Diagnosis of Prostate Cancer

Doctors may feel the prostate gland via the rectum (Digital rectal examination) in order to detect any abnormality. A small, hard nodule may reveal the presence of cancer.

Further tests by measuring Prostate-specific antigen (PSA) levels in your bloodstream followed by an Ultra sound scan, can help to detect the disease. Preferably men older than age 40 should have an yearly Digital Rectal Examination and men older than 50 should check their PSA levels yearly.

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Stages of Prostate Cancer

If you are diagnosed with prostate cancer, it is important to know how far the cancer has spread. The physician stages the tumor based on its size, the character of its cells, and the extent of metastasis.

Prostate cancer can be staged as 'A,B,C,D'. Stage A and B cancers are curable. Stages C and D are treatable, but their prognoses are discouraging.

Stage A - This is the very early stage without any symptoms, in this stage cancer cells are confined to the prostate. It can be identified with PSA tests and Biopsy. This type of cancer is usually curable.

Stage B - In this stage, it is known that cancer is in several places within the prostate. It is detectable by Digital rectal examinationand by elevated PSA.

Stage C - In this stage, cancer cells can be found throughout the prostate as well as near by tissue or the bladder. This stage is determined by Digital Rectal Exam, or CT/ MRI scans, and/or Sonography. Some Stage C cancers are curable.

Stage D : At this stage, cancer has spread beyond the prostate and nearby lymph nodes, distant bones, organs such as liver, lungs and also to other tissues. This is usually determined by bone scan, Prostascint scan or other studies. Stage D cancer is not curable but treatable.

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Treatments of Prostate Cancer

Treatment depends on individual circumstances such as the man's age and general health, extent of the cancer etc. Elderly patients with minor symptoms, early stage cancer, or coexisting illness may be treated conservatively.

There are many different ways to treat prostate cancer. It is advisable to get advise from two or more doctors before making a final decision about the treatment. Treatment includes Prostatectomy and Hormone Therapy or anti-antrogen drugs, Chemotherapty and Radio Therapy.

Hormone Therapy : Hormone therapy, is used either alone or in combination with surgery or radiation. It is based on the fact that prostate cancer cells frequently use the male hormone , testosterone as a fertilizer and the absence of this hormone may lead to the death or weakening of prostate cancer cells. So It is used to stop the production of testosterone hormone and hence a person with Stage C and D cancer can have their life extended and improved by the use of hormonal therapy.

There are side effects associated with Hormone therapy. They include hot flashes, weight gain, erectile dysfunction, decrease in muscle mass and strength, personality changes, decreased mentation and osteoporosis.

Prostatectomy : Patients in good health and under age 70 is usually offered surgery as a treatment option. Various types of surgical procedures are done depending on the stage of prostate cancer and patient's over all health.

Prostatectomy is the most common treatment option for localised prostate cancer. It involves surgical removal of prostate gland and some other near by tissues and reattaching the urethra and bladder. It will prevent further spread of the cancer. If the prostate cancer is in the early stages, prostatectomy can treat the cancer completely. This is done either through a surgical incision in the lower abdomen or the space between the scrotum and rectum.

This procedure also produce side effects like impotency, Urinary incontinence, narrowing of the urethra and difficulty in urination.

Radio Therapy : It is a form of treatment which uses high levels of radiation to kill cancer cells or keep them from growing and dividing thus reducing damage to healthy cells. It is more effective for early stage prostate cancer.

Good nutrition is an important part of recovering from the side effects of radiation therapy.

Slight skin changes will be visible after radiation. Skin may become red, swollen, warm and sensitive, as if in a sunburn but it is temporary. The long term effects include, slight darkening of the skin, enlarged pores, increased or decreased sensitivity of the skin and a thickening of tissue or skin.

Chemotherapy : It is a combination of drugs which is effective to kill or slow the growth of rapidly multiplying cells. Chemotherapy is usually prescribed to men with advanced prostate cancer. Chemotherapy drugs are carefully controlled in both dosage and frequency so that cancer cells are destroyed while minimizing the risk to healthy cells. As the drugs circulate throughout the whole body, they can effect the healthy cells also.

The side effects of chemotherapy include hair loss, nausea, vomiting, diarrhea, lowered blood counts, reduced ability of the blood to clot, and an increased risk of infection.

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Types of Mesothelioma Cancer

Mesothelioma is a rare form of cancer in which malignant cells are found in the mesothelium. When it occurs, the cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also spread to other parts of the body.

Mesothelium is a membrane that covers and protects most of the internal organs of the body. A layer of specialized cells called mesothelial cells lines the chest cavity, abdominal cavity, and the cavity around the heart. These cells also cover the outer surface of most internal organs. The tissue formed by these cells is called mesothelium. The mesothelium of chest is called pleura, of the abdomen is peritoneum and of the pericardial cavity, i.e the sac-like space around the heart, is called pericardium.

Most cases of mesothelioma begin in the pleura or peritoneum. The fibrous sheets, pleura helps to protect the lungs. There are 2 pleura and they can be called pleural membranes. Pleural space is the gap between them and they produce a lubricating fluid that fills the gap. This helps the lungs to move smoothly in the chest when they are inflating and deflating as we breathe. Peritoneal or Peritoneum is a smooth membrane, which lines the cavity of the abdomen (stomach). It helps to protect the contents of the abdomen. It also produces a lubricating fluid which helps the organs to move smoothly inside the abdomen as we move around.

Types of Mesothelioma Cancer

The three types of mesothelioma are

Pleural mesothelioma or cancer of the lung lining is the most common form.

Peritoneal mesothelioma or cancer of the abdomen lining

Pericardial mesothelioma

The structural appearance of cells under the microscope determine the cell or sub-type of mesothelioma. They are

Epithelioid - which is the least aggressive, most common, and considered the most amenable to treatment

Sarcomatous - the most aggressive form


Biphasic or mixed - a combination of both of the other cell types.

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Causes of Mesothelioma

Mesothelioma is caused by asbestos exposure. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles and insulation. Asbestos is a very dangerous substance and can cause a lot of damage to your health. It is made up of very small fibers. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed and can their way to pleura. Once these fibers work their way into body tissues, they may stay there indefinitely. Of the white, brown and blue asbestos used, brown and blue are commonly associated with mesothelioma.

Men are typically affected more, due to the common presence of asbestos in industrial settings. Once exposed to asbestos particles a person may have no symptoms of the disease from between 30 to 50 years. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.

Smoking does not appear to increase the risk of mesothelioma. But smoking along with asbestos exposure significantly increases a person's risk of developing cancer. An increased risk of developing mesothelioma was found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other trades people.

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Symptoms of Mesothelioma Cancer

Symptoms of pleural mesothelioma include shortness of breath, pleural effusions (fluid in the chest cavity), persistent cough, loss of appetite and pain in the chest due to an accumulation of fluid in the pleura. Weight loss, abdominal pain, swelling due to a buildup of fluid in the abdomen, bowel obstruction, blood clotting abnormalities, nausea, anemia, and fever are some of the symptoms of peritoneal mesothelioma.

If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. These symptoms may be caused by mesothelioma or by other conditions. If any symptoms is found, consult a doctor because only he can make a diagnosis.

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Diagnosis of Mesothelioma

Mesothelioma is typically difficult to diagnose and treat, because of its uncommon nature. Symptoms like cold, cough and chest pain are so similar to pneumonia that they are often misdiagnosed.

Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. Asbestos exposure can be diagnosed through tests of urine, feces, mucus and material rinsed out of the lungs. A CT scan or MRI may also be helpful. If any of these preliminary tests prove suspicious for mesothelioma; a biopsy is necessary to confirm the diagnosis.

If further examination is warranted, the following tests may be done:

Thoracoscopy
This test is for pleural mesothelioma. A small cut is made through the chest wall and a special instrument called thoracoscope will be inserted into the chest between the two ribs. If fluid has collected in the chest, it is removed through a needle and the process is called thoracentesis.

Peritoneoscopy
It is the test for detecting peritoneal mesothelioma. A special instrument, peritoneoscope is put into an opening made in the abdomen to look inside. The process of removing collected fluid is called paracentesis.

Drugs may be given through a tube in the chest to prevent more fluid from accumulating.

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