Prostate cancer is one of the most common cancers in the male population, but fortunately it is certainly not the most serious. At the base of this disease there is an alteration of some prostate cells, which to make the idea are often painted as crazy; these cells, in fact, undergo a mutation that makes them able to proliferate, that is to replicate, in an anomalous way. excessive and uncontrolled. Over time, the accumulation of these crazed cells forms a mass, and in some cases the cancer can spread to other organs. Prostate cancer can originate from one of several cell types that make up its tissues. Precisely for this reason, different forms of prostate cancers differ. Some, most to tell the truth, are characterized by a very slow growth, remain confined within the gland and, at times, may not even cause disturbances and clinical manifestations for life. Other forms are more aggressive, have a very rapid progression and rapidly invade the tissues surrounding the prostate, such as the seminal vesicles or the rectum. Diseased cells can also spread to other parts of the body, through the blood and lymphatic system, giving rise to so-called metastases. This latter behavior is typical of malignant tumors, also called cancerous tumors or cancers; in most cases, malignant tumors of the prostate are represented by prostate adenocarcinoma.
As with many types of cancer, the causes of prostate cancer are not yet fully understood. However, some risk factors have been identified that increase the likelihood of occurrence. Among these factors, age and familiarity are certainly included. From an epidemiological point of view, in fact, prostate cancer mainly affects men over the age of 50. Not surprisingly, from the age of 45, it is the most common cancer in men. The incidence of the disease also increases progressively with age. Regarding the family predisposition, it has been found that men with a close relative suffering from prostate cancer have an increased risk of developing the disease. Another risk factor is belonging to the African-American ethnic group: in this population the incidence of prostate cancer is higher than in Caucasians. Additionally, some conditions appear to increase the risk of getting sick. These conditions include recurrent inflammation of the prostate (called chronic prostate), but also high levels of male sex hormones (especially dihydrotestosterone), exposure to environmental pollutants, smoking, obesity and an unbalanced diet. that is, rich in saturated fats and sugars, and low in fiber, fruit and vegetables. Crucifers such as cabbage and broccoli, soy and other legumes, as well as the lycopene contained in tomatoes and yellow-red foods, could instead reduce the risk of prostate cancer.
As for the symptoms, prostate cancer occurs in a very variable way. Often, the tumor causes no symptoms for many years and is discovered randomly during a urological visit. Unfortunately this does not help to fight the disease, since when the symptoms arise and push the patient to undergo a check-up, the tumor is often in an already advanced stage. For this reason, screening for prostate cancer has now assumed a certain importance. After 40/50 years, in relation to individual risk factors, screening is based on the dosage of the Prostate Specific Antigen in the blood, associated with rectal exploration of the prostate. Alongside the asymptomatic cases, there are also cases in which prostate cancer gives symptoms similar to other prostate problems, such as benign prostatic hypertrophy or prostatitis. This is why in the presence of even just some of these symptoms, it is always advisable to undergo medical examinations. This allows the doctor to formulate a correct diagnosis and to undertake the most appropriate treatment for the case. Generally, the earlier one intervenes, the greater the chances of recovery. Returning to the symptoms, due to the particular anatomical location of the prostate, which surrounds a tract of the urethra, gland diseases in many cases also affect urinary function. Prostate cancer can therefore also determine the onset of urinary symptoms. , which are mainly due to the increase in the size of the neoplastic mass. The possible symptoms of prostate cancer therefore include: increased frequency of urination both day and night, heartburn, pain and difficulty in urinating, weakness of the urinary stream and occasional presence of blood in the urine or semen These symptoms may be associated with back, hip or pelvis pain, difficulty getting an erection, painful ejaculation, fatigue, loss of appetite and general malaise.
Unfortunately, sometimes prostate cancer is found in an advanced stage or with regional or distant metastases that are now overt. In these cases, the symptoms refer to the organs involved in the spread of the disease. In particular, prostate cancer tends to metastasize mainly to the lymph nodes of the pelvis and to the bones of the spine, pelvis, ribs and femur. Bone pain, therefore, can be a symptom of advanced prostate cancer. Also, if the metastasis compresses the spinal cord, it can cause weakness or numbness in the lower limbs, urinary and fecal incontinence.
As for the diagnosis, the suspicion of tumor arises first of all in the presence of anomalies in rectal exploration; for example, when the doctor detects the presence of a swelling or a palpable lump. Even the progressive increase or persistence of high PSA values in the blood justifies the execution of further investigations. Just by combining the results of the PSA with those of the rectal exploration, the disease can be identified from the initial stages. However, in order to obtain a certain and definitive diagnosis, further investigations must be carried out. Among these, the trans-rectal prostatic ultrasound allows to evaluate the size of the gland and other morphological characteristics. However, it is with the prostate biopsy that the urologist finally arrives at the diagnosis of cancer. This examination allows to obtain samples of prostate tissue, to be examined under a microscope to confirm the presence of cancer cells inside the gland. they make a decisive contribution to planning the most appropriate treatment for the patient.Other investigations, such as computed tomography (CT), magnetic resonance imaging (MRI) and bone scintigraphy, allow to evaluate the local or distant spread of the disease.
Prostate cancer treatment includes several possible approaches. The choice depends on the characteristics of the tumor, the age of the patient and his general state of health. If, for example, the tumor is at a very early stage, grows very slowly and causes no symptoms, the patient may decide to delay treatment. In these cases, observation in the absence of treatment includes regular medical checks to monitor any changes in the gland, and intervene with therapy as soon as it becomes necessary.The most common treatment for cancer still localized within the prostate gland is surgery. This operation consists in the complete removal of the prostate and some surrounding tissues, through a procedure called radical prostatectomy. The goal of surgery is to do so. to eliminate the disease by preserving urinary continence and sexual function as much as possible. Radiotherapy, on the other hand, involves the use of radiation to kill cancer cells. This treatment represents a valid alternative for the treatment of localized prostate cancer and to slow down the progression of metastatic cancer. Chemotherapy, hormone therapy, high intensity focused ultrasound (HIFU), cryosurgery, or a combination of these techniques are among the different treatment options. The appropriateness and success of the various treatments depend on a number of features of the disease, which include ind ice of aggression, local invasiveness and stage of the tumor. After treatment, the patient will need to be monitored with periodic checks that can identify any recurrences of the disease.
