Prostatakrebs: Symptome & Früherkennung
Prostate cancer is the development of cancer in the prostatea gland in the male reproductive system. Factors that increase the risk of prostate cancer include older age, a family history of the disease, and race. Prostate cancer screening is controversial. Many cases are managed with active surveillance or tnm Prostatakrebs waiting.
Early prostate cancer usually has no clear symptoms. Sometimes prostate cancer does cause symptoms, often similar to those of diseases such as benign prostatic hyperplasia. These include frequent urination, nocturia increased urination at nightdifficulty starting and maintaining a steady stream of urine, tnm Prostatakrebs blood in the urineand dysuria painful urination.
A study based tnm Prostatakrebs the Patient Care Evaluation in the US found that about a third of patients tnm Prostatakrebs with prostate cancer had one or more such symptoms, while two-thirds had no symptoms. Prostate cancer is associated with urinary dysfunction as the prostate gland surrounds the prostatic urethra. Changes tnm Prostatakrebs the gland, therefore, directly affect urinary function.
Because the vas deferens deposits seminal fluid into the prostatic urethra, and secretions from the prostate gland itself are included in semen content, prostate cancer may also cause problems with sexual function and performance, such as difficulty achieving erection or painful ejaculation. Metastatic prostate cancer that has spread to other parts of the body can cause additional symptoms.
The most common symptom is bone painoften in the vertebrae bones of the spinepelvisor ribs. Spread of cancer into other bones such as the femur is usually to the proximal or nearby part of the bone. Prostate cancer in the spine can also compress the spinal cordcausing tingling, leg weakness and urinary tnm Prostatakrebs fecal incontinence.
A complete understanding of the causes of prostate cancer remains elusive. Prostate cancer is very uncommon in men younger than 45, but becomes more common with advancing age.
The average age at the time tnm Prostatakrebs diagnosis is Men who have first-degree family members with prostate cancer appear tnm Prostatakrebs have double the risk of getting the disease compared to men without prostate cancer in the family. In the United States inthere were an estimatednew cases of prostate cancer and 30, deaths due to prostate cancer.
Tnm Prostatakrebs background may contribute to prostate cancer risk, as suggested by associations with race, family, and specific gene variants. Men who have tnm Prostatakrebs first-degree relative father or brother with prostate cancer have twice tnm Prostatakrebs risk of developing prostate cancer, and those with two first-degree relatives affected have a fivefold greater risk compared with men with no family history.
No single gene is responsible for prostate cancer; many different genes have been implicated. Two large genome-wide association studies linking single-nucleotide polymorphisms SNPs to prostate cancer were published in This SNP explains part of the increased prostate cancer risk of African American men as compared to American men of European descent, since the C tnm Prostatakrebs is much more prevalent in the latter; this SNP is located in the promoter region of the MSMB gene, thus affects the amount of MSMB protein synthesized and secreted by epithelial cells of the prostate.
Finally, obesity  and elevated blood levels of testosterone  may increase the risk for prostate cancer. Consuming fruits and vegetables has been found to be of little benefit in preventing prostate cancer. Lower blood levels of vitamin D may increase tnm Prostatakrebs risk of developing prostate cancer. Folic acid supplements have no effect on the risk of developing prostate cancer.
There are also some links between prostate cancer and medications, medical procedures, and medical conditions. Tnm Prostatakrebs or inflammation of the prostate prostatitis may increase the chance for prostate cancer while another study tnm Prostatakrebs infection may help prevent prostate cancer by increasing blood flow to the area. In particular, infection with the sexually transmitted infections chlamydiagonorrheaor syphilis seems to increase tnm Prostatakrebs.
Papilloma virus has been proposed in several studies to have a potential role in prostate cancer, but as of tnm Prostatakrebs evidence was inconclusive. Although there is some evidence from prospective cohort studies that frequent ejaculation may reduce prostate cancer risk,  there are no results from randomized controlled trials concluding that this benefit exists.
The prostate is a part of the male reproductive system that helps make and store seminal fluid. In adult men, a typical prostate is about 3 centimeters long and weighs about 20 grams. The prostate surrounds part of the urethrathe tube that carries urine from the bladder during urination and semen during ejaculation.
In prostate cancer, the cells of these prostate glands mutate into cancer cells. The tnm Prostatakrebs glands tnm Prostatakrebs male hormonesknown as androgensto work properly. Androgens include testosteronewhich is made in the testes ; dehydroepiandrosteronemade in the adrenal glands ; and dihydrotestosteronewhich is converted from testosterone within the prostate itself. Androgens tnm Prostatakrebs also responsible for secondary sex characteristics such as facial hair and increased muscle mass.
Most prostate cancers are classified as adenocarcinomasor glandular cancers, that begin when normal semen-secreting prostate gland cells mutate into cancer cells.
The region of prostate gland where the adenocarcinoma is most common is the peripheral zone. Initially, small clumps of cancer cells remain confined to otherwise normal tnm Prostatakrebs glands, a condition tnm Prostatakrebs as carcinoma in situ or prostatic intraepithelial neoplasia PIN. Although there is no proof that PIN tnm Prostatakrebs a cancer precursor, it is closely associated with cancer. Over time, tnm Prostatakrebs cancer cells begin to multiply and spread to the surrounding prostate tissue the stroma forming a tumor.
Eventually, the tumor may grow tnm Prostatakrebs enough to invade nearby organs such as the seminal vesicles or the rectumor the tumor cells may develop the ability to travel in the bloodstream and lymphatic system.
Prostate cancer is considered a malignant tumor because it is a mass of cells that can invade other areas of the body. This invasion of other organs is called metastasis.
Prostate cancer most commonly metastasizes to the boneslymph nodesand may invade rectum, bladder and lower ureters after local progression. The route of metastasis to bone is thought to be venous as the prostatic venous plexus draining the prostate connects with the vertebral veins.
Tnm Prostatakrebs prostate is a zinc -accumulating, citrate -producing organ. The protein ZIP1 is responsible for the active transport of zinc into prostate cells. One of the zinc's important roles is to change the metabolism of the cell in order to produce citrate, tnm Prostatakrebs important component of semen. The process of zinc accumulation, alteration of metabolism, and citrate production is energy inefficient, and prostate cells sacrifice enormous amounts of energy ATP in order to accomplish this task.
Prostate cancer cells are generally devoid of zinc. This allows prostate cancer cells to save energy not making citrate, and utilize the new abundance of energy to grow and spread. The absence of zinc is thought to occur via a silencing of the tnm Prostatakrebs that produces the transporter protein ZIP1.
The cause of the epigenetic silencing is unknown. Strategies which transport zinc into transformed prostate tnm Prostatakrebs effectively eliminate these cells in animals. Unfortunately, oral ingestion of zinc is ineffective since high concentrations of zinc into prostate cells is not possible without the active transporter, ZIP1. Loss of cancer suppressor genes, early in the prostatic carcinogenesis, have been localized to chromosomes 8p10q13qand 16q.
P53 mutations in the primary prostate cancer are relatively low and are more frequently seen in metastatic settings, hence, p53 mutations are a late event in the pathology of prostate cancer. RUNX2 is a transcription factor that prevents cancer cells from undergoing apoptosis thereby tnm Prostatakrebs to the development of prostate cancer. The androgen receptor helps prostate cancer cells to survive and is a target for many anti cancer research studies; so far, inhibiting the androgen receptor has only tnm Prostatakrebs to be effective in mouse studies.
The American Cancer Society 's position regarding early detection tnm Prostatakrebs PSA testing is "Research has tnm Prostatakrebs yet proven that the potential benefits of testing outweigh the harms of testing and tnm Prostatakrebs.
Starting at age 50, 45 if African American or brother or father suffered from condition before age 65 talk to your doctor about the pros and cons of testing so you can decide if testing is the right choice for you. There are also several other tests that can be used to gather more information about the prostate and the urinary tract.
Digital rectal examination DRE may allow a doctor to detect prostate abnormalities. Cystoscopy shows the urinary tract from inside the bladder, using a thin, flexible camera tube inserted down the urethra. Transrectal ultrasonography creates a picture of the prostate using sound waves from a probe in the rectum. But the only test that can fully confirm the diagnosis of prostate cancer is a biopsythe removal of small pieces of the prostate for microscopic examination.
Ultrasound US and magnetic resonance imaging MRI are the two main imaging methods used for prostate cancer detection. Urologists use transrectal ultrasound during prostate biopsy and can sometimes see a hypoechoic area tissues or structures that tnm Prostatakrebs relatively less of the ultrasound waves directed at them.
As ultrasound has tnm Prostatakrebs tissue resolution, it is generally not used clinically. Prostate MRI has better soft tissue resolution than ultrasound. MRI in those who are at low risk tnm Prostatakrebs help people choose active surveillance; in those who are tnm Prostatakrebs intermediate risk it may help with determining the stage of disease, while in those who are at high risk it might help find bone disease.
Prostate MRI is tnm Prostatakrebs used for surgical planning for tnm Prostatakrebs undergoing robotic prostatectomy. It has also shown to help surgeons decide whether to resect or spare the neurovascular bundle, determine return to urinary continence, and help assess surgical difficulty.
If cancer is suspected, a biopsy is offered expediently. During a biopsy a urologist or radiologist obtains tissue samples from the prostate via the rectum. A biopsy gun inserts and removes special hollow-core needles usually three to six on each side of the prostate in less than a second. Prostate biopsies are routinely done on an outpatient basis and rarely require hospitalization. Antibiotics should be used to prevent complications like feverurinary tract infectionsand tnm Prostatakrebs  even if the most tnm Prostatakrebs course or dose of the antibiotic is still undefined.
The tissue samples are then examined under a microscope to determine whether cancer cells are present, and to evaluate the microscopic features or Gleason score of any cancer found. Prostate specific membrane antigen is a transmembrane carboxypeptidase and exhibits folate hydrolase activity. Tissue samples can be stained for the presence tnm Prostatakrebs PSA and other tumor markers in order to determine the origin of malignant cells that have metastasized.
The oncoprotein BCL-2 is tnm Prostatakrebs with the development of androgen-independent prostate cancer, due to its high levels of expression in androgen-independent tumours in advanced stages of the pathology.
The upregulation of BCL-2 after androgen ablation in prostate carcinoma cell lines and in a castrated-male rat model further established a connection between BCL-2 expression and prostate cancer progression. The expression of Ki by immunohistochemistry may be a significant predictor of patient outcome for men with prostate cancer. An important part of evaluating prostate cancer is tnm Prostatakrebs the stageor how far tnm Prostatakrebs cancer has spread.
Knowing the stage helps define prognosis and is useful when selecting therapies. Its components include the size of the tumor, the number of involved lymph nodesand the presence of any other metastases. The most important distinction made by any staging system is whether or not the cancer is still confined to the prostate.
Several tests can tnm Prostatakrebs used to look for evidence of spread. Medical specialty professional organizations recommend against the use of PET scansCT scansor bone scans when a physician stages early prostate cancer with low risk for metastasis.
Bone scans should reveal osteoblastic appearance due to increased bone density in the areas of bone metastasis —opposite to what is found in many other cancers that metastasize.
After a prostate biopsy, a pathologist looks at the samples under a tnm Prostatakrebs. If cancer is present, the pathologist reports the grade of the tumor.