Introduction:-
Prostate could be a glandular organ present only in males. It surrounds the neck of bladder & the primary half 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,2 lateral and a median lobe.Since the first half of the urethra withstand it any lesion in the prostate can produce issue in passing urine.
Diseases of the prostate gland:-
1) Prostatitis:-
This is often the inflamation of the prostate gland because of bacterial infection.
2) Benign enlargement of the prostate:-
This is a non cancerous tumour of the prostate seen after the age of 50.
3) Cancer of the prostate:-This is the 4th most typical explanation 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 degree of sex hormone will increase the growth rate of cancer conjointly increases.It’s found that when the removel of testes there is marked reduction in the scale of tumour.
Site of tumour:-
Prostate cancer is seen mainly in the posterior lobe.Non cancerous enlargement is seen in other lobes.
Changes in the gland in cancer:-
The gland becomes hard with irregular surface with loss of traditional lobulation .Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells within the gland)
Growth :-
Growth rate is terribly quick in prostate cancer .The tumour compresses the urethra and turn out problem in urination.
Spread of tumour:-
Metastasis in cancer of prostate is very early.
1) Local spread:-
From the posterior lobe the cancer cells attend the lateral lobes and seminal vesicles.Tumour cells additionally 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 group of lymph nodes.From there cells move to retroperitonial(Behind the peritonium) and mediastinal lymph nodes(within the chest)
three) 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 diagnosed accidentely.
2) Slight problem in urination:-
Here the tumour is enlarged and urethra is slightly compressed.Shortly there can be frequent urge for urination with tough urination.
3) When the tumour unfold to all or any nearby areas including 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.In this condition patient may get convulsions because of renal failure and eventually coma.
5) Signs of metastasis:-
Some patients come with the signs and symptoms of metastasis.
a) Lumbo sacral pain because of unfold of cancer cells to lumbar and sacral vertebrae.
b) Fracture of spine because of cancerous growth in the spine.
c) Swelling, pain and fluid assortment within the abdomen because of lesion within the abdomen.
d) Respiratory complaints thanks to cancer of mediastinal lymphnodes and lungs.
e) General weakness thanks to unfold of cancer to totally different parts 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 seek 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 operate 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;-
Gives idea concerning prostate,bladder,kidney ect.
7) C T scan:-
More detailed info about organs and tumour.
MRI of the spine:-
Gives detailed data regarding spine ,disc and nearby soft tissues.
9) Lymphangiography:-
Offers plan concerning lymphatic unfold of cancer.
10) Biopsy to confirm cancer:-
Biopsy is taken from the tumour and is send for histopathological examination under the microscope.This can 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 along with parentral nutrition and electolyte supply.
4) Specific treatment is prostatectomy(removal of prostate)
Partial prostatectomy :-
Here solely the affected lobe is removed.
Radical prostatectomy :-
Total removal of prostate along with nearby lymphnodes.
5, Hormone therapy :-
Stilbestrol is given to cut back tumour growth.Since this treatement will increase the chance 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 give great relief and will increase the life span.
9) Yoga and meditation is also healpful.
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