Introduction:-
Prostate is a glandular organ gift solely in males. It surrounds the neck of bladder & the primary part of urethra and condributes a secretion to the semen. The gland is conical in form and measures three cm in vertical diameter and 4 cm in transverse diameter.It has got five lobes anterior,posterior,2 lateral and a median lobe.Since the first part of the urethra go through it any lesion in the prostate will turn out issue in passing urine.
Diseases of the prostate gland:-
1) Prostatitis:-
This can be the inflamation of the prostate gland due to bacterial infection.
2) Benign enlargement of the prostate:-
This can be a non cancerous tumour of the prostate seen once the age of 50.
3) Cancer of the prostate:-This can be the 4th most common cause of death from malignant diseases in males.
Cancer of the prostate.
Cancer of the prostate is directly linked with the male sex hormones(androgens).If the degree of sex hormone increases the expansion rate of cancer additionally increases.It is found that when the removel of testes there is marked reduction in the scale of tumour.
Site of tumour:-
Prostate cancer is seen mainly within the posterior lobe.Non cancerous enlargement is seen in different lobes.
Changes within the gland in cancer:-
The gland becomes laborious with irregular surface with loss of normal lobulation .Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells within the gland)
Growth :-
Growth rate is very fast in prostate cancer .The tumour compresses the urethra and turn out difficulty in urination.
Spread of tumour:-
Metastasis in cancer of prostate is very early.
1) Local unfold:-
From the posterior lobe the cancer cells visit the lateral lobes and seminal vesicles.Tumour cells additionally move to the neck and base of the urinary bladder.
2) Lymphatic unfold:-
Through the lymph vessels cancer cells reach the internal and external illiac group of lymph nodes.From there cells move to retroperitonial(Behind the peritonium) and mediastinal lymph nodes(within the chest)
3) Unfold through the blood:-
Unfold of cancer cells takeplace through the periprostatic venous plexus and reaches the vertebral veins while coughing and sneezing and finally enders the vertebral bodies of the lumbar vertebrae.
Signs and symptoms of prostate cancer:--
Signs and symptoms depend upon the stage of the cancer. The subsequent symptoms could be seen.
1) No symptoms:-
Tumour is tiny and solely within the posterior lobe. This is often diagnosed accidentely.
2) Slight problem in urination:-
Here the tumour is enlarged and urethra is slightly compressed.Shortly there will be frequent urge for urination with tough urination.
3) When the tumour spread to any or all nearby areas as well as neck of bladder and urethra there can be painful urination with bleeding.Urine comes drop by drop.
4) Retention of urine:-
When the urethra is totally compressed there will be retention of urine.This will lead to hydronephrosis, renal failure ect.During this condition patient might get convulsions because of renal failure and eventually coma.
5) Signs of metastasis:-
Some patients return with the signs and symptoms of metastasis.
a) Lumbo sacral pain because of spread of cancer cells to lumbar and sacral vertebrae.
b) Fracture of spine thanks to cancerous growth in the spine.
c) Swelling, pain and fluid assortment within the abdomen because of lesion in the abdomen.
d) Respiratory complaints due to cancer of mediastinal lymphnodes and lungs.
e) General weakness because of unfold of cancer to completely different elements of the body.
f) Anaemia because of involment of bone marrow and increased destruction of RBCs.
Clinical examination :-
Includes per rectal examination to feel the prostate gland,palpation of abdomen to feel the swelling in kidneys and any tumours.Patient is examined from head to foot to search out out any lesions.
Investigations:-
1) Complete blood investigations;-
RBC,WBC,Platlets,ESR,bleeding time ,clotting time ect.
2) Urine analysis:-
Microscopic examination to detect pus cells,occult blood,casts,Crystals ect.
3) Renal perform tests:-
Blood urea level,serum creatinine level,electrolyte level ect.
4) Serum acid phosphatase:-
Increased in cancer of prostate.
5) x-ray of the spine:-
To detect any tumour or fracture.
6) Ultra sonography;-
Offers idea regarding prostate,bladder,kidney ect.
7) C T scan:-
Additional detailed information concerning organs and tumour.
MRI of the spine:-
Provides detailed data about spine ,disc and nearby soft tissues.
9) Lymphangiography:-
Gives plan regarding lymphatic spread of cancer.
10) Biopsy to substantiate cancer:-
Biopsy is taken from the tumour and is send for histopathological examination below the microscope.This will detect the presence of cancer cells.
Treatment:-
1) If there's retention of urine catheterisation is needed.
2) Dialysis if kidney failure.
3) If there is coma monitoring of all important functions together with parentral nutrition and electolyte supply.
4) Specific treatment is prostatectomy(removal of prostate)
Partial prostatectomy :-
Here only the affected lobe is removed.
Radical prostatectomy :-
Total removal of prostate together with nearby lymphnodes.
5, Hormone therapy :-
Stilbestrol is given to scale back tumour growth.Since this treatement will increase the possibility for cardiovascular disease phosphorylated diethyle stilbesterol is employed nowadays.
6) Chemotherapy:-Drugs like cyclophosphamide, cisoplatim ect are given.
7) Radiotherapy is also done for a few cases.
Homoeopathy:-
Homoeopathic medication like carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur ect will be given according to symptoms.Constitutional homoeopathic medication will provide great relief and will increase the life span.
9) Yoga and meditation is additionally healpful.
