The prostate is a glandular-muscular organ that lies below the bladder and surrounds the urethra (urinary canal). Two phases of prostate growth are distinguished: an initial spurt during puberty and adulthood (age 40), followed by a period of slower growth for the rest of life. During its development over the years, the prostate gland undergoes various changes related to its structure and hormone production. Unfortunately, in most cases, prostate diseases are detected late because of their asymptomatic course. The appearance of clinical symptoms indicates the advanced stage of the disease process. Prostate cancer is a malignant disease affecting men over 50 years of age. It is the second leading cause of death after lung cancer. That is why annual ultrasound and urological examinations greatly help in its early diagnosis. Several reasons for the appearance of prostate cancer are indicated: hormonal imbalance (increased level of sex hormones, mainly estrogens), chronic inflammatory processes. Its development is also associated with benign prostatic hyperplasia, in which the formation of nodules in the parenchyma of the gland is observed. Early diagnosis of cancer is of great importance. Unfortunately, the rate of late detection is very high – only when there are metastases (spreads). It is characteristic of prostate cancer that it has a slow development, over years. Pain deep in the pelvis, going back to the back, is one of the first unpleasant sensations for the patient. Symptoms appear only when there is a functional violation of urination. Patients complain of frequent urination, small portions of urine, a weak stream, a feeling of incomplete bowel movement. The presence of blood can be detected in the semen or in the urine, which indicates the advanced stage of the malignant process. Bone complaints are a late sign suggesting the presence of metastases. Thrombophlebitis is also observed as a result of venous and lymphatic stasis. The reason for this is the compression that the tumor formation exerts on the vessels in the pelvis. Conducting regular preventive examinations allows timely “catching” of pathological changes in the prostate gland. Early detection of the disease significantly improves the prognosis and survival of patients. Prostate-specific antigen (PSA) testing is recommended every two years after the age of 50. It is used as a tumor marker because its production increases under the influence of malignant cells. It is important to know that PSA is organ specific (produced by the prostate) but is NOT tumor specific. Its quantity may be increased in other disease states of the gland, as well as in its mechanical irritation (after rectal douching). NEWS_MORE_BOX Another diagnostic method is the manual examination of the prostate, which is performed through the patient’s rectum (rectal douching). By palpating the gland,the urologist can judge its density and size, whether there are nodules and what their boundaries are. This test should be administered every year in men who have reached the age of 40. Often, during an ultrasound examination on another occasion, structural changes in the prostate gland are accidentally discovered – increased size, presence of cysts, calcifications or nodules. Another indicator of the changed size is the presence of residual urine in the bladder. This is due to the compression of the urethra by the prostate and the inability to have a complete bowel movement. The ultrasound image (through the abdomen or transrectally) only points to changes in the gland, but cannot make the final diagnosis. This is done through puncture biopsy and histological examination of the whole material. Among the new imaging methods for detecting prostate cancer are computed tomography and magnetic resonance imaging. They are done in order to specify the size of the tumor, the degree of involvement of the surrounding structures and possible detection of distant lymphatic and organ metastases. Bone scintigraphy is an established method for the early diagnosis of bone fractures.
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