules are in the prostate for 15 minutes and then removed.

The concentration of radioactivity in the “grains” is higher than with low-dose brachytherapy, which means that capsules cannot be left in the patient’s body for a long time to avoid complications.

Such radiation therapy is carried out based on the individual characteristics of the disease case noted by a specialist.

Pros of therapy

• short duration of the procedure and recovery period. If the therapy is carried out without subsequent complications, then the patient can engage in usual activities in the next week after the procedure,
• high degree of potency preservation,
• reducing injury to a minimum. After implantation, there are no rectal complications or problems with urination,
• well tolerated by patients. Brachytherapy is well tolerated by older people, as well as those who are simultaneously ill with other diseases,
• effectiveness. After using this type of treatment, the patient's optimal quality of life is maintained.

Possible complications

After the brachytherapy procedure, the patient may feel unreasonable fatigue, allergic reactions on the skin (itching, redness), inflammation of the bladder (cystitis), blood in the urine, and inflammation of the digestive tract. Possible diarrhea, difficulty urinating, decreased erection.

A narrowing of the urinary canal is possible, swelling of the legs and slight hair loss in the groin are possible. These effects of brachytherapy for prostate cancer can occur individually and at different times, almost never together and simultaneously.

Immediately after the operation, the wounds from the inserted needles may bleed for several days, and the presence of blood clots may be observed in the urine. This reaction of the body is acceptable and there is no need to sound the alarm.

Problems with urination, particularly urinary incontinence, are extremely rare. But problems with erection are observed in almost 35% of men, which can subsequently lead to complete impotence. Difficulties with bowel movements are possible, and mucus may appear in the feces.

Such difficulties with bowel movements usually go away after a few weeks without professional intervention or medication. Do not be afraid of the radioactivity of the capsules, as it has a short radius of action on the human body.

It is possible that after radical treatment methods the disease may return, which is a fairly common occurrence. According to statistics, biochemical recurrence of prostate cancer is detected in one third of patients with prostate cancer. This depends on the stage and location of the cancer, as well as on the level of prostate specific antigen (PSA), which should not exceed 0.2 ng/ml.

The history of changes and the totality of metastases in the lymph nodes are also taken into account. Recurrence can form both in the prostate itself and in the tissues adjacent to it. Damage to other organs is also possible; the lungs and bones are primarily at risk.

Conclusion

Relapse should be treated in accordance with previous therapy. The goal of treatment is to eliminate the tumor with subsequent improvement of the patient's condition, relief from symptoms, unwanted effects and avoidance of death. If the patient has undergone radiation treatment, re-irradiation of the tumor-affected area is not recommended.

Also, the development of recurrent cancer can be stopped for several years with the help of hormonal therapy. The main disadvantage of this treatment is that over time the cancerous tumor begins to grow , which indicates a hormonally resistant tumor. This stage of relapse is incurable, and patients with observed complications live for about a year.

It is possible to carry out chemotherapy , which reduces the intensity of symptoms, making the patient feel better. Over the course of three years, there has been stabilization and improvement in the general condition of the patient. Modern methods of treating relapse are cryosurgical and radiofrequency ablation, as well as an improved ultrasound system.

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Source: https://medeponim.ru/bolezni/vozmozhnye-oslozhneniya-brahiterapii-pri-rake-prostaty

Treatment of prostate cancer: methods of treating prostate cancer, prostate oncology, treatment

There are different types of treatment for prostate cancer in men; the doctor chooses tactics taking into account a number of factors. First of all, they focus on the stage of the tumor. If it does not extend beyond the prostate gland, surgical treatment is possible. If there are metastases in the lymph nodes, bones and other organs, surgical treatment will not lead to recovery.

It is also necessary to take into account concomitant health problems, and they usually exist, because malignant prostate tumors are more often diagnosed in older men. Such patients often suffer from arterial hypertension and have a history of stroke or heart attack. In such cases, surgery is often contraindicated.

Modern methods of treating prostate cancer

Treatment for prostate cancer may include surgery, radiation therapy, chemotherapy, and hormonal therapy. In some cases, the doctor adheres to active surveillance tactics.

Active Surveillance

For some men, due to age or underlying health problems, treatment can lead to complications and side effects that are more serious than the problems caused by the cancer itself. In such cases, the doctor may adhere to active surveillance. This tactic is possible in the following cases:

• The patient does not experience symptoms.
• The tumor is predicted to grow slowly.
• The tumor is small in size.
• The cancer has not spread beyond the prostate gland.

Find out the exact cost of treatment

Active surveillance tactics involve doctor's examinations and blood tests for prostate-specific antigen every six months. Once a year, your doctor may order a prostate biopsy.

Surgical treatment of prostate cancer

For prostate cancer, a radical prostatectomy is performed, an operation during which the prostate gland and surrounding tissue, including the seminal vesicles, are removed.

Radical prostatectomy can be performed in different ways:

• Retropubic prostatectomy is performed through a longitudinal incision from the umbilicus to the pubis. Usually the patient is discharged from the clinic a few days after the operation, the recovery period lasts several weeks.
• In a perineal prostatectomy, an arcuate incision is made between the scrotum and anus. This operation is faster than retropubic prostatectomy, but it makes it difficult to access the lymph nodes and is more likely to cause erection problems.
• Laparoscopic prostatectomy is performed using special instruments through punctures in the abdominal wall. It is accompanied by less bleeding and less tissue trauma compared to open interventions, and the recovery period is shortened. But the risk of complications is approximately the same.
• Robotic prostatectomy is performed using the da Vinci robot. In essence, this is the same laparoscopic intervention, but the surgeon does not hold the instruments himself, but controls the movements of the robot through a special remote control. Thanks to this, the movements of the instruments are more precise. But there is no evidence that it helps reduce the risk of complications.

Possible complications after radical removal of the prostate: urinary incontinence, erectile dysfunction, slight shortening of the penis, inguinal hernia, infertility, lymphedema (swelling due to removal of lymph nodes).

Radiation therapy for prostate cancer

Radiation therapy may be prescribed as an alternative to surgery. It is often as effective as surgery. Other indications:

• In combination with hormonal therapy for cancer that has spread beyond the prostate gland.
• When cancer recurs.
• As palliative treatment in later stages. This helps control tumor growth and increase the patient's life expectancy.

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There are two types of radiation therapy used for prostate cancer: external and internal (brachytherapy). External radiation comes in different types:

• Three-dimensional conformal radiation therapy uses computer technology to determine the exact location of the prostate gland and tumor. This helps reduce damage to surrounding healthy tissue.
• Intensity modulated radiation therapy is a more advanced form of 3D conformal radiation therapy. The device not only irradiates the tumor from different angles, but also regulates the intensity of the radiation. This allows an even higher dose to be delivered to the prostate without irradiating healthy tissue.
• Stereotactic therapy uses modern technology to deliver the entire dose of radiation to where the malignant tumor is located. It allows the course of radiation therapy to be shortened, ending up lasting days instead of weeks.

In brachytherapy, a small bead that produces radiation is placed directly into the prostate gland. This treatment is used for men with early stage prostate cancer that is slowly growing. In later stages, brachytherapy is sometimes used in combination with external beam radiation therapy.

Chemotherapy for prostate cancer

Chemotherapy is not the main treatment for prostate cancer, but it can sometimes be helpful. Chemotherapy drugs are prescribed in combination with hormonal drugs or in cases where hormonal therapy does not work.

For prostate cancer, the following drugs are used: docetaxel, cabazitaxel, mitoxantrone, estramustine.

Hormonal therapy for prostate cancer

It is known that male sex hormones - androgens - stimulate the growth of prostate cancer. The goal of hormone therapy is to lower the levels of androgens in the body or prevent them from interacting with cancer cells.

Hormone therapy stops tumor growth for a while. As monotherapy, it is not able to cure. Indications for its use:

• Presence of contraindications to surgical treatment and radiation therapy.
• Advanced prostate cancer when surgery and radiation therapy are ineffective.
• For aggressive tumors, when the risk of relapse is high, hormonal therapy is prescribed along with radiation therapy.
• It may be prescribed before radiation therapy to slow down tumor growth and improve treatment results.

Treatment for prostate cancer is constantly improving. More recently, a large study demonstrated the negative effects of hormonal therapy in patients with a recurrent process and low PSA levels. Doctors at the European Clinic closely monitor such changes and offer their patients only treatment that meets modern standards.

Treatment of stage 4 prostate cancer

At stage IV, prostate cancer spreads to the bladder, rectum, lymph nodes, and distant metastases appear in the bones and various organs. But even at this stage, depending on the extent of the process, remission can sometimes be achieved. In cases where cancer is incurable, palliative treatment will help curb its growth for a while and prolong the patient's life.

Typically, treatment for stage 4 prostate cancer includes the following:

• Hormonal therapy, in some cases in combination with chemotherapy.
• Surgery. If the cancer has not spread to the lymph nodes and there are no distant metastases, a radical prostatectomy can be performed. In other cases to fight
• with symptoms, they resort to palliative intervention - transurethral resection of the prostate (TURP).
• If the patient is contraindicated for all treatments and is asymptomatic, active surveillance may be considered.

Treatment of prostate cancer metastases to bone

If bone metastases are detected, hormonal therapy, radiation therapy, and chemotherapy are prescribed. In addition, in the treatment of bone metastases in prostate cancer, bisphosphonates (drugs that slow down bone destruction), denosumab (the same effect as bisphosphonates, but a different mechanism of action), drugs of adrenal hormones (reduce pain), and painkillers are used.

Advantages of prostate cancer treatment at the European Clinic

The main differences of the European clinic:

• We always act in the interests of the patient. When a doctor chooses treatment methods, he strives to achieve maximum effect with minimal risks for the patient.
• At the European Clinic, a team of doctors works with the patient: a clinical oncologist, an oncologist, a chemotherapist, and a radiation oncologist.
• Prostatectomy is a serious procedure. We care about the safety of patients, therefore, before surgery, a thorough examination is carried out, the patient is consulted by a therapist, neurologist, cardiologist, and anesthesiologist-resuscitator.
• Here you can get a second opinion from reputable doctors from Europe, Israel, and the USA.
• We provide treatment for prostate cancer in Moscow according to international protocols, in accordance with the principles of evidence-based medicine.

Patient reviews of prostate cancer treatment at the European Clinic

I had been under observation at a local clinic for many years and was prepared for the fact that sooner or later I would be diagnosed with prostate cancer. My grandfather and father had it. They both did not die from it, but it’s still quite alarming. So, six months ago, tumor markers showed a tumor.

I chose the clinic exclusively on the Internet, made a list of five, in my opinion, the best, and then called. In the end, I settled on the European clinic. When I arrived for the appointment, I immediately felt somehow calm. Avetis Agvanovich received me and explained my diagnosis, its prospects and methods of treatment very thoroughly and in detail.

It is immediately clear that the specialist knows the question “excellently.” We did some tests and procedures. They haven't started cutting yet. Perhaps you won't have to. Now I am in complete control of the situation, I know exactly what is happening there, and most importantly, I know for sure that there is an excellent doctor who remembers me personally and is ready to respond at any necessary moment.

Thank you, Avetis Agvanovich, and until the next inspection! Igor Andreevich Shch.

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Source: https://www.euroonco.ru/onkourologiya/rak-prostaty/lechenie-raka-prostaty

How is prostate cancer treated at different stages and what methods are most effective?

Prostate cancer is a problem that almost every man can face.

To date, there are no reliable methods for preventing this disease, nor reliable ways to find out in advance what the risk of encountering disaster is in each specific case.

However, doctors have already learned to recognize prostate cancer at the earliest stages, as well as successfully treat tumors. Therefore, if the oncologist suspects the presence of prostate cancer, do not rush to despair, because the chances of recovery are high.

Stages and characteristics of prostate cancer

The prostate gland is a small organ (about the size of a ping pong ball) located at the base of the bladder. Its main function is the synthesis of the secretion that makes up sperm and participation in the process of ejaculation.

Prostate cancer involves the appearance and increase in size of a tumor capable of rapid growth and metastasis (transfer of malignant cells to other organs and tissues). This disease can occur at any age, but in the vast majority of cases it is diagnosed in men over 60 years of age.

Prostate cancer is the third most common cancer among the stronger sex in Russia after lung cancer and stomach cancer. It is found in one in fifteen men over 40 years of age. Every year, a million people around the world are diagnosed with malignant prostate tumors, and approximately one in three of them die as a result of this pathology.

Why does prostate cancer develop? It is known that this is associated with changes in hormonal levels, genetic predisposition, poor nutrition and the influence of some other factors, the role of which has not yet been fully established.

From the moment the first cancer cell appears to the development of symptoms that lead a man to consult a doctor, several years usually pass.

For this reason, a patient often sees an oncologist with an advanced, enlarged tumor that is difficult to cure.

In total, there are four stages of prostate cancer:

• Stage 1 is characterized by the small size of the tumor, the absence of involvement of the lymph nodes in the pathological process (cancer cells can enter there with the lymph flow) and the patient’s good health. As a rule, at this stage, prostate cancer is detected by chance - during the treatment of another gland disease. The prognosis for the patient’s life is favorable, therapy does not take much time.
• Stage 2 prostate cancer means that the tumor has increased in size. It can be felt during a rectal examination (the prostate is adjacent to the anterior wall of the rectum, so the doctor is able to reach it with his finger). However, symptoms of the disease often still do not appear. That is why it is so important to undergo regular preventive examinations with a urologist. About 80% of patients diagnosed with stage 2 prostate cancer recover.
• Stage 3 of the disease is characterized by tumor growth beyond the prostate membrane. Cancer cells are found in the pelvic lymph nodes and in some neighboring organs. At this point, the patient usually feels discomfort: due to deformation of the gland, urination is impaired, and pain appears in the perineum. To defeat a tumor, it is no longer enough to perform surgery, so oncologists often use combined tactics, combining different approaches to destroying cancer cells. The survival rate for this stage of prostate cancer is less than 40%.
• Stage 4 means that, in addition to the prostate, the cancer has affected distant organs or lymph nodes. Metastases can be found in the bones, lungs, liver, etc. If the patient is an elderly person with severe chronic diseases, doctors will decide to abandon surgery in favor of gentle methods of therapy that will prolong life and alleviate the suffering of the patient, although they will not help defeat cancer .

Prostate cancer treatment methods

How prostate cancer is treated depends not only on the stage of the disease. The type of tumor is important - it is determined during a biopsy by taking several tissue samples and examining them under a microscope.

Some types of cancer - such as polymorphous cell prostate cancer - tend to grow rapidly, aggressively, while others are influenced by hormones.

The technical equipment of the clinic also plays an important role. It is no secret that many modern technologies and medications are simply not available in domestic oncology centers or are at the implementation stage. And even such classical approaches as surgical removal of the prostate can differ significantly, which affects not only the success of treatment, but also the patient’s quality of life.

Surgery

The prostate gland is an important organ, but an adult man is quite capable of living without it.

Therefore, if the cancer has not spread to neighboring organs and tissues, and the patient’s condition allows surgery, the oncologist will recommend the man a radical prostatectomy - removal of the prostate.

In the initial stages of the disease, this approach allows for a complete recovery in a short time (a hospital stay takes about 7 days).

Meanwhile, it is important to remember that we are talking about a serious intervention in the functioning of the body, which is associated with a risk to life and also leads to some unpleasant consequences. Thus, patients often experience problems with urination for many months after surgery; more than half of men complain about the disappearance of an erection.

A gentle option for surgical treatment of prostate cancer is laparoscopic intervention, in which the prostate is removed through small incisions - just a few millimeters in length. As a result, the risk of postoperative complications is reduced, and the procedure itself is much easier to tolerate by the patient.

In countries with advanced medicine, for example in Israel and the USA, the operation is performed using innovative robotic systems, such as Da Vinci.

Cryosurgery

An alternative to traditional surgery can be cryosurgery of a prostate tumor. This method is applicable in the early stages of the disease, when the cancer has not yet spread beyond the organ. During the procedure, special needles are inserted into the patient's prostate through which liquid argon or nitrogen is supplied.

Low temperatures destroy gland tissue, and the doctor uses ultrasound to monitor that the impact does not damage neighboring organs. As a result, the gland does not have to be removed (although its functions are irreversibly impaired).

In recent years, cryosurgery has increasingly been offered as a primary treatment option for prostate cancer, suitable for patients of all ages.

Radiosurgery

One of the leading areas of surgical treatment of prostate cancer. Involves the use of the Cyber ​​Knife system.

The method is based on the impact of a focused beam of radiation on the tumor, which leads to its local destruction while maintaining the integrity of adjacent tissues.

An important advantage of the method is that it is absolutely painless and non-traumatic: the patient can leave the hospital immediately after the procedure.

Radiotherapy

If the tumor is aggressive or has grown beyond the prostate, or in cases where the patient is too weak for surgery, a radiation therapy machine may be an alternative to a scalpel.

First of all, X-rays kill rapidly dividing cells - and cancer cells tend to grow uncontrollably.

Therefore, during radiotherapy sessions, the tumor shrinks, and the tissues affected by malignant cells are “cleansed”.

External beam therapy also has its own variations. Oncologists strive to minimize the harmful effects of radiation on body tissue, so they try to direct the radiation beam to the tumor as accurately as possible.

Methods such as 3D conformal radiation therapy, intensity modulated radiation therapy (IMRT), stereotoxic radiation therapy (SBRT) and proton beam therapy help them do this. Each of these approaches has advantages and disadvantages.

Radiation therapy often leads to persistent urinary disorders and erectile dysfunction.

Internal radiation therapy (brachytherapy) significantly increases the effect of radiation by reducing the distance from its source to cancer cells.

The radioactive beads used for the procedure contain radioactive iodine, palladium and other chemicals that can affect surrounding tissue for a long time.

Depending on the method, these granules can remain in the body for many months (permanent brachytherapy) or only during treatment sessions (temporary brachytherapy).

Chemotherapy

Chemotherapy is used, as a rule, in situations where cancer has spread throughout the body, so it is necessary to influence the disease globally.

Drugs used to treat malignant prostate tumors are prescribed in courses, monitoring the results of therapy and the development of side effects. Chemotherapy drugs have a bad effect not only on cancer, but also on healthy tissue.

Therefore, patients undergoing such treatment often suffer from digestive disorders, weakness, hair loss and infectious diseases.

Immune therapy

This type of treatment is aimed at activating the patient’s immune system. Cancer cells are foreign to our body, but thanks to special adaptive mechanisms they are able to evade the immune response.

Preparations for immune therapy are manufactured individually - in laboratory conditions, the patient’s blood cells are “trained” to recognize a tumor, and then the resulting vaccine is injected into the body. Unfortunately, oncologists have not yet been able to achieve high efficiency of this technique, so it is more often used as an auxiliary one, as well as in the later stages of the disease.

Hormonal treatment for prostate cancer

Since tumor growth is often provoked by the action of male sex hormones, in the later stages of prostate cancer, doctors can prescribe drugs to the patient that block the synthesis of these substances. Usually we are talking about lifelong use of pharmaceuticals.

Such treatment means medical castration: against its background, sexual function fades. In combination with other methods, such as radiotherapy, hormones can lead to complete cure in patients who are contraindicated for radical prostatectomy.

At the same time, medical castration is reversible - after stopping the medications.

Treatments for prostate cancer are varied, and new effective approaches become available every year. In other words, there are almost no hopeless cases left when medicine is powerless to help the patient. It is important to find a doctor who will select effective treatment tactics. Don't despair - defeating cancer largely depends on you.

Source: https://www.pravda.ru/navigator/rak-prostaty.html

Urological complications of prostate cancer

Prostate cancer is one of the most common malignancies in older men.

In general, the incidence of this type of cancer in Russia ranges from 2 to 4%, but the mortality rate associated with this disease is 10% and is steadily increasing.

In the United States, for example, prostate tumor is the third most common cause of death in men from various types of cancer.

at risk . The average age of prostate cancer patients in Russia is 69 years, and the average age of those who die is 70 years. In the US these figures are 72 years and 77 years respectively. The insidiousness of the disease lies in its long asymptomatic course.

Unfortunately, a person most often begins to notice alarming symptoms only at the moment when the tumor has already begun to spread beyond the prostate, that is, during the period of metastases. This fact significantly reduces the effectiveness of treatment.

If there is a suspicion of prostate cancer, it is customary to carry out three main examinations (based on materials by V.V. Meshkov):

• Digital rectal examination. Feeling the prostate gland through the rectum is a useful procedure, but, unfortunately, if the doctor manages to detect a tumor in this way, this only indicates that the disease is in one of the last stages.
• Determination of the concentration level of PSA (prostate specific antigen) in the blood. The procedure has the lowest number of false negative results and the highest specificity.
• Transrectal ultrasound examination of the prostate gland. The specificity of the method for diagnosing prostate cancer is 20-30%, sensitivity is up to 70%, accuracy is up to 90-98%.

The definitive diagnosis of prostate cancer is made after a prostate biopsy. To do this, a small piece of the gland is taken through the perineum or through the rectum with a special needle for examination.

Urinary dysfunction is the most common urological complication of prostate cancer, occurring with a frequency of 60-80%. The cause of the pathology is cancerous obstruction (obstruction). The free flow of urine is disrupted by the following forms of tumor (according to M.N. Zilberman):

• infravesical (obstruction of the vesicourethral region);
• supravesical (tumor compression of the pelvic ureters);
• a combination of both types of obstruction.

Acute urinary retention develops in 20% of patients with prostate cancer. It can become either one of the first symptoms of the disease or a complication as a result of its treatment. Bladder catheterization can partially overcome this problem.

Impaired urodynamics of the upper urinary tract (ureters and kidneys) is another common problem in patients with prostate cancer.

More than 50% of patients experience various pathologies in this area, the most common of which are unilateral or bilateral ureterohydronephrosis and hydronephrosis. At its core, it is an expansion or stretching of the area of ​​the kidneys where urine collects, as a result of obstruction of its outflow.

Such a disorder is most often congenital, and if it is caused by cancer, the dangerous asymptomatic course of the disease again comes to the fore.

In approximately 70% of patients with prostate cancer, doctors note more or less pronounced signs of pyelonephritis . Dystrophic changes in the kidneys are a consequence of drug therapy for cancer.

Unfortunately, the disease tends to become chronic, which is one of the main causes of disability in patients.

In 20% of cases, chronic renal failure develops (up to uremia).

Doctors note that the classification and timely diagnosis of urological complications in prostate cancer has a significant impact on improving the quality of life of this severe group of patients.

Source: http://med-info.ru/content/view/1807