Because the natural history of an individual prostate cancer is unknown, it is felt that older men with concomitant medical problems are the best candidates for observation only. Specific alpha blockers act primarily on the prostate with fewer systemic effects. This includes vitamins, minerals, herbs, botanicals, other plantderived substances, amino acids the individual building blocks of protein , concentrates, metabolite constituents, and extracts of these substances. Circulating testosterone then stimulates prostate cancer growth. After the patient is injected with the isotope, he is placed under a machine that scans his skeleton and the rest of his body for uptake of the radioisotopes. Frequency and urgency can occur in 20% to 30% of patients, and a small percentage of patients, less than 10%, may require a transurethral resection of the prostate because of urinary retention. These data would suggest that the best candidates for watchful waiting are men with a relatively short life expectancy and low Gleason score tumors.
In addition, alpha blockers can interact with some other drugs, particularly those used to treat high blood pressure, and these potential drug interactions should also be discussed with the treating physician. Hydronephrosis dilation of the kidneys, usually due to obstruction. Alpha 1a receptors are found in very high concentrations within the prostatic smooth muscle and therefore are very important in regulating prostatic tone. A recent study in the New England Journal of Medicine 2006;354:557—566 , however, demonstrated that there was no significant difference between saw palmetto and placebo as measured by symptom scores or urinary flow rates. Impotence the inability to achieve an erection or to maintain an erection until ejaculation.
What is microwave therapy of the prostate? A radionuclide bone scan is used to detect prostatic cancer metastases to the skeleton. Neurogenic bladder a bladder that has an abnormality in its nerve supply. A second approach is the laparoscopic radical prostatectomy. Chemotherapeutic drugs are also being used for patients who have developed hormone-refractory prostate cancer—namely patients who were initially on hormone therapy but whose prostate cancer has mutated, which permits it to grow even in the face of low testosterone levels. What types of 5 alpha reductase inhibitors are available? Bladder ultrasound a test done through the skin to measure how much urine is left in the bladder after voiding. Prostate cancer is the most common male cancer and prostatitis is a very common infection.
About 30 herbal compounds have been used to treat prostatic urinary symptoms. The number of times the needles are placed into the prostatic lobes is at the discretion of the urologist based on the size of the prostate gland. The glossary is detailed and together with the index will assist readers with navigating the text. Reported erectile dysfunction rates vary widely. How common is prostate cancer? In addition, the use of some alpha blockers is relatively contraindicated when the patient is taking certain impotence medications.
Azotemia increased serum creatinine which is a sign of kidney dysfunction. How is metastatic disease diagnosed? It is estimated that a man with a first-degree relative with prostate cancer has a 2. Alpha receptors, however, are found throughout the body, and they control a variety of physiologic functions, not just voiding. A prostate ultrasound and biopsy is performed to obtain prostatic tissue to make a definitive diagnosis of prostate cancer. There has also been increasing interest in herbal therapy to treat benign enlargement of the prostate.
For instance, getting up three times per night may bother one man a great deal and another not at all. Gene therapy: A technique used to correct defective genes. Penis the male organ used for urination and sexual intercourse. Suprapubic tube: A type of catheter placed percutaneously through the skin into the bladder through the lower abdominal wall in order to drain urine. What are the risk factors for prostate cancer, and who is at risk? Type 1 is found predominantly in extra prostatic tissues such as the skin and liver, although it is also found in the prostate.
The initial management is to replace the blood loss with appropriate blood transfusions and to increase the irrigation fluid that is used to irrigate the bladder through what is known as a three-way urethral catheter. Nocturia getting up at night to urinate. . What is microwave therapy of the prostate? Antiandrogen: Drugs that counteract the action of testosterone. The patient is sent home on oral antibiotics, and the patient may see blood in his urine, stool, or semen for several days or at times for several weeks after the biopsies. The total dose administered and the field of the radiation therapy depend on the grade and stage of the prostate cancer. The probes are removed and, in most cases, an indwelling urethral catheter is left for a few days.
A retropubic simple prostatectomy is similar to a suprapubic simple prostatectomy as it is also performed through a lower abdominal incision. Perineal pain has also been associated with cryoablation of prostate cancer, but the most devastating potential complication is a prostate—rectal fistula, which is leaking of urine from the prostatic urethra through the rectum. What are the side effects of 5 alpha reductase inhibitors? A final approach to a radical prostatectomy is the perineal prostatectomy, which is performed through the perineum, which is the skin between the scrotum and anus. During this type of surgery, several long instruments, including a thin lighted tube with a small video camera to guide prostate removal, are inserted into the body through small incisions. A schema that depicts the action of 5 alpha reductase appears in Figure 5. At almost the same time, a major study of Finnish men revealed that vitamin E, with alpha- and gamma-tocopherols, appeared to cut the risk of prostate cancer by 50%. First, prostate cancer would be diagnosed more readily in younger men, and second, it would prompt fewer biopsies in older men.
This results in a lower threshold to initiate an evaluation in younger men and a higher threshold for evaluation in older men. Part 5 Treatment of Prostate Cancer p. The E-mail message field is required. Laser technology continues to evolve rapidly, and not every hospital or urologist has access to every laser technology. Variable amounts of the glycine are absorbed during a resection, depending on the amount of bleeding and length of time associated with the operation. What are the side effects of brachytherapy? It therefore has a Peak urinary flow rate 70 Greater than 30% improvement in total symptom scores Percent of patients 60 50 40 30 20 10 0 Placebo 2 mg 5 mg 10 mg Treatment group Figure 4 Symptom scores and flow rates. Electrovaporization of the prostate has been most often applied in patients with a history of bleeding disorders or in cases in which it is desired to minimize blood loss.