Prostate cancer is the most common cancer among men in general. Currently, in Germany rediscovered each year approximately 50,000 cases of prostate cancer. This number has risen sharply in recent years. This is due among other things, intensive prostate cancer screening. This means that not necessarily the number of cases has increased, but only that the number of diagnosed cases has increased.
How is prostate cancer?
The exact causes of diseases are still unknown. Several factors seem to play a role, however:
Age: Age is the biggest risk factor for the development of prostate cancer. If the disease at a young age still very rare, so the number of people affected increases sharply with age. About 90 percent of patients aged over 60 years.
Hereditary factors: If a family member of the first degree (father, brother) are affected by prostate cancer, the risk doubled for the other male family members to develop prostate cancer. A further increase in risk occurs when two or more first degree relatives or two relatives before the 55th Age of cancer. About 10 percent of all prostate cancers are due to hereditary factors.
Hormonal factors: so-called androgens (including testosterone) play a role in the growth of prostate cancer.
Nutrition: eating habits can influence the onset and progression of prostate cancer. Especially animal proteins and fats seem unfavorable.
Environmental factors: The number of diagnosed cases of prostate cancer is the world differently. Environmental factors and ethnic origin seem therefore also play a role in the pathogenesis of play.
What are the symptoms of prostate cancer?
At an early stage of prostate cancer rarely causes symptoms. Only when the disease progresses, certain symptoms indicate prostate cancer:
Discomfort during urination: Because the prostate surrounds are considered part of the urethra must be discomfort during urination (eg, pain, weakness of urinary stream, frequent urination, nighttime urination) and prostate cancer.
Blood in the urine
Impairment of bowel movements
Bone pain: In some of the victims of the cancer already has spread to the bone, if the disease is discovered (called metastasis). Skeletal pain are therefore in many cases the first symptom of the disease.
As a prostate cancer diagnosed?
For the diagnosis of prostate cancer, various investigations. They are usually used in combination to increase the validity of the results.
Disease history: the early diagnosis is the history of the disease concerned (anamnesis). The exact data of complaints, relevant medical history and family history can provide the physician with important information first.
rectal examination with the finger: From the rectum from the doctor touched with a finger on the prostate and assess their limit, consistency and texture. Because prostate cancer usually occurs in the part of the prostate, the rectum is turned towards the already small changes can be detected by the doctor. The rectal examination is performed by finger in the context of prostate cancer screening (usually in combination with the determination of PSA level).
Determination of the PSA value: The prostate-specific antigen (PSA) is used as a so-called tumor markers. Elevated levels in the blood (usually> 4) may indicate prostate cancer and should be further clarified. Hand, a normal PSA level of prostate cancer is not certain. In addition, findings are inconclusive, the quotient of the so-called free (unbound) PSA to total PSA may be helpful.
Transrectal ultrasound: By the rectum from imported ultrasound abnormalities can be detected in the tissue structure of the prostate. The study can be used as an aid to diagnosis and follow-monitoring are used.
Prostate biopsy: If any suspicion of prostate cancer (suspicious rectal touch examination or elevated PSA value) should have a biopsy of the prostate are performed. Using this so-called prostate biopsy secured the diagnosis and the appropriate therapy instituted. Today, the prostate biopsy is usually performed from the rectum. The correct position while using an ultrasound device is controlled. If the biopsy is negative, but there is still a reasonable suspicion of prostate cancer, it may be necessary to repeat the biopsy.
Bone scan: This test can be detected in bone metastases. Other radiological investigations in the diagnosis of prostate cancer occur only in exceptional cases to use.
As prostate cancer is treated?
The respective stages of prostate cancer is crucial for the treatment concept. In addition to surgery and radiation therapy, chemotherapy and hormonal therapy are used.
Operation: If the cancer completely limited to the prostate, the prostate removal (so-called radical prostatectomy) is the therapy of choice. The most common side effects of this surgery are impotence and incontinence.
Radiation therapy: In the early stages of the radiotherapy represents an alternative to radical prostatectomy, for example, if the operative risk is too great for the person concerned. In addition to conventional radiotherapy in prostate cancer is also often used the so-called brachytherapy. In this method, the radiation sources using hollow needles which are inserted through the perineum, is introduced directly into the prostate.
Hormone therapy: In advanced stages, when metastases are already occurred, the treatment with hormones, the most sensible option. By special hormones to the growth-promoting effect of androgens on the prostate can be suppressed. In addition to the surgical removal of the testes, where androgens are produced, various pharmacological agents are available.
Chemotherapy: Does the prostate poorly to the rest of the therapy, chemotherapy may be considered.
Active monitoring: Under certain circumstances, with the first treatment and wait for the course should be carefully monitored. Unnecessary diagnostics and therapies that provide no benefit to the person concerned should be avoided. Such an approach can be considered as affected in older (> 75 years, life expectancy <15 years).
How is prostate cancer?
The progression of prostate cancer depends on the stage at which the disease is discovered off. The sooner this happens, the better the prognosis. After radical prostatectomy, the long-term cure rate of 90 percent. Total population, viewed across all stages of the disease after five years 87 percent of all concerned. Because prostate cancer causes few symptoms early, often lie at diagnosis prior to bone metastases. A complete healing is usually not possible. After completing treatment, periodic follow-up cancer is extremely important for early detection of recurrence of the disease (called relapse). Observed in this case, the treating physician, especially the history of the PSA value.
How to prevent prostate cancer?
A measure for the prevention of prostate cancer is the regular visit to the screening for early detection of prostate cancer. This study, however, is still controversial, there is a real benefit in terms of an extension of the life has not been established.
Using a change in diet can reduce the risk of developing prostate cancer. Avoid consumption of animal fat and vegetarian diets can be increased. Recent studies demonstrate that also can affect the long-term use of a so-called 5-alpha-reductase inhibitor preventively. Which people could benefit from this drug is currently being investigated in trials.
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