Introduction: -
Prostate is a glandular organ present only in males. It surrounds the neck of the bladder and the first part of the urethra and condributes a secretion to semen. The gland is conical in shape and measures 3 cm in vertical diameter and 4 cm transverse diameter.It has five lobes anterior, posterior, two lateral and a median lobe.Since the first part of the urethra passes through it any injury in the prostate will produce difficulty in urination.
Diseases of the prostate gland: -
1) Prostatitis: -
This is inflammation of the prostate due to a bacterial infection.
2) Benign enlargement of the prostate: -
This is a non-cancerous tumor of the prostate seen after the age of 50 years. 3, prostate cancer, “This is the 4th most common cause of death from malignant disease in men.
Prostate cancer.
The prostate cancer is directly related to male sex hormones (androgens). If the levels of sex hormones increases the rate of cancer growth is also increases.It that after the removel of testes there is marked reduction in tumor size.
Tumor site: -
Prostate cancer is seen mainly in cancerous lobe.Non further expansion seen in other lobes.
Changes in the gland in cancer: -
The gland becomes hard with irregular surface with loss of normal lobulation. Histologically prostate cancer is an adeno cancer (cancer of epithelial cells in the gland)
Growth: -
The growth rate is very fast in prostate cancer. The tumor compresses the urethra and cause difficulty in urination.
Spread of the tumor: -
Metastasis in prostate cancer is very early.
1) Local spread: -
From the posterior lobe the cancer cells go to the lateral lobes and seminal vesicles. Tumor cells also move to the neck and base of the bladder.
2) Lymphatic spread: -
Through the lymphatic vessels cancer cells reach out to the internal and external iliac nodes nodes.From cells move retroperitonial (behind the peritoneum) and lymph nodes in the mediastinum (chest)
3) Spread through the blood: -
Spread of cancer cells takeplace through the periprostatic venous plexus and reaches the vertebral veins while coughing and sneezing and finally failed vertebral bodies of lumbar vertebrae.
Signs and symptoms of prostate cancer: -
Signs and symptoms depend on the stage of cancer. The following symptoms may be seen.
1) No symptoms: -
Tumor is small and only in the posterior lobe. This is diagnosed accidentely.
2) Slight difficulty in urination: -
Here, the tumor enlarged and urethra is slightly compressed. Soon there will be frequent need to urinate, difficulty urinating.
3) When the tumor has spread to all nearby areas including neck of the bladder and urethra there will be pain on urination bleeding.Urine comes drop by drop.
Four) Retention of urine: -
When the urethra is completely compressed there urine.This retention can lead to hydronephrosis, renal failure ect.In condition of this patient may get convulsions due to renal failure and finally coma.
5) Signs of metastasis: -
Some patients come with signs and symptoms of metastasis.
a) Lumbo sacral pain due to the spread of cancer cells to lumbar and sacral vertebrae.
b) The fracture of the spine due to cancerous growth in the spine.
c) Swelling, pain, fluid in the abdomen due to injury in the abdomen.
d) respiratory problems due to cancer of mediastinal lymph nodes and lungs.
e) General weakness due to spread of cancer to different parts of the body.
f) Anaemia due to the involvement of the bone marrow and increased destruction of red blood cells.
Clinical examination: -
Includes per rectal examination to palpate the prostate gland, palpation of the abdomen to feel the swelling in the kidneys and tumours.Patient examined from head to toe to find any injury.
Investigations: -
1) Complete blood investigations -
RBC, WBC, Platlets, ESR, bleeding time, ect clotting time.
2) Urinalysis: -
Microscopic examination to detect pus cells, occult blood, casts, crystals etc.
3) renal function tests: -
level of blood urea, serum creatinine, electrolyte level ect.
April) acid phosphatase: -
The increase in prostate cancer.
5) X-ray of the spine: -
To detect any tumor or fracture.
6) Ultra sonography, -
Da idea of the prostate, bladder, kidney etc.
7) TC: -
More detailed information about organs and the tumor.
MRI of the spine: -
Provides detailed information on the spine, disc and nearby soft tissues.
9) lymphangiography: -
Da idea of lymphatic spread of cancer.
10) Biopsy to confirm cancer: -
The tumor biopsy is taken and sent for histopathological examination under the microscope.This detect the presence of cancer cells.
Treatment: -
1) If there is retention of urine catheterisation is needed.
2) Dialysis if kidney failure.
3) If there is coma monitoring activities of all vital functions, along with nutrition and the provision parentral electolyte.
4) Specific treatment is prostatectomy (removal of the prostate)
Partial prostatectomy: -
Here only the affected lobe is removed.
Radical prostatectomy: -
total removal of the prostate along with nearby lymph nodes.
5, hormone therapy: -
Stilbestrol administered to reduce tumor growth.Since this treatment increases the likelihood of cardiovascular disease stilbesterol diethyl phosphorylated used today.
6) Chemotherapy-drugs such as cyclophosphamide, etc cisoplatim occur.
7) Radiation therapy is done in some cases.
Homoeopathy: -
Homeopathic drugs like carcinocin, hemlock, sabal, Crotalus, yours iodum, selinium, Staphysagria, ect sulfur can occur according to homeopathic medicine symptoms.Constitutional give great relief and can increase shelf life.
9) Yoga and Meditation is also healpful.
