Introduction:-
Prostate could be a glandular organ gift solely in males. It surrounds the neck of bladder & the first part of urethra and condributes a secretion to the semen. The gland is conical in shape and measures three cm in vertical diameter and 4 cm in transverse diameter.It has got five lobes anterior,posterior,two lateral and a median lobe.Since the primary half of the urethra tolerate it any lesion in the prostate will manufacture problem in passing urine.
Diseases of the prostate gland:-
1) Prostatitis:-
This is the inflamation of the prostate gland because of bacterial infection.
2) Benign enlargement of the prostate:-
This can be a non cancerous tumour of the prostate seen when the age of 50.
3) Cancer of the prostate:-This can be the 4th most common reason for 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 amount of sex hormone will increase the growth rate of cancer conjointly increases.It's found that after the removel of testes there is marked reduction in the size of tumour.
Web site of tumour:-
Prostate cancer is seen mainly within the posterior lobe.Non cancerous enlargement is seen in different lobes.
Changes in the gland in cancer:-
The gland becomes laborious with irregular surface with loss of traditional lobulation .Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells in the gland)
Growth :-
Growth rate is very quick in prostate cancer .The tumour compresses the urethra and produce problem in urination.
Spread of tumour:-
Metastasis in cancer of prostate is terribly early.
1) Local unfold:-
From the posterior lobe the cancer cells visit the lateral lobes and seminal vesicles.Tumour cells conjointly 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(in the chest)
3) Unfold through the blood:-
Unfold of cancer cells takeplace through the periprostatic venous plexus and reaches the vertebral veins whereas coughing and sneezing and eventually enders the vertebral bodies of the lumbar vertebrae.
Signs and symptoms of prostate cancer:--
Signs and symptoms rely upon the stage of the cancer. The subsequent symptoms might be seen.
1) No symptoms:-
Tumour is tiny and only in 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 unfold to all nearby areas including neck of bladder and urethra there will be painful urination with bleeding.Urine comes drop by drop.
4) Retention of urine:-
When the urethra is totally compressed there can be retention of urine.This will cause hydronephrosis, renal failure ect.During this condition patient might get convulsions due to renal failure and finally coma.
5) Signs of metastasis:-
Some patients return with the signs and symptoms of metastasis.
a) Lumbo sacral pain due to 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 collection in the abdomen due to lesion in the abdomen.
d) Respiratory complaints thanks to cancer of mediastinal lymphnodes and lungs.
e) General weakness thanks to spread of cancer to totally different components of the body.
f) Anaemia thanks to 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 find 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 function 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 plan about prostate,bladder,kidney ect.
7) C T scan:-
A lot of detailed data concerning organs and tumour.
MRI of the spine:-
Provides detailed information concerning spine ,disc and nearby soft tissues.
9) Lymphangiography:-
Offers idea concerning lymphatic unfold of cancer.
10) Biopsy to verify cancer:-
Biopsy is taken from the tumour and is send for histopathological examination beneath the microscope.This will detect the presence of cancer cells.
Treatment:-
1) If there is retention of urine catheterisation is needed.
2) Dialysis if kidney failure.
3) If there's 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 along 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 used nowadays.
6) Chemotherapy:-Drugs like cyclophosphamide, cisoplatim ect are given.
7) Radiotherapy is additionally done for a few cases.
Homoeopathy:-
Homoeopathic drugs like carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur ect can be given per symptoms.Constitutional homoeopathic medicine can provide great relief and will increase the life span.
9) Yoga and meditation is additionally healpful.
