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Prostate Cancer: Diagnosis and Treatment

Prostate Cancer: Diagnosis and Treatment

The statistics of prostate cancer

  • 10,000 deaths per year
  • More than 5% of prostate cancers are linked to an hereditary predisposition
  • More than 62,000 new cases in 2005
  • Prostate cancer is the most common cancer in men over 50 years
  • The average age of prostate cancer is around 70 years but some men are affected at an earlier age
  • 25% of new cases of cancer found in men are prostate cancers
  • Its incidence in France is around 90 per 100 000 inhabitants.

Screening for prostate cancer

Doctors urologists recommend to perform a dosage of PSA, prostatic specific antigen and a digital rectal examination in all men aged over 50 years and under 75 years.
The PSA test depends on patient age: an elevated PSA directs to a diagnosis of prostate cancer.
A normal dosage does not exclude the presence of a tumor of the prostate. A rectal examination can check to verify the completeness of the prostate.

The manifestations of prostate cancer

Prostate cancer develops slowly over a decade or so. Cancer is sometimes never discovered in living patients.
Many men die with prostate cancer without the latter is the cause of their deaths.
  • Frequent urination.
  • Difficulty in retaining urine or, conversely, to begin to urinate.
  • Inability to urinate.
  • Weak urinary flow or batch.
  • Pain or burning on urination.
  • Blood in the urine.
  • Painful ejaculation.
  • Dull pain in lower back, the hips or upper thighs.

The Review of Prostate Cancer

The dosage of PSA, prostatic specific antigen, prostate-only protein that can suggest the diagnosis and monitoring the development of prostate cancer.
  • This dosage does not provide a 100% reliability.
  • A biopsy is needed to confirm the diagnosis.

The rectal examination

The rectal examination is the first step in finding prostate cancer. It is recommended that men over 50 years to perform once a year by their doctor, a rectal examination to detect the disease at the earliest stage.

The biopsy

Biopsy performed under echographic control can confirm the nature of the cancerous tumor.

The assessment of extension

It includes: scanners, MRI, scintigraphy...

Treatment of prostate cancer

Surgery, radiotherapy, brachytherapy, associated or not with hormonal therapy and chemotherapy may be considered depending on the stage of the tumor.

The surgery, called prostatectomy

It involves removing the prostate and lymph nodes.
It is the surgical removal of the prostate, vas deferens, a part of the bladder neck and seminal vesicles.
The surgeon always attempts to preserve tissues essential for good erection and verifies the absence of lymph node involvement.

The external radiotherapy

External radiotherapy destroys tumor cells. (irradiation of the prostate by a radiation source located outside the patient).

The curietherapy

It is done for localized cancers.
This treatment has the advantage of low toxicity to organs near the prostate, require a shorter hospital stay (one or two days) and complications (urinary disorders, and impotence) less important.

The hormone therapy

It involves blocking hormones "male" responsible for developing the tumor. The modalities of hormone therapy are variable.
This treatment relates more particularly to older men and men with cancer with extensive metastases.

The chemotherapy

It concerns the case of hormone-resistant cancer.

The monitoring of treatment

The PSA is almost 'undetectable when treatment was started successfully.
Monitoring of treatment based on clinical examination and repeated dosage of PSA.
A rise in PSA may indicate a recurrence of cancer or reflect a lack of efficacy.

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