The prostate is a glandular organ present in males. It surrounds the neck of the bladder & the first side of the urethra plus it contributes to the emission of seminal fluid.
The gland is tapering in form, 3 cm straight down diameter as well as 4 cm in sloping diameter. It has five lobes: fore, posterior, two lateral as well as a median lobe. Seeing as it is at the initial part of the urethra passage, any lesion in the prostate will raise blockage issues in passing urine.
Diseases of the prostate gland:
- Prostatitis:
This is the inflamation of the prostate gland due to bacterial infection.
- Gentle bulge of the prostate:-
This is a non cancerous tumour of the prostate seen after the age of 50.
- Sarcoma of the prostate
A more serious condition which can result ultimately in death
Cancer of the prostate
Cancer of the prostate is asscociated with the male gender hormones(androgens). If the levels of this male sexual hormone increases the growth rate of malignancy can also increase.It is noted that as soon as the removel of testes takses place there is marked reduction in the appearance of tumors.
Location of tumour
Prostate malignancy is seen predominantly in the following lobe. Non cancerous amplification is seen in supplementary lobes.
Changes in the gland in malignant cells:
The gland goes hard and bumpy along with loss of natural lobulation. Histologically prostate melanoma is an adeno carcinoma (malignancy of the epithelial cells in the gland)
Development :
The advance rate can be very fast in prostate cancer. The tumour presses the urethra in addition to produce problems in urination.
Spread of tumour:
Metastasis in malignant cells of the prostate
- Local spread
Starting with the fore lobe the malignancy cells spread to the side lobes along with determining vesicles.Tumor cells also spread to the collar along with pedestal of the urinary bladder.
- Lymphatic spread
From end to end the lymph vessel sarcoma cells reach the inner and external iliac cluster of lymph nodes. Starting nearby cells go to retroperitonial (Behind the peritonium) as well as mediastinal lymph nodes (in the chest)
- Spread from first to last the blood
Spread of sarcoma cells takes place through the periprostatic venous plexus to the vertebral veins while coughing and sneezing in addition to the vertebral bodies of the lumbar spine.
Signs and symptoms of prostate melanoma
Signs and symptoms depend on the stage of the malignant cells.
The following symptoms are listed
- No symptoms:
Tumour is miniature and only in the subsequent lobe. This is diagnosed accidentally.
- Urination:
Now the tumour is inflated as the urethra is slightly packed in. In a minute there will be a repeated urge for urination through difficult urination.
- The tumour multiplies to all in the vicinity areas as well as the neck of bladder in addition to the urethra and at this stage there will be painful urination and bleeding.
- Retention of urine:
When the urethra is utterly condensed there will be withholding of urine.This may show up as hydronephrosis, renal collapse ect. In this statethe sufferer may get convulsions due to renal failure along with finally coma.
Signs of metastasis:
a) Lumbo sacral – extending of tumor cells to lumbar along with sacral vertebrae.
b) Break of spinal column due to cancerous intensification in the spine.
c) Puffiness, pain as well as fluid collection in the abdomen due to laceration in the stomach.
d) Respiratory complaints due to tumor of mediastinal lymphnodes and lungs.
e) Common limitation due to spread of melanoma
f) Anaemia
Clinical examination :
Includes rectal exam to feel the prostate gland, palpation of tummy to feel the inflammation in kidneys and any tumours. The patient is examined beginning head to foot to search for any lesions.
Investigations
1) Whole blood investigations: RBC,WBC, Platelets, ESR, bleeding time, clotting time etc.
2) Urine analysis: Microscopic examination to detect pus cells,occult blood,casts,Crystals ect.
3) Renal function tests: Blood urea point, serum creatinine level, electrolyte level etc.
4) Serum acid phosphatase: Augmented in sarcoma of prostate.
5) x-ray of the spinal column: To notice any tumour or break.
6) Ultra sonography: Gives idea about prostate, bladder, kidney etc.
7) C T scan: More detailed information about organs in addition to tumour.
MRI of the spine: Gives complete information about spine ,disc and nearby soft tissues.
9) Lymphangiography: Gives idea about lymphatic spread of cancer.
10) Biopsy to back up suspected cancer diagnosis: Biopsy is taken plus histopathological examination of cells beneath the microscope.This will reveal the presence of sarcoma cells.
Treatment:
1) If there is retention of urine, catheterisation is needed.
2) Dialysis, if kidney malfunction.
3) If there is coma, monitoring of all crucial functions together with parentral nutrition along with electrolyte supply.
4) Specific treatment is prostatectomy (removal of prostate)
Partial prostatectomy:
At this juncture only the affected lobe is removed.
Far-reaching prostatectomy :
Total subtraction of prostate along with nearby lymphnodes.
5, Hormone therapy : Stilbestrol is given to moderate tumour escalation.Since this treatment increases the possibility for cardiovascular disease phosphorylated diethyle stilbesterol is used at the moment.
6) Chemotherapy: Drugs like cyclophosphamide, cisoplatim etc are specified.
7) Radiotherapy is also prepared for several cases.
Homoeopathy: Homoeopathic drugs akin to carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur etc can be given according to symptoms. Constitutional homoeopathic medicine can offer relief.
9) Yoga plus reflection and meditation is also helpful.
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