Prostate adenocarcinoma: diagnosis and treatment

Adenocarcinoma of the prostate, which modern men are increasingly faced with, is a special malignant disease. The pathology most often manifests itself in men over 50 years of age. If the pathology is not treated, the disease will automatically lead to death. It is for this reason that you need to know how to recognize the disease, what forms it can take, and what measures need to be taken to eliminate it.

What is prostate adenocarcinoma

Prostate adenocarcinoma is a malignant tumor disease. In fact, it is a nodular tumor, which consists of a large number of affected and altered epithelial cells, which at a certain time degenerate into oncological formations.

The problem requires exclusively comprehensive treatment. Therapy should be carried out strictly under the supervision of the attending physician. If a man delays treatment, there is a risk of encountering quite serious complications that will significantly aggravate the course of the disease and significantly worsen the patient’s condition.

Important! Adenocarcinoma of the prostate is today the most common cause of death in modern men. That is why this issue deserves special attention.

Risk factors

Despite the fact that the exact causes of the disease have not been established, there are some factors that often provoke it and cause the development of oncology. These include:

• Age . According to official statistics, every year the probability of adenocarcinoma increases by 5%.
• Genetics . If the disease was diagnosed in relatives, there is a high probability of developing pathology.
• Poor nutrition. The disease can be triggered by consumption of animal fats, unhealthy high-calorie foods, as well as foods with GMOs.
• Presence of the Negroid gene .
• Alcohol and cigarette abuse.
• Work in hazardous industries , long-term contact with chemical substances that cause toxic poisoning.
• Long-term use of hormone-containing drugs , in particular testosterone.

One of the most common reasons for the development of the disease is the lack of treatment for bacterial and infectious infections of the reproductive and urinary systems.

Stages of the disease

The main stages of the disease differ in the degree of damage to the body. Based on the stage of development, the specialist determines the main treatment tactics and makes prognoses. Thus, prostate adenocarcinoma is divided into 4 stages:

1. The first is that there are no signs at all, since the changes in the prostate are minor. The problem can be diagnosed during this period only by biopsy or blood tests.
2. The second is that the symptoms become more significant, the carcinoma has affected both the left and right lobes of the organ, and the peripheral part of the prostate is often affected. The damage can spread to numerous structural tissues and organ membranes. The disease can be detected through rectal palpation.
3. Third , the tumor is detected at the visual level. The disease is complicated by the penetration of metastases into nearby organs.
4. Fourth , this stage of the disease is irreversible, since cancer cells affect a large number of organs and lymph nodes. The affected area extends to a larger number of organs.

Important! The earlier the problem is detected, the higher the likelihood of obtaining a positive treatment result.

Classification

Adenocarcinoma is a very serious disease. In its advanced stage, it is quite severe and difficult to treat. Most often, oncological tumors are assessed using the Gleason (Gleason) score. To increase the effectiveness of the prescribed treatment, it is necessary to determine the type and category of the disease. The following types of pathology are now distinguished:

1. Small-acinar. This is the most common type of disease, which is detected in more than 90% of cases. The disease is characterized by rapid and multiple growth of foci. The number of tumor formations is increasing.
2. Large acinar. Formed in glandular tissues. It is distinguished by its atypical structure and increased level of malignancy.
3. Highly differentiated . This is an aggressive form of the disease. This form is divided into mucinous, papillary, mucus-forming, and cribriform. Aggressiveness is manifested in the rapid growth of local tumor formation, but the disease slowly spreads to neighboring organs. 2-6 points on the Gleason scale. It is written like this: 2(1+1), 3(1+2), 4(2+2), 5(3+2), 6(3+3).
4. Moderately differentiated. It can be successfully treated, although more than half of the cells have already been changed. 7(3+4) points on the Gleason scale.
5. Poorly differentiated . It is very difficult to treat surgically and medically. The pathology ends in death in almost 100% of cases. From 8 to 10 points on the Gleason scale – 8(4+4), 9(4+5), 10(5+5).

Adenocarcinoma can vary in color. Thus, there are clear cell and dark cell tumors. The first is characterized by imperceptible staining of cells during histological examination. The second completely absorbs the color pigment, due to which the cells acquire a dark shade.

Symptoms

As noted above, at the initial stage it can be quite difficult to recognize pathology. It is usually discovered accidentally during the diagnosis of other diseases. The first signs appear only after the tumor node begins to compress nearby organs.

You should consult a doctor if you have symptoms such as:

1. numerous urges to urinate;
2. pain during bowel movements;
3. a small amount of urine excreted;
4. pain during urination;
5. intermittent and weak stream;
6. no feeling of emptying the bladder;
7. deterioration of intimate life;
8. pain and discomfort in the perineum;
9. increase in gland size.

In advanced stages, a man may experience urinary incontinence, rapid weight loss and a significant deterioration in health.

Diagnostics

To identify the type and stage of the disease, timely diagnosis is needed. So, the patient may be prescribed:

• manual palpation;
• general and biochemical blood tests;
• prostate biopsy;
• pelvic x-ray;
• Ultrasound;
• transurethral echography;
• MRI;
• radioisotope research.

Important! To prescribe treatment that is optimally suited for a particular form of the disease, a comprehensive examination is required.

Treatment

Just like diagnosis, treatment of adenocarcinoma requires an exclusively comprehensive approach. Otherwise, it will not be possible to achieve a result that will help stop the rapid development of a malignant tumor. Among the most effective measures aimed at eliminating the disease are the following:

• Taking modern hormonal drugs. This therapy quickly and effectively stops the process of tumor growth through a radical change in hormonal levels. This technique comes down to the use of androgen drug blockade, produced by taking pills and giving special injections.
• Chemotherapy. This is a special form of therapy when rather aggressive medications are injected into the veins. They cancel the increased activity of malignant cells. This technique is characterized by both a large number of positive factors and numerous disadvantages.
• Radiation therapy is an effective modern treatment based on exposure to ionizing radiation. Cancer cells are sensitive, so radiation therapy provides the opportunity to achieve truly unique results. In particularly advanced cases, several courses of radiation treatment are carried out with parallel medications.
• Surgical intervention . A radical treatment method that is used if the formation reaches a large size. During the operation, the specialist makes a small incision and removes the tumor or the entire gland through it.

There are several types of operations for prostate adenocarcinoma. Each of them has its own specifics.

Tumor ablation. Adenocarcinoma can be treated quite successfully with radiofrequency ablation. The technique is based on the effect of high-frequency current on the diseased organ and automatic heating of tissues. When exposed to radio waves, the tumor immediately dies and resolves quite quickly.

To ensure that healthy tissues are not damaged as a result of such effects, the process is necessarily monitored by an ultrasound or CT scanner.

The main advantage of this technique is that the process of tumor destruction is carried out through minimally invasive intervention.

There is no need for general anesthesia, and it only takes a few days for a man to recover.

Cryotherapy . This is one of the most popular minimally invasive therapy methods against prostate cancer. During the manipulation, the cancer cells are quickly and completely frozen. This is what the name of the procedure is based on.

When performing this manipulation, the ice crystals produced form a shell around the tumor, thereby promoting its complete dehydration. As a result of this event, tumor cells stop receiving nutrients and lose their viability. After about 1-4 weeks, protective cells remove dead tissue from the body.

The procedure is prescribed for a variety of stages of cancer and is especially relevant if there are contraindications to surgical treatment. The less advanced the pathology is, the higher the rates of achieving a positive result can be achieved.

Getting rid of adenocarcinoma is possible with well-thought-out complex treatment. It is necessary to combine the therapy prescribed by the doctor with physiotherapy. The use of folk alternative methods of treatment is allowed only at the initial stage. Therapy should be started immediately after pathologies are detected, which theoretically could cause the rapid development of adenocarcinoma.

Prevention

To prevent the occurrence of prostate adenocarcinoma, prevention should be carried out:

1. After 45 years, all men are required to undergo a thorough medical examination of the genitourinary system at least once a year.
2. If adenocarcinoma is detected in relatives, it is necessary to donate blood for tumor markers.
3. It is necessary to eat a healthy and balanced diet, exclude high-calorie foods from the diet and stop consuming animal fats.
4. Exercise regularly.

It is important to monitor your psycho-emotional state. Frequent stress provokes the disease no less often than the above symptoms.

Forecast

The prognosis once diagnosed is usually positive. The feasibility of therapy is achieved for stage 1-3 disease. At the last stage of the disease, irreversible changes may appear.

During this period, therapy will not be aimed at eliminating the pathology, but at alleviating symptoms.

How long will patients live? Statistics show that after surgery to remove prostate acinar adenocarcinoma, more than 80% of those cured live for more than 5 years.

If the pathology is not advanced, with a competent approach you can get rid of the disease without serious complications. 

Giving up bad habits will lead to better health and a reduction in the likelihood of developing a malignant tumor.

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Source: https://MedProstatit.ru/adenocarcinoma-predstatelnoj-zhelezy.html

Prostate adenocarcinoma - symptoms and treatment

Prostate adenocarcinoma is currently the most common cancer affecting men over 45 years of age. Among malignant diseases, it is one of the top three diagnoses with a likelihood of death.

What is prostate adenocarcinoma?

The most common disease among older men is prostate adenocarcinoma, a malignant neoplasm characterized by glandular-epithelial transformations of cells into cancerous ones. Represents nodules of cancer cells of a single or multiple nature.

A treatment regimen for this disease must be prescribed individually based on:

• Gleason scores (histological examination of cells);
• tumor size;
• rate of spread of metastases.

The Gleason score for prostate cancer is the most commonly used indicator of the level of disease.

The most common form of the disease is acinar adenocarcinoma of the prostate - what is it?

Acinar adenocarcinoma of the prostate is a disease that follows a predictable course and does not involve atypical manifestations. Small acinar adenocarcinoma of the prostate gland is often diagnosed, characterized by multiple foci of cancer cell development.

Symptoms

Typically, prostate malignancy does not bother a man in the early stages of development. As a rule, prostate cancer is diagnosed by chance when visiting a doctor, due to the similarity of symptoms with benign adenoma at the initial stage of development.

These symptoms include:

• difficulty urinating, accompanied by a burning sensation;
• constant feeling of heaviness and fullness of the bladder;
• frequent urge to empty the bladder;
• decreased potency.

At this stage, the diagnosis can be made due to the high PSA level and the experience of the urologist. In later stages of development, the following symptoms are added:

• heaviness and pain in the lower abdomen, most often in the groin;
• defecation disorder;
• presence of blood in urine and semen;
• enlarged inguinal lymph nodes.

Kinds

The division into types is based on changes in prostate tissue, as well as the stage of the lesion and the speed of spread. The following types of prostate cancer are distinguished:

1. Low and highly differentiated.
2. Small and large acinar.
3. Papillary.
4. Cystic glandular.
5. Endometrioid.
6. Cribrotic.
7. Mucus-forming.
8. Solid trabecular.

Degrees and stages

The course and development of this malignant formation does not differ from other oncological diseases of the male gland in terms of stages (degrees) of development:

1. The stage in which the tumor is present, but has not spread to the lymph nodes, has a favorable prognosis.
2. A distinctive feature of the second stage is the large size of the tumor nodes and the beginning of germination into adjacent tissues, as well as the beginning of the spread of metastases. The further prognosis is influenced by the beginning of timely treatment; in general, it is successfully treated.
3. The third stage is characterized by active growth of cancer cells, with further growth into other organs; metastases are confidently determined in the lymph nodes. A favorable outcome is influenced by a large number of factors.
4. At the fourth stage - the stage of decomposition, the tumors acquire enormous sizes, and metastases affect other organs and lymph nodes. The prognosis is unfavorable.

The division into stages occurs according to the internationally accepted TNM system, in which T indicates the presence and size of the tumor, N indicates the presence or absence of metastases in the lymph nodes, and M indicates whether there are distant metastases.

Reasons for development

Oncologists around the world are unanimous in the opinion that the exact origin of the development of oncology in this gland is not fully understood, but some risk factors are present, among them:

• overweight;
• presence of a history of the retrovirus XMRV;
• increased content of Cd (cadmium) in the body;
• inherited predisposition;
• disruption of the endocrine system.

According to average statistics, the rate of development of malignant tumors ranges from 5 to 9 years, significantly shortening the patient’s life.

Why is adenocarcinoma dangerous?

Without paying due attention to their health, men risk not noticing the development of a disease that can shorten their lives. Let's look at the difference between adenoma and cancer:

• adenoma is characterized by slow growth in size;
• absence of metastases;
• An adenoma grows inside an organ; it does not tend to grow into adjacent tissues or other organs. Unlike cancer that grows through its borders.

The prognosis of the course of the disease - prostate cancer according to the Gleason score, makes it possible to determine how aggressively the malignant tumor behaves, and is designated in the form of numbers:

• aggressiveness at a low level, this is from 1 to 4 Gleason points, has a favorable prognosis;
• among scattered cells there is a tendency to unite and grow, this is from 5 to 7 points, a favorable outcome is possible;
• the appearance of infiltrates (seals of various types) of tissues adjacent to the affected organ, this is 8 points, the prognosis is unfavorable;
• from 9 to 10 points, this is a score characterizing a tumor consisting entirely of cancer cells, with a tendency to accelerated growth, the prognosis is unfavorable;
• 10 points - this is a mucus-forming cancer that cannot be treated.

The growth of prostate adenocarcinoma, which affects tissues and organs, is considered irreversible and cannot be treated with medication or surgery.

Diagnostics

Early diagnosis of malignant disease of the male gland is the main condition for a favorable outcome.

The modern level of medicine offers a sufficient number of studies that can diagnose cancer in the early stages:

1. PSA blood test.
2. Ultrasound examination, TRUS.
3. Histology analysis - biopsy.
4. MRI.

Treatment of prostate adenocarcinoma

Based on the results of diagnostic studies to determine the type and stage of the disease, the doctor can choose the most appropriate treatment method:

• surgical treatment (removal of the formation with the gland together);
• conservative treatment (radiation therapy - using an external radiation source, or using radioactive capsules taken orally);
• alternative therapy - cold and ultrasound treatment.
• hormonal therapy (the same drugs are used as hormonal pills for prostatitis in men).

Hormone therapy

It involves stopping the growth of malignant cells with the help of hormonal drugs, as well as minimizing the production of testosterone. The use of hormonal drugs allows you to delay the development of the tumor as much as possible.

Surgical removal

Depending on the patient’s age, stage of development, size and other factors, the surgeon decides on the nature of the manipulation. If detected in the early stages and with a favorable prognosis, removal of the formation along with the testicles and the gland itself gives a good chance of a full recovery.

There are several types of surgical treatment:

1. Laparoscopic (through small incisions in the abdominal wall).
2. Through the perineum between the scrotum and anus.
3. Strip (through an incision in the lower abdomen).
4. With the help of a robot.

Recommended for large, aggressive tumors.

Radiation therapy

The use of radioactive exposure from the outside, by introducing a radiation source that destroys the DNA of cancer cells. This therapy is aimed at exterminating cancer when surgery is not possible and as an additional treatment.

Chemotherapy for adenocarcinoma

Therapy based on the characteristics of poisons and toxins to fight malignant neoplasms through medications. It has a direct effect on the tumor. Before use, it is necessary to compare the expected benefits and harm to the patient’s body. It is used as an additional method of treatment.

Ablation

A method of damaging cancerous tissue by bringing a source of ultrasonic waves to the immediate location of the tumor. It is a modern, effective method of treating the initial stage of the disease with a short recovery period and a low risk of complications.

Cryotherapy for adenocarcinoma

Cryotherapy is considered an advanced method of combating this disease, widely used by leading clinics around the world. It is based on the introduction of liquefied argon or helium, which has a freezing effect, thus destroying adenocarcinoma. Effective when the tumor spreads beyond the gland. Indicated for patients who plan to maintain an erection.

Forecast

It is very important to diagnose prostate adenocarcinoma as early as possible, since in the early stages of development this disease can be completely cured. At the third stage, treatment is complicated by the large size of the tumor and the presence of metastases. The disease in the fourth stage is considered incurable.

Prevention

Among the preventive measures, one can note an annual visit to the urologist and support for physical activity (swimming, walking, running); prostate massage for adenoma is especially effective. Treatment and prevention of prostatitis at home reduces the risk of prostate cancer. It is also important to give up bad habits, streamline your diet and reduce stress.

Source: https://prostatoff.ru/prostatit/adenocarcinoma-predstatelnoj-zhelezy

Prostate adenocarcinoma - symptoms, diagnosis, treatment and prognosis

Content

Source: https://elena-canton.ru/diagnostika/adenokarczinoma-predstatelnoj-zhelezy-simptomy-i-lechenie/

Prostate adenocarcinoma: degrees and stages, treatment and symptoms of prostate adenocarcinoma

Prostate cancer is one of the most common types of malignant tumors in men. There are several types of prostate cancer, differing in the structure and characteristics of the tumor cells. The most common of these is adenocarcinoma, a malignant neoplasm of glandular epithelial cells.

Differences between adenocarcinoma and adenoma

In some cases, patients confuse two fundamentally different concepts - prostate adenocarcinoma and prostate adenoma. BPH is called benign prostatic hyperplasia, which also causes prostate growth and disruption of its function, but is not cancer.

Symptoms may be similar, but treatment approaches and prognosis are different, so it is important not to confuse these two diseases.

It should also be noted that an adenoma, although not cancer, can cause serious complications and can become malignant, and also requires attention and treatment from a specialized specialist.

Causes and risk factors

The cause of adenocarcinoma is the same as that of most cancers - the inability of antitumor immunity to cope with the emerging tumor cell. It is more correct to talk about risk factors for prostate adenocarcinoma as a separate type of tumor. These include:

1. Patient's age. This type of tumor is much more common in older men.
2. Heredity. There is a genetic predisposition to prostate adenocarcinoma. Persons whose relatives suffered from these diseases are at greater risk than those who did not have such a pathology in their family.
3. Hormonal background. Research is currently underway to better define which hormones are key in increasing the risk of prostate cancer. Today it is known that disruption (most often due to age) of the normal hormonal balance leads to an increased risk.
4. External factors. These include working in hazardous industries, infections, poor nutrition, and excessive sun exposure.

Separate mention should be made of precancerous diseases. These are atypical hyperplasia and intraepithelial neoplasia of the prostate. Atypical hyperplasia is an optional precancer of the prostate, i.e. its transition to cancer is possible, but not obligatory. Intraepithelial neoplasia is an obligate precancer that, without proper treatment, invariably leads to adenocarcinoma.

Types of disease (classification)

Depending on the type of tumor-forming cells, prostate adenocarcinomas are divided into the following morphological types:

• small acinar;
• large acinar;
• cribriform;
• solid-trabecular;
• others

Also in oncourology, the Gleason classification is used, according to which the degree of tumor differentiation is divided into five gradations:

1. the neoplasm consists of small, homogeneous glands with minimal changes in the nuclei;
2. the tumor contains groups of glands separated by stroma, but located in a cluster;
3. the glands that make up the tumor vary in size and structure, characterized by infiltration into the stroma and surrounding tissues;
4. the tumor consists of cells with pronounced atypia and infiltrates the surrounding tissues;
5. the tumor is represented by layers of undifferentiated atypical cells.

The classic TNM subdivision of tumors is also applicable. This type of classification indicates the size of the tumor and the presence or absence of metastases to lymph nodes and distant organs.

Stages

The stages of prostate adenocarcinoma are divided into:

Stage A (A1, A2). An early, usually asymptomatic, stage in which tumor cells are contained only in the prostate gland. It is extremely rarely diagnosed.

Stage B (B0, B1, B2). Tumor cells are within the prostate, but the formation can already be felt by palpation, the PSA level is elevated.

Stage C (C1, C2). The tumor extends beyond the prostate, growing into the capsule and spreading to neighboring organs.

Stage D (D0, D1, D2, D3). The most advanced and severe stage. Characterized by metastasis to lymph nodes and distant organs.

When formulating a diagnosis, several classifications are often used, which allows a more accurate description of the nature of the disease.

Symptoms

In the early stages, prostate adenocarcinoma is asymptomatic. As the disease progresses, complaints of difficult or incomplete urination, discomfort when emptying the bladder, urinary incontinence, and sexual dysfunction appear.

These symptoms are also characteristic of benign prostate tumors, therefore, clarification of the diagnosis is possible only with the help of laboratory and instrumental diagnostic methods.

In the later stages, symptoms may appear associated with damage to distant organs, associated with complications of the underlying disease (in particular, prostate adenocarcinoma can lead to the development of renal failure), as well as due to “cancer intoxication” (anemia, low-grade fever, weight loss, etc.) .

Diagnostics

Diagnosis of prostate adenocarcinoma begins with the collection of complaints, asking the patient about certain symptoms of trouble that concern him regarding the processes of urination and sexual function. In the early stages, these symptoms may not be present.

After interviewing the patient, the doctor conducts an examination, which includes a digital examination of the rectum. It is through the rectum that you can touch the prostate gland with your finger and evaluate its size, density and uniformity.

The examination is painless.

More accurate diagnostic methods are ultrasound examination of the prostate with a transrectal sensor, computed tomography and magnetic resonance imaging, and scintigraphy.

Laboratory research methods are also used, ranging from blood and urine tests to specific ones, such as the PSA tumor marker.

A prostate biopsy allows you to get a conclusion about what cells the detected tumor contains, whether they are malignant, and what type of tumor they belong to.

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Treatment

Treatment tactics for prostate adenocarcinoma depend on the stage of the disease, age and concomitant pathology of the patient, and histological (tissue) characteristics of the tumor.

Currently, hormonal therapy, surgical treatment methods, radiation therapy, chemotherapy, and cryotherapy are used. If there are complications, they are simultaneously treated with appropriate methods, often with the involvement of related specialists.

Hormone therapy

Due to the fact that the function of the prostate gland is greatly influenced by hormonal levels, one of the methods of treating prostate adenocarcinoma is hormone therapy. The goal of this method is to change the balance of male and female hormones in such a way as to disrupt tumor growth.

As a result of a large study, the results of which were published in early 2019, it was found that prescribing hormonal therapy to patients with recurrent prostate cancer and low PSA levels not only does not increase survival, but also worsens the prognosis. Radiologists at the European Clinic are familiar with the results of this study and in practice apply modern recommendations for the treatment of patients suffering from prostate cancer.

Surgical removal

The classic treatment for any malignant tumor is surgery, and prostate adenocarcinoma is no exception.

Currently, various methods for its removal have been developed, including low-traumatic ones, carried out through the urethra.

The applicability of the surgical method and the choice of a specific technique is determined by the size of the tumor and the stage of the disease. Each case is considered individually.

Radiation therapy

The method of radiation therapy is based on the damaging effects of radiation on tumor cells. It is used both in combination with surgical treatment (before or after it) and as an independent method. May also be used in conjunction with chemotherapy or hormone therapy.

A separate type of radiation therapy is brachytherapy. Its peculiarity is that the radiation source is placed directly in the tumor area, which allows using smaller doses of radiation to achieve the maximum effect.

Chemotherapy for adenocarcinoma

The chemotherapy method is based on the use of special drugs that disrupt cell reproduction and inhibit tumor growth. When the drug is introduced into the body, other tissues are also exposed to its effects, but the peculiarity of drugs in this group is that they have the strongest effect on rapidly dividing cells, which are prostate adenocarcinoma cells.

The disadvantage of this method is that it is not always well tolerated.

Chemotherapy can be used either alone or in combination with other treatment methods.

Ablation

Ablation is effective for small tumors in the early stages of the disease. The essence of the method is to destroy tumor cells by targeting them with ultrasonic waves.

The procedure is performed using special equipment.

A distinctive feature of the method is the low percentage of complications during its use and the short recovery period after the procedure.

Cryotherapy for adenocarcinoma

Cryotherapy is cold treatment, “freezing”. Unlike the usual nitrogen cryotherapy, liquefied helium and argon are used in the treatment of prostate adenocarcinoma. Using a special device, they are brought to the affected area and, as a result of exposure to low temperatures, the tumor cells die.

Recovery period after treatment

The rate of recovery after treatment for prostate adenocarcinoma depends on the patient’s age, the presence of concomitant diseases, the stage of the oncological process and the chosen treatment method.

Complications

Complications in the treatment of prostate adenocarcinoma are divided into several groups.

1. Complications possible with any surgical intervention. This group includes bleeding due to vascular damage, wound infection, suture failure, etc. At the current level of development of surgery, it is impossible to completely eliminate the risk of these complications, but their percentage is extremely low.
2. Complications caused by changes in hormonal levels. In particular, when using hormone therapy, the patient’s balance of sex hormones changes, which leads to a set of negative consequences. These complications can be called an inevitable and reasonable price for a cure.
3. Complications associated with the damaging effects of instruments during manipulation. Manifest in the form of urinary incontinence due to trauma to the urethra. In the vast majority of cases, this is temporary and completely reversible.
4. Carcinogenic effects of radiation during radiation therapy. With proper selection of the radiation dose, the risks are minimized.
5. Complications during chemotherapy. This should include damage to the gastrointestinal tract due to vomiting during treatment, infectious diseases due to immunodeficiency due to chemotherapy, etc.

When discussing complications and risks, it should be remembered that we are talking about the treatment of a deadly pathology. You should not refuse treatment, worrying about the possible consequences, because the consequences of refusal itself are much more serious.

Relapses

The risk of recurrence depends on the size of the tumor, the stage of the process, and the nature of the treatment. To monitor the patient’s condition and timely detection of relapse, screening is used in the form of a PSA blood test, which is performed for 5 years after the end of treatment.

Survival prognosis and prevention

The favorable prognosis depends primarily on the timeliness of initiation of treatment. If the patient seeks medical help in a timely manner, the prognosis is quite favorable.

As preventive measures, annual examinations by a urologist are extremely important; if there are complaints, monitoring laboratory parameters and performing an ultrasound examination of the prostate.

Preventive measures should also include adherence to physical activity, prevention of sexually transmitted infections, timely treatment of prostatitis and prostate adenoma, and general strengthening measures.

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Source: https://www.euroonco.ru/onkourologiya/adenokartsinoma-prostaty

Adenocarcinoma of the prostate: causes, symptoms, diagnosis and treatment of acinar adenocarcinoma of the prostate in Moscow

Prostate adenocarcinoma is a common malignant tumor that often occurs in older men. High mortality from adenocarcinoma has been recorded after the age of 75 years.

Prostate adenocarcinoma is prone to metastasis; the initial development goes unnoticed.

In the later stages, tumor metastases affect regional lymph nodes, nearby tissues and organs, then spread to distant lymph nodes and distant organs, affecting the bones, lungs, adrenal glands, liver, the tumor extends beyond the prostate gland.

The oncology department of the Yusupov Hospital provides diagnosis, treatment and rehabilitation of patients with prostate cancer.

Diagnosis is carried out using blood tests, ultrasound, CT, MRI if indicated, biopsy of prostate tissue, and osteoscintigraphy.

Surgical care is provided not only in the oncology department of the Yusupov Hospital, but also in a network of partner clinics. After treatment, the patient can undergo rehabilitation at the Yusupov Hospital under a special program for cancer patients.

Acinar adenocarcinoma of the prostate

Prostate carcinoma is prostate cancer, the development of which begins from the epithelium of the alveolar-cellular elements of the gland. There are several types of prostate adenocarcinoma:

• Large acinar.
• Small-acinar.
• Cribrotic.
• Solid trabecular.
• Endometrioid.
• Papillary.
• Glandular-cystic.
• Mucus-forming.

Prostate adenocarcinoma: causes

Causes of prostate adenocarcinoma:

• Increased testosterone levels, hormonal imbalance.
• Infection with the XMRV virus.
• Hereditary predisposition.
• Cadmium intoxication.

Factors predisposing to the development of prostate cancer:

• Chronic inflammatory processes of the prostate gland.
• Autoimmune diseases.
• BPH.
• Age-related changes.
• Bad habits.
• Nutritional features.

Small acinar adenocarcinoma of the prostate occurs in most cases of prostate cancer. This type of adenocarcinoma does not manifest itself with urological symptoms; affected men have no history of diseases of the genitourinary system. The disease is asymptomatic in the early stages.

Prostate carcinoma: symptoms

Symptoms of carcinoma at an early stage include increased frequency of urination, pain and a burning sensation when urinating. Often, at an early stage, prostate carcinoma is mistaken for prostate adenoma - the diseases have similar symptoms.

With the development of the tumor, the symptoms become pronounced - the patient is bothered by pain in the lower back, abdomen, radiating to the rectum, testicles, and pubic area. The lymph nodes of the groin area are enlarged.

Over time, pain begins to bother the ribs and tailbone, the patient begins to lose weight, loses appetite, and feels weak.

Acinar adenocarcinoma of the prostate Gleason 3+3

The Gleason score is a five-point scale that evaluates a biopsy specimen according to the degree of tumor differentiation. One point is a highly differentiated tumor, five points is a poorly differentiated tumor.

When adding the scores of the examined biopsy, the Gleason score is obtained, which can range from 2 to 10.

The Gleason score helps evaluate and classify prostate carcinoma, helps select therapeutic treatment, and make a prognosis for the disease.

According to the Gleason index, histological determination of tissues is carried out:

1. The structure of glandular tissue is not very homogeneous.
2. Numerous gaps are observed in the structure of the glandular parenchyma.
3. Changed cells have penetrated to the edge of the prostate gland, cellular infiltration is observed.
4. A small amount of glandular tissue with a mass of atypical cells is detected.
5. Single cells of glandular tissue are identified in the biopsy specimen.

The Gleason index contains the total components:

• Preferential differentiation of cells from the first biopsy sample.
• The next predominant cell differentiation is in the second sample, containing a minimum of 5% atypical cells.

The studies are scored using a Gleason score and the total score can range from 2 to 10 when added together. The highest result corresponds to a highly aggressive cancer tumor. The lowest Gleason score for prostate adenocarcinoma is considered to be 3+2, in most cases the score is 3+3 (Gleason score 6).

This indicator means that predominantly cells of the same type are found in the biopsy specimen. The gland has a heterogeneous structure; infiltration of the prostate stroma and neighboring tissues begins. Small acinar adenocarcinoma of the prostate Gleason 7 – represents TNM stages II-III.

Gleason score 7 is an indicator of moderately differentiated to poorly differentiated prostate cancer.

Prostate adenocarcinoma: treatment

Diagnosis of prostate adenocarcinoma is carried out using various methods:

• Palpation, rectal examination.
• Blood for tumor markers. PSA (prostate specific antigen) with a prostate tumor rises above 26 ng/ml.
• Puncture of prostate tissue.
• General urine and blood tests.
• Ultrasound.
• MRI or CT.
• Gleason score studies.

Treatment depends on the stage of the cancer. In the early stages of prostate adenocarcinoma, the prostate is removed along with the seminal vesicles. To reduce the risk of tumor recurrence, external irradiation of the prostate and lymph nodes is performed.

Treatment depends on the age of the man - at a young age, radical prostatectomy is more often performed, at an older age, radiation therapy is more often used.

In the later stages of tumor development, hormonal therapy is often used in combination with other methods, surgical castration, and chemotherapy.

Laser therapy, brachytherapy, and minimally invasive treatment methods (cryotherapy, ultrasound and other methods) are used as treatment.

At the Yusupov Hospital, diagnosis of the disease is carried out using innovative equipment, doctors conduct research to identify the causes of cancer development and factors predisposing to cancer.

After the examination, the doctor determines the prognosis of the disease and selects the most appropriate treatment in this case. The patient is recommended a special diet, recommendations are given, and for localized prostate cancer, dynamic monitoring is carried out.

The decision on dynamic observation is made jointly by the patient and the doctor. The Yusupov Hospital provides comprehensive treatment for prostate adenocarcinoma. The hospital uses radiosurgery, radiation therapy, chemotherapy, targeted therapy, and organ-conserving surgery.

You can make an appointment with a doctor by phone.

Natalya Aleksandrovna Vyaznikova

• ICD-10 (International Classification of Diseases)
• Yusupov Hospital
• Cherenkov V. G. Clinical oncology. — 3rd ed. - M.: Medical book, 2010. - 434 p. — ISBN 978-5-91894-002-0.
• Shirokorad V.I., Makhson A.N., Yadykov O.A. The state of oncourological care in Moscow // Oncourology. - 2013. - No. 4. - P. 10-13.
• Volosyanko M.I. Traditional and natural methods of preventing and treating cancer, Aquarium, 1994
• John Niederhuber, James Armitage, James Doroshow, Michael Kastan, Joel Tepper Abeloff's Clinical Oncology - 5th Edition, eMEDICAL BOOKS, 2013

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Source: https://yusupovs.com/articles/oncology/adenokartsinoma-predstatelnoy-zhelezy/