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Urology, General Hospital
Prostate cancer is one of the most frequent cancers in the male population. This is the most frequent malign tumour in the male urogenital system and the second cause of death from cancer in men after lung cancer, with a mortality rate of 12%.
If there is any suspicion, due to symptoms or high PSA levels, a rectal examination will be performed along with a new serum PSA analysis. If the rectal exam is positive (if a nodule or hardening of the prostrate is detected) a biopsy will be carried out. If the rectal examination is negative, the PSA levels will be assessed, to determine whether to carry out a biopsy or not. The PSA is used as a filter for the general population, in order to enable early diagnosis of prostate cancer.
It is a good tumour marker, because it increases when the prostatic glands break down due to tumour growth. As it is also present in normal prostates and it also increases in the benign growth of the prostate, it must always be interpreted in each patient's individual context. An increase in PSA is not a synonym for prostate cancer, and a rectal examination and ultrasound scan should always be carried out. The final diagnosis is given only by a biopsy.
It is often asymptomatic and the first warning sign is high PSA levels. Patients may also present tiredness, loss of appetite and weight loss. Local alterations are also frequent: urinary obstruction, urinary retention, presence of blood in the urine, urinary infections. In the case of spreading, bone pain is frequent.
The typical profile is a male between 50 and 70 years old, in whom benign prostate growth may coexist.
Diagnosis of prostate cancer is carried out using serum PSA, rectal examination and an ecodirected prostate biopsy.
When prostate cancer is localised and low-risk, it can be treated through extirpation and radiotherapy. In the case of spreading, treatment through radiotherapy and hormones will be assessed, in order to stop tumour growth. Occasionally, if the patient is elderly, the development of the cancer will be closely monitored before extirpation, as in some cases, it poses no short-term threat to their survival.
Rectal examination, determination of serum PSA, prostate biopsy.
Survival rates for prostate cancer depend on the state at the time of diagnosis; it is quite favourable in local states, less so in advanced states and worse once it has spread. Periodic prostate evaluation by primary care doctors is therefore indicated.
Analytical testing provides a lot of information which enables the origin and severity of the kidney disease to be established. A kidney biopsy allows a microscopic study that is often essential. Genetic testing also provides very important information.
These tests serve to determine the origin of the kidney disease. There are many causes that may be genetic or acquired via a bacterial or viral infection, or resulting from a metabolic disease (diabetes) or an autoimmune disease such as lupus.
In addition to blood and urine tests, a kidney biopsy and/or a genetic analysis, imaging tests can also be useful.
A kidney biopsy may produce minimal bleeding that almost always stops by itself. If it doesn't, it can be controlled using an interventional radiology procedure, whereby the kidney is catheterised to close the area of bleeding. Genetic testing is increasingly used to decrease the need for a kidney biopsy. However, kidney biopsy continues to be the main diagnostic method for kidney disease.
If you are concerned or have any of the symptoms listed below, it is important that you see a doctor.
It is important for young men to perform regular self-examinations; especially those who are considered to be at risk of contracting testicular cancer.
A testicular self-examination can help a man detect any changes in their testicles on time. This means that if treatment is needed, it can be started as soon as possible.
The purpose of the tests is to detect prostate cancer in the early stages, before the disease progresses. There are two common initial screening tests. Depending on the result, you may be referred to a urologist for a biopsy. These initial tests are:
- Rectal examination
- Prostate-specific antigen (PSA) blood test
The PSA blood test seeks to identify a protein in the blood that is specifically produced by prostate cells.
An elevated or rising PSA level alone does not always mean that a man has prostate cancer. PSA levels may increase with age and other benign conditions, such as benign prostatic hyperplasia or prostatitis. To diagnose prostate cancer, you will need to undergo a prostate biopsy.
Depending on the results, you may be referred to a urologist in order to undergo a magnetic resonance imaging (MRI) scan and a biopsy. This is the only way to determine the presence of a cancer.
This is another type of biopsy which uses the images obtained from the MRI scans and real-time ultrasound images. Using a computer programme, the images obtained in the ultrasound scan are fused, or merged, with those of the previously-performed prostate MRI. This allows lesions to be located with greater accuracy. Samples will be taken from the lesion and from the rest of the prostate. The prostate samples will be sent to the anatomopathologist (a specialist who analyses and studies the tissues). After analysing the samples under a microscope, they will confirm whether or not the patient has cancer. If they do have cancer, the anatomopathologist will also confirm how aggressive it is.
We suggest that you talk with your doctor to see whether or not you need to undergo a PSA blood analysis.
Together you can decide on the best way to proceed.
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