Prostate Cancer

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A Brief Introduction To Prostate Nodules

A prostate nodule is any growth on the prostate which can be felt upon a digital rectal examination. Characterized as hard, soft, smooth or gritty, prostate nodules or the thickening in some portions of the prostate often develop as men grow older.
The evaluation for a prostate nodule may be included in the evaluation for prostitis or a possible infection. As a rule, all prostate nodules found require further evaluation to rule out the possibility of cancer, which may come without any other symptom.
Benign Prostate Nodules
A nodule does not automatically mean that cancer is present. Hard, rocky nodules may indicate calcification or a case of benign prostatic hyperplasia, where the epithelial and prostatic stromal cells multiply and grow large enough to form large nodules around the periurethral region of the prostate. Surgical removal is often necessary if the nodule has grown large enough to block the urethral canal and cause problems with urination. Sometimes, after a PSA test has shown borderline or elevated levels and there is presence of an infection, the doctor may initially put the patient in antibiotics for 2 to 4 weeks, after which the tests are repeated. If all tests are normal within this time, cancer can be ruled out, although a repeat exam is needed in 3 to 6 months.
Cancerous Prostate Nodules
About 50% of prostate nodules are malignant. Although a digital rectal examination cannot determine whether a nodule is cancerous or not, a biopsy can. A biopsy often follows when the doctor finds abnormal results from a Prostate Specific Antigen test. Once the biopsy has revealed cancer, important variables which are then taken into consideration will include grading and staging. Grading of the cancerous prostate nodule makes use of the Gleason score, which determines the degree of abnormality of the prostate cells from 2 (least aggressive) to 10 (most aggressive).
Staging, on the other hand is done on the basis of the DRE. A cancerous nodule is staged as follows:
T1c (PSA detected)
T2a (small prostate nodule)
T2b (larger prostate nodule)
T3 (very large prostate nodule with probable spread outside of the prostate)
T4 (prostate cancer spreading into adjacent organ such as the bladder)
Prevention And Treatment Of Prostate Nodules
There is no known cause why the prostate tends to enlarge as men get older, and why some men found to have prostate nodules develop prostate cancer and some don’t. Experts think genes and diet may play a role. Good nutrition may contribute to overall prostate health. Men who eat fruits and vegetables, foods that naturally contain antioxidants like lycopene and minerals like selenium lowered their risk for the disease significantly.
For men in their forties or older, an annual DRE may be necessary, especially for high-risk individuals. In some cases, whether the nodule is benign or malignant, surgical excision or complete removal of the nodule may become necessary.

How To Spot Aggressive Prostate Cancer

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Prostate cancer is the cancer which develops in the prostate gland, the gland which is responsible for secreting one of the fluids that constitutes semen in males. In prostate cancer the cells grow and multiply uncontrolled by the body’s normal functions, so that eventually the mutated cells move out or metastasize into adjacent organs like the bones or the liver. This spread often causes pain, difficulty urinating and other symptoms.
Prostate cancer can progress either rapidly or slowly. Prostate cancer which spreads faster than normal characterized by highly abnormal cells is referred to as aggressive prostate cancer.
What Is Aggressive Prostate Cancer
Aggressive prostate cancer is the condition where the cancer spreads too rapidly compared to the typical type of prostate cancer and mutated cells are very different from normal, healthy cells in appearance. Aggressive prostate cancer also does not go into remission despite a lowered level of androgens as a result of androgen-deprivation therapy, which is one of the first-line treatments against the disease.
Recently, a protein was identified to be a good predictor of the nature of the prostate cancer involved, that is, if it will mutate into the aggressive form or not. p27 is the protein that normally functions to suppress tumor growth. It has been found that patients with aggressive prostate cancer have very low levels of this protein. Aggressive prostate cancer has a worse prognosis than the typical type of prostate cancer, and patients with this disease also face a higher risk of recurrence.
How To Identify Aggressive Prostate Cancer
A yearly prostate examination is ideal for early detection of possible tumors in the prostate, especially since prostate cancer usually does not come with visible signs and symptoms. A routine physical inspection can be done through a digital rectal examination or a transrectal ultrasound, while a tumor biopsy is done to confirm the diagnosis of a malignant tumor.
There are many ways to determine how aggressive the cancer is. Tumor markers are often used to determine if the cancer is low-risk, intermediate risk, or high risk, with aggressive prostate cancer falling under the last category. These markers include prostate-specific antigen (PSA) levels, the PSA velocity, and the Gleason score. PSA is a substance which is normally produced by the prostate gland in little amounts. Higher-than-normal levels of PSA in the blood often signal an infection, an enlargement, or a disease in the prostate. The PSA velocity can show if the cancer is the aggressive or not. Studies have shown that when PSA levels rise sharply a few months before surgery, it is often an indication that the cancer is aggressive. The Gleason score, on the other hand, can also show how aggressive the cancer is by grading of the appearance of the mutated cells. The more abnormal the cells appear, the more aggressive they are.
As with most diseases, early detection may just make the difference between a good and bad prognosis. Although it cannot lower the risk for aggressive prostate cancer, annual digital prostate exams, transrectal ultrasound and other physical exam tests can identify potential cancerous tumors at an earlier time when treatment can be most effective.