The abnormal condition, which appears when the cancerous cells start to multiply at an abnormal and rapid rate while the normal ones experience a fast growth and die even faster, is known under the name of cancer; cancer determines the spreading of the primary tumor from the primary site to other surrounding areas of the infected part of the body, by growing different small and secondary tumors, until, eventually, the cancer becomes metastasized. The spreading process begins once the cancerous cells enter into the bloodstream or the lymph fluid; these cells travel at an alarming speed through the blood vessels or the lymph system, formed by the lymph nodes and the lymph vessels that carry the lymph, a clear fluid, to the heart. If the cancer is diagnosed as locally advance, left untreated, it will eventually become metastatic, leading to a painful death.
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The cancer is named after the body part from where it starts developing, so, if the primary tumor appears in the prostate gland then the disease will have the name of prostate cancer. If we are talking about the existence of two or more metastatic tumors, doctors refer to this condition as metastases. If the cancer is recurrent and comes back as metastases, this condition is known as distant recurrence; sometimes the cancer has spread so far or the spreading process is so complex that physicians find it hard to identify the exact body part where the primary tumor is: in this situation the medical community name the cancer as cancer of unknown primary. Carcinomas are more likely to metastasize to bone in comparison to the sarcomas and the most common bone sites affected by the metastatic cancer are the spine, the pelvis or the hip, the femur or the upper leg bone, the ribs, the humerus or the upper arm bone and the skull; in most cases the distant bone structures are less likely to get infected by tumors if the patient starts a treatment immediately after the diagnose.

The bones structures are the third most common site affected by the metastatic cancer, either being a breast cancer, a prostate cancer or any other type of cancer and the MRI detection method or the magnetic resonance imaging, is considered as the most sensitive one, allowing the spotting of the cancerous cells long before they reach and affect the bone structures. The other recommended methods of detection are the radionuclide bone scans and the coaxial tomography. The symptoms associated with bone metastasis are pain, hypercalcemia and pathological fractures. The metastasized cancer will cause pain, reported by almost seventy percent of the patients diagnosed with bone metastases; this happens dew to the predilection of the prostate cancer to affect first the bone structures. The pain is caused because of the tumor, responsible for the stretching of the periosteum but also because of the nerve stimulation in the endosteum. The metastatic bone lesions are characterized as osteolytic, osteoblastic or mixed. Osteolytic lesions or tumors can cause an abnormal resorption of bone by the enzymes known as proteolytic and the spreading process outstrips the laying down of the new bone. Osteoblatic tumors cause a secretion of bone extracellular matrix proteins or ECM; in other words the tumor stimulates the bone growth. In most cases the lesions are identified as mixed.

For the advanced forms of cancer, especially when the bone system is affected, the recommended treatments are chemotherapy, a healing procedure used not only for treating cancer but also for cases of leukemia, the radiotherapy or the radiation therapy, a procedure used for damaging the DNA of the cancerous cells and to stop their multiplication; the radiotherapy is works by inserting radioactive seeds into the gland and leave them there to slowly decay or by using the external proton beam radiation. The side effects for both treatment procedures can not be avoided.
Before choosing for a treatment, the doctor will advise you and explain what are the consequences of the prostate cancer, so make sure to listen to whatever he says or recommends.

The prostate cancer is divided into many types and they are all related to the stages and evolution of the tumor or the cancerous cells in the gland.
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The right type of prostate cancer can be diagnosed only with the help of the screening tests, the prostate biopsy and eventually using the Gleason scale. If a tumor is discovered but left untreated, the cancerous cells will continue their abnormal multiplication until they’ll reach the surrounding areas of the gland, traveling through the bloodstream or the lymph vessels, spreading to the bones, the seminal vesicle, the rectum, the liver or even the lungs in its most advanced stage, when the cancer is metastasized.

The prostatic intraepithelial neoplasia or PIN, described as the abnormal growth of the cells, is not cancerous but it is considered to be the precursor of the prostate cancer because there is always a high risk of developing this disease if it is not monitored regularly. There are other certain diseases affecting the prostate like prostatitis or the benign prostatic hyperplasia or BPH, but are not related to cancer. The tumor can be malignant or benign, like in the case of the BPH. To make things clear, the benign tumors can be removed and they are not cancer but there is always the small possibility of tumor recurrence. On the other hand, the malignant tumor means cancer. The cancerous cells will divide and spread rapidly, so the original or the primary tumor will form secondary tumors in the invaded organs. This stage is known as the metastatic cancer. The prostate cancers are classified as neuro-endocrine cancer or small cell anaplastic cancer, which doesn’t produce the prostate specific antigen but it spreads earlier, and adenocarcinomas, developing in the glandular tissue.

Many of the prostate cancers are adenocarcinomans or malignant cancers, developing first in the cells lining the tubes and the ducts of the glandular organ. The term adenocarcinoma can be split into adeno, defined as ‘pertaining to a gland’, and carcinoma, associated with the cancer found in the epithelial cells. It is the most common form of prostate cancer, affecting a great number of men over sixty five, and it can only be compared to melanoma if we talk about the recurrence possibility. The small cell carcinoma is a type of cancer made up of round cells, small in size, and it usually appears at the nerve cells. This cancer doesn’t increase the level of the prostate specific antigens, but it is aggressive and hard to detect if the cancer is in its advanced form. The squamous cell carcinoma is a non glandular cancer similar to the small cell carcinoma. Other rare types of cancer are the transitional cell carcinoma, it can develop in the prostate gland but the primary tumors are found in the urethra or the bladder, and the sarcomas. As I’ve stated before the recommended screening tests and the prostate biopsy will determine exactly what type of cancer is affecting your body structures. It is necessary to make a correct diagnose because the treatment will be prescribed according to what are the results of the tests. The staging process will probably be the next step; doctors need to know how far spread is the cancer: local confined, locally advanced or metastatic, and determine exactly what are the risk factors that could irreversible affect your health.

The prostate cancer is a common type of cancer affecting a serious number of men from all over the world.

Its early symptoms don’t exist, so the best medical advice to detect the prostate cancer at an early stage is to regularly have screening tests.

The most common manifestations of a prostate disorder are frequent and painful urination, problems of sexual function or blood found in the urine.

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If we talk about an advanced stage we encounter symptoms such as weakness in the legs, fecal an urinary incontinence, bone pain; if the cancer had spread to the lungs and liver it will cause breathing problems, chest and abdomen pains; if the spinal cord is affected it can cause the compression of the spine. If we are talking about metastatic cancer the most affected parts of the body will be the pelvis, ribs and vertebrae.

An early diagnosis of the exact disorder which affects the prostate can be obtained by using the screening procedure, done on a regular basis, the results being either normal when cancerous cells are not detected and abnormal, suggesting cancer.

Screening tests include two procedures: the digital rectal exam or DRE, when the doctor searches for hardness or lumps on the surface of the prostate gland by inserting a gloved finger into the rectum and the prostate specific antigen blood tests or PSA using as an indicator for the spreading of the cancer the prostate-specific antigen.

If the PSA test result indicates under four nanograms per milliliter of blood then it is considered as a normal result, the result between four and ten is at the borderline, depending on the patients age, genetic inheritance, symptoms and even race, a result higher than ten is abnormal, as also if the values are between thirty and forty which definitely indicate the existence of a prostate cancer.

In this last case the doctor has to inquire further medical investigations to reach for an exact diagnosis. A biopsy is the best procedure used in this case and is described as the withdrawing of one or two small pieces of the prostate tissue, using a needle trans-rectally, all this is done with the guidance of ultrasound images of the prostate area.

Biopsies can also be performed near the lymph nodes, the urinary bladder or the rectum. If the cancer has spread to the bones, radionuclide bone scans can confirm that, if we are talking about affected surrounding organs coaxial tomography or CAT scans and magnetic resonance imaging or MRIs can tell how much the cancer has spread in these areas.

If cancer is diagnosed, a pathologist uses the Gleason scale to classify the stages of the cancer: scores of two to four indicate a slow growing tumor, scores of five to six indicate an intermediate aggressiveness of the tumor while scores from seven to ten indicate the rapid growth of the cancerous tumor.

There is also the staging process which indicates how spread is the disease, and there are usually four stages: stage I, stage II, stage III and stage IV.

The next step is to start treating this disease under the guidance of a doctor and to start caring about what foods you consume. For that a doctor’s advices are imperative.

Not all men show signs of prostate cancer, but for those who do, symptoms have a very important role in early detection. The signs of prostate cancer include an increasing need to urinate, frequent urination during night time, a burning or urgency in urinating, urine that is weak or interrupted, blood in the urine, as well as difficulty in urinating. Moreover, pain and discomfort in the back, hips or pelvis can also indicate prostate cancer, as can the sensation that your bladder is not empty after urinating.

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These symptoms do not necessarily indicate cancer, as there are many other medical reasons that can be behind these symptoms. The best thing you can do is go see a doctor and let them tell you what this is about. If certain symptoms or the results of early detection tests suggest that you might have prostate cancer, your doctor will perform a prostate biopsy to find out if the disease is really present.

A biopsy is a procedure in which a sample of body tissue is removed and then looked at under the microscope. A core needle biopsy is the most frequent method used to diagnose prostate cancer. It is usually done by an urologist or a surgeon who treats cancers of the genital and urinary tract, which includes the prostate gland.

Using trans- rectal ultrasound to see the prostate gland, the doctor rapidly inserts a needle through the wall of the rectum into the prostate gland. When the needle is pulled out, it removes a small part of tissue. This is repeated from 8 to18 times, although most urologists will take about 12 samples. These are then sent to the lab in order to see if cancer is present.

Though this procedure sounds very painful, it may only cause a brief, uncomfortable sensation because it is done with a special biopsy instrument. The device inserts and removes the needles in just a fraction of a second. Most doctors who do the biopsy will first numb the area using a local anesthetic alongside the prostate. You might want to make sure your doctor will do that before the biopsy.

How is prostate cancer detected? In order to detect prostate cancer you can take a PSA blood test, which comes from prostate specific antigen or a digital rectal exam, also known as DRE.

Digital Rectal Examination - During the digital rectal examination, the doctor will insert a lubricated and gloved finger into your anus. Then, the doctor will feel around to search for any type of abnormality or any unusually firm areas around the prostate.

Prostate-Specific Antigen Test - Prostate Specific Antigen (or also known as PSA) is a protein found in men's blood. The prostate cells produce the protein. Men with prostate cancer have higher levels of PSA in their blood than healthy men.

PSA-Related Tests - There are multiple other health factors that can cause a high PSA, and this is why most doctors using a PSA test will perform several additional tests in order to be sure that the patient really has prostate cancer or not. The doctor also may choose to monitor the patients’ PSA velocity, or how quickly the PSA levels rise over a certain period of time. Typically this procedure involves three tests over 18 months. You can also ask your doctor how is prostate cancer detected, so that you have all the information you need from a specialist in the domain.

Science is making new discoveries every day and with these new discoveries come hopes and aspirations of a better fight against cancers of all types, including prostate cancer, as well as hopes of the best detection for prostate cancer. At the moment, specialists have a series of tests at their disposal, which they use to be sure of the condition they are dealing with and the risks and threats the patient is facing.

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Some of these tests are standard, and should be performed regularly, especially by men aged over 50. The test I am speaking here is called a rectal digital examination and it is performed by a doctor or a nurse. In this procedure, the doctor, or nurse, inserts a lubricated finger into the patient’s anal cavity and feels the rectum and prostate to check for any abnormalities. Signs of trouble here would include a prostate that is increased in size, a prostate that is too small, or any other irregularities that may exist on the surface or in the density of the prostate.



Another test meant to detect or show indications of prostate cancer is a blood test. Here, the doctor draws some blood from the patient and analyzes the levels of prostatic specific antigens in the patient’s blood. The prostatic specific antigen is present in the cytoplasm of the prostatic ductal epithelial cells, in the secretions of the ductal lamin (prostatic seminal fluid), urine, serum.

Prostatic specific antigen is mainly responsible for the dissolution of the gel formed during ejaculation, through the proteolysis of major proteins in the sperm. However, high levels of prostatic specific antigen in the blood might also be the temporary effect of recent ejaculation. Thus, the level of prostatic specific antigens in the blood is analyzed several days after the digital rectal examination, and in the meantime the patient is asked by the doctor not to have sexual activity, in order to reduce to a minimum the number of reasons for which the prostatic specific antigen levels might be high in the blood.

However, when there are sufficient red flags raised by the digital rectal examination and prostatic specific antigen analysis, the best detection for prostate cancer is obtained through a biopsy. Biopsy is the procedure through which the specialist or doctor in charge with the case collects some tissue from the prostate in order to analyze it later under a microscope. This procedure allows the direct observation of any abnormal cells or any unusual development in the tissue.



What this procedure seeks is neoplastic cells, namely cells that have entered neoplasia. A cell becomes potentially cancerous, or develops malign potential, when it starts a chaotic process of division caused by flawed genetic instructions transmitted by the genes. In this process, the cell starts dividing uncontrollably and starts forming a malign mass of cells, called a tumor. The formed cells, in their turn start a similar process of division. This is cancer, and these are the types of cells the specialist is looking for after collecting the tissue sample from the patient. Other prostate cancer detection procedures include image testing, namely x-rays and ecography.

By anatomical disposition, the prostate surrounds the first part of the urethra. Most patients with prostatic pathology claim low urinary suffering, without a specific area. The prostate cancer is also subject to this relation, but the impact of the urinary symptoms sparked by prostate cancer on the patient’s quality if life is variable. In most cases, the establishing of a diagnosis in due time is delayed.

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The clinical manifestations of prostate cancer are, in most cases, similar to those of benign hypertrophy in the prostate. The urinary symptoms dominate the clinical panel, which, in some cases, can favor errors in diagnosis. What are the symptoms of the patient? - The patients could claim often urination during the day and the night, difficulty when urinating, difficult initiation of the urination, interrupted urinary jet, impossibility of urination.



The loss of urine in the blood may occur as single symptom in prostate cancer patients and it has nothing characteristic suggesting the existence of prostatic neoplasia. Urinary incontinence can complete the clinical panel of the prostate cancer in cases of local neoplasia invasion of the external urethral sphincter. The loss of blood in the sperm can be a sign of prostate cancer, but is a seldom symptom.

There are situations in which the first symptom is renal insufficiency, accompanied by bilateral lumbar pain. Patients of medium age with major erectile dysfunction, with impotence, need to know that this can be caused by the invasion of the neurovascular bandelets. Wide bone metastasis, aside from pain, spontaneous fractures, can also produce severe anemia, through the invasion of the bone marrow.

Metastases in the internal ganglion groups can lead to an increase in the lymph node’s volume and the occurrence of urethral blockage, sometimes bilaterally. There is also a connection between high fever and advanced prostate cancer. Respiratory symptoms, dry coughing, sometimes accompanied by dyspnea and fever, can be due to the prostate cancer when there are pulmonary metastases. Prostate cancer can lead to the almost complete obstruction of the rectal lumen, which is clinically visible through constipation and sometimes rectal bleeding. High fever and prostate cancer have been shown to be connected in rare cases.

Investigation protocol - For prostate cancer, investigations need to contain, aside from a rectal digital examination, the level of prostate specific antigens in the blood. The protocol also needs to include image testing. Diagnosis is only confirmed following a transrectal ecography and a prostatic bioptic puncture. What the patient needs to know before examination - Transrectal puncture is performed after prior preparations, which include:
-therapy with antibiotics (for protection against potential infection complications);
-an enema on the morning of the examination;
-interruption of antiaggregant medication if need be. For example aspirin;
-on the day of examination, the patient will not eat anything and will only drink fluids.



The main therapeutic options in prostate cancer - Curative treatment is achieved through the complete removal of the prostate (radical prostatectomy), cryogenic surgery, brachytherapy  (method of radiotherapy that consists of radioactive implants, within or near the tumor) which may or may not be accompanied by hormone therapy. Palliative treatment consists of estrogen therapy, the removal of the testes and chemotherapy.

It has been launched a prostate cancer test which can detect the first signs of prostate cancer in just 10 minutes. In other words, the prostate cancer test evaluates in a very short time the level of blood of a certain indicator of prostate cancer, which is called PSA- the Prostate Specific Antigen.

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Before this test was available on the market, men were forced to wait for several days before they received the test results. The Prostate Specific Antigen is a protein which is released by the prostate when it is affected by a possible disease. A high level of Prostate Specific Antigen does not necessarily mean the patient has prostate cancer, but it can suggest the necessity of further investigation.



The new test, called Prostate Specific Antigen Watch, makes the medical investigation procedure easier and brings new benefits by saving a substantial number of lives. In order to make this kind of test, the doctors only need a small amount of your blood which will be then tested with the help of a portable device. Normal prostate cancer tests require sending the sanguine tests to a special lab, in order to analyze the samples.

Doctor Tim Larner, specialist at the Brighton University and University Hospital in Sussex, believe doctors are already counting very much on the prostate cancer test in Great Britain and that this test became one of the most important criteria of diagnose. This test will be very useful for patient who have to permanently supervise their Prostate Specific Antigen level or for patients who need regular monitoring of the disease’s evolution or treatment’s success. For these people, any delay can cause anxiety and useless stress, according to doctor Larner.

Mediwatch drug producer announced last year that they have discovered another urine test, called PCA3Plus, which can be more precise in detecting prostate cancer. This test detects another molecular indicator of the prostate cancer. The two tests, used together, can change the life of ill men who are suspected of prostate cancer. This simple blood test allows doctors to quickly identify people who have an increased risk of developing prostate cancer and who need further investigation, while the PCA3Plus helps them to identify the prostate cancer risk after an unclear biopsy test, according to doctor Larner.

After taking this simple blood test, the patients are then asked to go to a specialist, depending on the Prostate Specific Antigen test results. But these are not the only results taken into account. There are also other factors which are taken into account by doctors, such as the age and the medical history of the patient’s family.



Measuring the Prostate Specific Antigen level also represents a vital way of monitoring the progresses made by prostate cancer patients which have been diagnosed with this disease. In Great Britain, approximately 34.000 men are diagnosed annually with prostate cancer. From those, 10.000 die because of prostate cancer. The prostate cancer is the most frequent cancer type on men and it represents a quarter of the new cancer types diagnosed on men around the world.