Prostate cancer is the most frequently diagnosed cancer among the male population. In most cases, the disease is unlocked, manifested and developed after the age of 50. As age increases, so does the risk of developing prostate cancer. Men with a family history of prostate cancer and/or taking anabolic steroids or substances affecting the levels of male sex hormones in the body should be observed with caution. Proven risk factors are smoking, a diet rich in animal fat, and being overweight. Symptoms of prostate cancer depend on the location of the pathological process in the gland and the degree of spread of the disease. In some cases, the first complaints of patients are from a metastatic process in the bones and lymph nodes. Dysuria (urinary disorders) is among the first symptoms of prostate cancer. Characteristic dysuric complaints are a feeling of incomplete emptying of the bladder, a change in the flow of urine, frequent urination, including at night. Such complaints may be absent or may have been present previously due to benign prostatic hyperplasia. Hematuria (blood in the urine) or erectile dysfunction are other possible but non-specific prostate cancer symptoms that require diagnostic clarification. Pelvic pain occurs when a malignant tumor extends beyond the confines of the prostate and infiltrates and/or compresses surrounding nerves. Pain in the pelvic region, spine and ribs in proven prostate cancer may be a sign of bone metastases. A rectal exam is one of the routine physical examinations performed during a physical examination, when the prostate gland is felt through the wall of the right intestine (rectum). Its consistency (density) and the presence of nodules are noted. Prostate cancer can appear both as a single nodule and as a complete involvement of the organ by a tumor process when the gland has an uneven surface and cartilaginous density. Of the laboratory tests, it is mandatory to determine the value of the tumor marker – PSA (prostate-specific antigen). Blood for the test is taken before performing a rectal douching, because mechanical pressure on the prostate increases the values of the marker in the blood. Similarly, instrumental examinations of the urethra (passing through the prostate) or anal sex in the days before the examination are prerequisites for falsely elevated PSA values. Although defined as a tumor marker, an elevated PSA is not a sure indicator of prostate cancer. It also increases with benign growth of the gland, infections (prostatitis), etc. Furthermore, not all malignant prostate tumors produce the marker in large quantities. NEWS_MORE_BOX Rectal douching and PSA testing are the “gold standard” in routine prophylactic examinations at a urologist. However, in only 25% of the cases of detected deviations in these studies,Prostate carcinoma is proven. This indicates that these tests are of low diagnostic value for prostate cancer. The definitive diagnosis of prostate carcinoma is made after a biopsy of the organ. Biopsy material is taken from at least 8 sites of the gland (3 from the left lobe, 3 from the right and 2 from the intermediate and urethral parts). Imaging studies are relevant to specifying the spread of the disease (staging). Magnetic resonance imaging (MRI) of the small pelvis is appropriate for evaluating whether the carcinoma has infiltrated and extended beyond the confines of the prostatic capsule, which has implications for treatment. Contrast-enhanced computed tomography (scan) of the pelvis, abdomen, and chest visualizes possible sites of visceral distant metastases, and bone scintigraphy (SPECT/CT) specifies bony involvement. Symptoms and rectal smear guide the diagnosis, biopsy proves or disproves it, and imaging determines the stage. Documented results are transmitted to complex oncology centers for assessment of therapeutic behavior.
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