Introduction:-
Prostate is a glandular organ present only in males. It seals the bladder, neck, and urethra and secretes semen. The gland is conical in shape and measures 3 cm in a vertical diameter and 4 cm in a transverse diameter. The gland consists of five lobes: the anterior, posterior, two lateral, and a median lobe. obe. Any prostate lesion will make it difficult to urinate since the prostate is the first part of the urethra.
Diseases of the prostate gland:
1) Prostatitis:-
A bacterial infection has inflamed the prostate gland.
2) Benign enlargement of the prostate:
This non-cancerous prostate tumor typically manifests after age 50. 3. Cancer of the prostate: This is the 4th most common cause of death from malignant diseases in males.
Cancer of the prostate.
Male sex hormones (androgens) directly link to prostate cancer. If the levels of sex hormone increase, the growth rate of cancer also increases. The removal of testes results in a marked reduction in the tumor's size.
Site of tumor:
The posterior lobe is the primary site of prostate cancer. Other lobes exhibit non-cancerous enlargement.
Changes in the gland in cancer:
The gland becomes brittle with an irregular surface and loss of normal lobulation. Histologically, prostate cancer is an adenocarcinoma (cancer of the epithelial cells in the gland).
Growth :-
Prostate cancer exhibits a rapid growth rate. The tumor compresses the urethra and produces difficulty in urination.
Spread of the tumor:
The metastatic process in prostate cancer occurs at an early stage.
1) Local spread:
From the posterior lobe, the cancer cells go to the lateral lobe and seminal vesicles. Tumor cells also move to the neck and base of the urinary bladder.
2) Lymphatic spread:
Through the lymph vessels, cancer cells reach the internal and external illiac groups of lymph nodes. From there, cells move to retroperitonial (behind the peritonium) and mediastinal lymph nodes (in the chest).
3) Spread through the blood:
The spread of cancer cells takes place through the periprostatic venous plexus, reaches the vertebral veins while coughing and sneezing, and finally ends the vertebral bodies of the lumbar vertebrae.
Signs and symptoms of prostate cancer:
Signs and symptoms depend upon the stage of the cancer. The following symptoms may be seen:.
1) No symptoms: -
The tumor is small and only affects the posterior lobe. This is diagnosed accidentally.
2) Slight difficulty in urination:
The tumor has enlarged here, and the urethra has suffered slight compression. In the near future, there will be a frequent urge to urinate and difficulty in doing so.
3) Painful urination with bleeding occurs when the tumor spreads to all nearby areas, including the neck, bladder, and urethra. Urine comes drop by drop.
4) Retention of urine:
Urine retention occurs when the urethra becomes completely compressed. This can result in hydronephrosis, renal failure, among other complications. In this condition, the patient may experience convulsions due to renal failure, which could ultimately lead to a coma.
5) Signs of metastasis:
Some patients come with the signs and symptoms of metastasis.
a) The pain in the lumbar and sacral vertebrae is caused by the spread of cancer cells.
b) A fracture of the spine caused by a cancerous growth within the spine.
c) swelling, pain, and fluid collection in the abdomen due to a lesion.
d) Respiratory complaints due to cancer of mediastinal lymphnodes and lungs.
e) General weakness due to the spread of cancer to different parts of the body.
f) Anaemia due to involvement of bone marrow and increased destruction of RBCs.
Clinical examination:-
We perform a rectal examination to feel the prostate gland, palpate the abdomen to detect kidney swelling, and check for any tumors. We examine the patient from head to foot to identify any lesions.
Investigations:-
1) Complete blood investigations;
The laboratory tests include RBC, WBC, Platelets, ESR, bleeding time, clotting time, and more.
2) Urine analysis:
We use microscopic examination to find pus cells, occult blood, casts, crystals, and more.
3) Renal function tests:
Check the blood urea level, serum creatinine level, electrolyte level, and so on.
4) Serum acid phosphatase:
Increased cancer of the prostate.
5) x-ray of the spine:
To detect any tumor or fracture.
6) Ultrasonography;
It provides guidance on issues related to the prostate, bladder, kidney, and more.
7) C-T scan:
Provide more comprehensive details about organs and tumors.
8) MRI of the spine:
It provides comprehensive details about the spine, disc, and surrounding soft tissues.
9) Lymphangiography:-
It provides insight into the lymphatic dissemination of cancer.
10) Biopsy to confirm cancer:
We take a biopsy from the tumor and send it for a histopathological examination under a microscope. This will detect the presence of cancer cells.
Treatment:-
Catheterization is necessary if there is urine retention.
2) Dialysis if kidney failure occurs.
3) All vital functions, including parentral nutrition and electrolyte supply, should be monitored in a coma.
4) Specific treatment is prostatectomy (removal of prostate).
Partial prostatectomy:
Here, we only remove the affected lobe.
Radical prostatectomy:
The prostate and its surrounding lymph nodes were completely removed.
5. Hormone therapy:
We give stilbestrol to reduce tumor growth. Nowadays, people use phosphorylated diethyle stilbesterol because it increases the risk of cardiovascular disease.
6) Chemotherapy involves the administration of drugs such as cyclophosphamide, isoplatim, and others.
Some cases also require radiotherapy.
8) Homoeopathy:-
Symptoms can guide the administration of homoeopathic drugs such as carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulfur, and so on. Constitutional homeopathic medicine will give tremendous relief and can increase the life span.
9) Yoga and meditation are also healing.
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