Prostate cancer in the elderly.

Prostate cancer in the elderly.

Prostate Cancer is a type of cancer that is most common in males. It usually grows slowly in the prostate, which is one of the organs of the male reproductive system. It resembles a small chestnut, which produces water for nourishing and transporting sperm.

Symptoms of prostate cancer.
Early-stage prostate cancer will not show symptoms until the tumor becomes enlarged or when cancer begins to spread beyond the prostate gland. Cancer cells grow to the pressure on the urethra, As a result, prostate cancer patients often have problems with urination. as follows:

  1. Hard to urinate.
  2. Abrasive urine to spread out
  3. Frequent urination pain, especially at night.
  4. Feel like can’t urinate.

Other symptoms of prostate cancer in severe stages are as follows:

  1. Weight loss for unknown reasons
  2. Nausea, vomiting, fatigue.
  3. Swelling in the lower body.
  4. The legs are tired or can’t move, and they often have constipation.
  5. There’s a weakness.
  6. May hurt the pelvis or lower back.

Causes of Prostate Cancer.
At present, doctors have not been able to determine the exact cause of prostate cancer. It is only known that it is caused by abnormal prostate cells and DNA mutations until the cells grow and grow faster than usual.

This causes the progression and destruction of normal cells in the area. While these abnormal cells will continue to live and it causes tumors that can spread to surrounding tissues. It may also spread to other parts of the elderly body.

Prostate cancer can also be caused by other factors. These people may be at high risk of developing the disease:

  1. Elderly, the older you are, the greater the risk of developing this type of cancer. Most prostate cancer diagnoses are found in men over 50 years of age.
  2. There are people in the family who have suffered from prostate cancer. Having a father or brother under the age of 60 with this disease or have a female relative with breast cancer. This may lead to a higher risk of prostate cancer.
  3. Obesity patients, recent research has found that prostate cancer may be linked to obesity. Obesity can also increase the severity of cancer and result in difficult treatment, diagnosis of prostate cancer.

The diagnosis of prostate cancer can be carried out in a variety of ways. The doctor will talk to the patient about the pros and cons of each method. To allow the patient to choose the most appropriate and comfortable diagnosis.

Screening tests are recommended at age 50 or older. Or it could be early in cases where there is a high risk of this type of cancer. This may be done with a rectal exam. And blood checking to find cancer indications in the prostate.

Prostate-specific Antigen (PSA) is a blood sample to be analyzed for PSA in the bloodstream. The higher the value level of the substance may indicate infection, inflammation, prostate enlargement, including cancer.

Digital Rectal Exam (DRE), Because the prostate is attached to the anus. The doctor can wear gloves and insert a finger into the patient’s anus to check if the surface, shape, and size of the prostate any abnormalities.

However, both preliminary tests are not definitive. It is not yet possible to confirm that it reduces the risk of death from cancer. After a preliminary diagnosis with DRE and PSA tests, if any abnormalities are found, The doctor may recommend that the patient undergo an additional prostate cancer diagnosis. As follows:

Ultrasound Examination.
It’s Ultrasound through the anus by using a small examination tool inserted into the anus. Then use sound waves to help in the shooting of the prostate. The tool can also be used to help diagnose prostate biopsies.

Prostate Biopsy (TRUS)
The doctor will collect the sample biopsy from the prostate. By using a thin needle device to insert it into the anus. The ultrasound device guides the needle through the anus wall and then penetrates it to the prostate.

To take the piece of sample to the laboratory to determine whether there are cancer cells. If a diagnosis found the necrosis of the sample piece, Doctors will continue to analyze how likely the cancer cells are to spread. Then consider at the stage of cancer to determine the appropriate treatment at the next stage.

In the case of cancer cells, The likelihood of spreading to other areas of the body is high. Other methods of testing may also be used as follows:

  1. Electromagnetic field imaging (MRI) or CT scan to see the parts inside the body.
  2. Isotope Bone Scan for the diagnosis of cancer that spreads to the bone. Using radiation opacity. Injected into the blood vessels. This substance accumulates in the area where the bone is abnormal and visible in color.

Treatment of prostate cancer.
The decision to choose a treatment depends on several factors, such as the speed of cancer growth, the spread of cancer cells, the overall health of the elderly, and the side effects of the treatment in that way. This will be cured or only possible to sustain the symptoms depending on the severity of the disease.

Stages of prostate cancer.
Prostate cancer can be divided into 4 phases as follows:
Stage 1, early stages of the disease. Cancer cells are small and mild when viewed with a microscope.
Stage 2, cancer cells may still be small, But there’s quite a lot of severity. Or in some cases, cancer cells may become larger and grow on both sides of the prostate.
Stage 3, It is the progression of the prostate gland. to the reproductive system or other surrounding tissues.
Stage 4, Cancer cells grow into nearby organs like the bladder or spread to lymph nodes, bones, lungs, or other organs.

Active Surveillance
Early detection of prostate cancer may not require immediate treatment. The doctor may monitor by giving the patient a blood test (PSA) or rectal examination (DRE). And maybe a biopsy to see the development of cancer cells. If the cancer is found to grow, it may be used to continue treatment.

Disease surveillance may be an alternative for patients who do not show symptoms of cancer. The cancer is expected to grow slowly and is located in a small area of the prostate. It may also be used to support patients with other serious diseases or older patients whose treatment is difficult. However, This approach carries a risk that cancer will grow and spread during surveillance. This may result in less chance of recovery.

Radiation Therapy
High-energy radiation therapy kills cancer cells, There are two ways to irradiate radiation, First is from outside the body with x-ray or proton radiation. Do 5 days a week for 4-8 weeks. and the second is radiation from within the body by the grain-sized radiation seeds are inserted into the prostate tissue. These seeds emit radiation over a long time until the radiation is depleted by itself and does not need to be removed from the body.
This method is suitable for the treatment of specific cancers and cancers that grow in the prostate. It also reduces the progression of cancer and relieves symptoms.

Side effects of radiotherapy that may occur briefly are pain or irritation in the anus. Diarrhea Fatigue, cystitis Frequent urination or sore urine, and genital hair loss. Long-term side effects may cause the penis to become erection, Hard urination, or problems with excretion include diarrhea, bleeding, or irritation in the anus.

This treatment is one-third of the chance that a patient will return to face prostate cancer. Doctors will opt for medications to control cancer, but they will not use surgery. Because surgery is highly risky for complications in patients who have previously had radiotherapy. And if radiotherapy fails, it may continue to opt for high-frequency ultrasound therapy (HIFU) and cold therapy (Cryotherapy).

Hormone Therapy
Treatment to inhibit the production of testosterone of the body. This is a hormone that will cause prostate cancer to grow. Inhibiting this hormone is therefore a way to reduce the development of cancer cells or cause cell death. Reducing the level of this hormone in the body may be done by using testosterone-inhibiting drugs, Anti-cancer drugs of testosterone, or surgery to remove the testicles.

This treatment is often used in patients with advanced prostate cancer. It helps cancer cells shrink smaller and grow slower. Including first-stage patients may use this method to shrink the cancer cells to be smaller Before further radiation therapy will help get more results. In addition, hormone therapy may also be used after radiotherapy. To reduce the occurrence of cancer cells again.

Side effects from this type of treatment include: Decreased sexual desire, Erectile dysfunction, The chest is swollen and softened, Hot flushes, sweating, osteoporosis, weight gain.

Prostate Cancer Surgery
Prostate cancer surgery is an option to treat cancer that is expected to spread outside the prostate. The main method is Dissection of the entire prostate (Radical Prostatectomy). Including surrounding tissue and some lymph nodes as well.

Surgery may be at risk for urinary incontinence and erectile dysfunction. Other side effects also depend on the type of procedure used, the age and overall health of the patient.

Cryosurgery
Using extreme cold kills cancer cells by inserting a needle into the prostate gland through the rectal wall. These needles contain extremely cold gas that helps harden the tissues around the prostate. Then do it again, but this time, use a needle containing hot gas to warm the tissue. This process makes the cancer cells and surrounding tissue to die.

Cryosurgery is sometimes used on cancers that have not spread beyond the prostate gland. It may be a secondary option. When the use of radiotherapy is ineffective However, long-term results could not be confirmed.

The side effects that can occur are erectile dysfunction and urinary incontinence. Side effects such as rectal problems or perforation may occur. But not often found

Chemotherapy
The use of the drug kills cancer cells that are growing rapidly. The dosage may be injected intravenously in the arm or taken. It is commonly used with prostate cancer that spreads to other areas of the body and does not respond to hormonal therapy. Chemotherapy may not cure it, but it will control the occurrence of cancer and the symptoms of cancer.

The main side effect of chemotherapy is that it affects the normal cells around the area, like immune cells Including infection, nausea, vomiting, mouth ulcers, fatigue, hair loss, loss of appetite. But these side effects may be somewhat controlled with the use of other preventive medications.

In addition to the above treatment, There is another method, biological therapy. It is a treatment by using the immune system to fight cancer cells. It takes the patient’s immune system cells to do genetic engineering in the laboratory to fight cancer cells. Then it is injected back into the body through the vein again.

Complications of prostate cancer.
Prostate cancer and treatment can cause complications as follows:
Cancer metastasis It may have spread to nearby organs such as the bladder or through the bloodstream or lymphatic system to bones and other organs can have the following symptoms.

  1. severe pain
  2. Broken and fractured bones
  3. Weakened hip, thigh, or back pain.
  4. The calcium level in the blood is higher than normal. Nausea, vomiting, dizziness may occur.
  5. Spinal cord compression occurs Causing muscle weakness and unable to hold urine or stools
  6. Complications from bone cancer spread can be alleviated by oral bisphosphonate or denosumab injection.

Urinary incontinence
It is both complications from the disease and side effects of the treatment. Because it is attached to the nerves and muscles that control the bladder function. Treatment for urinary incontinence depends on the type of symptom it is, the severity, and the trend of the outcome. Treatment options include urinary insertion, medication, urinary catheterization, and surgery.

Erectile dysfunction
Prostate cancer and treatments such as surgery, radiotherapy, and hormone therapy, can affect the nerves that control the penis’s response because it is very close to the prostate. This erectile dysfunction may be treated with medication. The use of vacuum devices that help the penis erect and surgery.

Prostate cancer prevention
The following actions to reduce the risk of prostate cancer are as follows:

  1. Eat a healthy diet with a focus on fruits and vegetables. This includes various grains that are rich in vitamins and nutrients that are good for health. And although there is no proven evidence that it helps prevent prostate cancer. But is also helpful in improving overall health.
  2. Weight control. Having the right standard weight can be followed by healthy and disease-free health. Should control the number of calories received each day.
  3. Exercise often Exercise affects both physical and mental health. It also helps control weight. Some studies have shown that older people who do not exercise have a higher PSA(Prostate-Specific Antigen) than those who exercise are less at risk of prostate cancer.
  4. Talk to your doctor about your prostate cancer risk.

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