Settlement In Lawsuit Claiming Doctors Missed Man’s Prostate Cancer For Years

Coordinating the patient care may actually make the difference between life and death. The inovolvement of more than one physicians in the treatment of a patient means that some doctors might have important information that needs to be relayed to the patient as well as the other physicians for appropriate follow up. Without it the patient could very well go on not receiving appropriate and essential treatment. Many people think that the doctor will contact them in case there are any adverse findings from tests ordered by the doctor.

Generally, when people do not receive a follow up communication from a doctor many view that as an indication that everthing is fine and that there is no need for them to follow up with the doctor. It becomes more problematic, however, if the one doctor who is on the right track ends up not communicating his or her suspicions and the other physicians are not catching the signs and not ordering the proper tests.

Consider the following reported lawsuit. Several physicians had a chance to detect the male patients prostate cancer before it spread The man first saw his primary care physician, a general practitioner, with complaints of urinary problems at 56 years old age. The family doctor thought that the patient’s problems were not a result of cancer. Thus, the family doctor did not order any diagnostic testing, like a biopsy and did not refer the patient to a urologist.

Ten months afterwards the individual consulted with a urologist who did a physical examination on the prostate gland and did a PSA blood test. The individual then learned that the urologist was not approved by his insurance and he went to a different urologist who was approved.

The PSA test ordered by the first urologist came back and that urologist advised a biopsy. Unfortunately, that recommendation apparently did not get related to the PCP or the urologist approved by the insurance company. The approved urologist did not order a PSA blood test. The approved urologist also did a physical examination of the prostate but found no abnormalities and concluded that the patient did not have cancer.

It was an additional 2 years before the patients prostate cancer was finally detected. By that point, the cancer had spread outside the prostate and had metastasized. Had the cancer been detected at the time the patient initially complained of urinary problems, when he saw the first urologist, or even when the second urologist failed to find any abnormalities with his prostate and failed to order a PSA test, it would have still been contained in the prostate and, with treatment, the patient could have had approximately 97% prospect of surviving the cancer. Since the cancer was already advanced , however, the patient was likely to die from the cancer in under five years. The law firm that handled this matter published that they were able to achieve a settlement during jury selection at trial for $2,500,000 on behalf of the patient.

As the case described above illustrates, having multiple doctors for the same issue may lead to multiple errors. The first mistake was not following the screening guidelines. This was a mistake committed by both the primary care physician and the second urologist. The other error was one in communication. This happened when there was a miscommunication of the findings, suspicions, and recommendations of the urologist who was not approved by the insurance company and the other doctors.

If the patient had been able to keep seeing the first urologist he would have known that cancer was a possibility and that a follow up biopsy was recommended. If the other physicians would have agreed with that recommendation or would have passed this information to the patient if they had received it is unknown but then the error would have been entirely theirs.

Person Finds Out He Has Advanced Colon Cancer Even Though His Physician Knew Of Symptoms For Years

In a number of situations colon cancers bleed. In certain cases, the blood may show up in the stool. When the cancer is close to the rectum, the blood might even appear as bright red. Regardless of whether the blood is not visible, the bleeding might still be detectible in other ways. As an example, the loss of blood may appear as anemia. Blood tests may uncover internal loss of blood that may be the consequence of a tumor in the colon. The key blood test results to check include the hemoglobin, hematocrit, and Mean Corpuscular Volume (MCV) levels. Levels below the normal range might reveal blood loss and iron deficiency anemia. When someone presents with levels that are below normal levels for these tests doctors generally acknowledge that there should be additional testing to determine the reason for the blood loss, like the possibility of cancer of the colon.

Look at the case of a 64 year old male patient whose blood tests exhibited all of the above. The subsequent year, the person’s blood work showed a deterioration of the individual’s problem. Additionally, a guaiac test showed the presence of blood in the patient’s stool. Yet, doing no additional testing, the person’s doctor added a diagnosis of hemorrhoids into the individual’s record. In addition, the patients PSA level (a test that is used to screen males for prostate cancer) was a 10.3 (anything above a 4.0 is often viewed as high and troubling for prostate cancer). The physician did not put any report in the mans chart to indicate an examination of the prostate gland. The doctor failed to relay to the person about the high PSA levels and failed to refer the individual to a specialist.

Roughly two years later the person went to a different doctor. Because of the mans age this physician had him undergo a barium enema. The result: a diagnosis of advanced colon cancer. The person passed away from metastatic colon cancer not even 3 years following his diagnosis. The patient’s family initiated a case against the doctor who ignored the patients abnormally low blood test results and overlooked the existence of blood in the mans stool. The law firm that represented the family reported a settlement in the amount of $1,250,000

Blood tests are done for a reason. Abnormal test results suggest that something may be wrong, maybe even seriously wrong with the person and call for follow up. Sometimes follow up means repeating the blood test in just a short period of time to see whether the levels improve but when the levels deviate sufficiently from normal levels or continue to worsen, doctors usually recognize that this raises the need to order appropriate additional tests to determine the explanation for those levels. Physicians further normally consent that blood in the stool of an adult person calls for fast attention to rule out colon cancer as the cause. A colonoscopy is often used to look at all the colon and either locate or exclude the existence of any tumors. This physician failed to dor any of this.

Although settlements usually include no without any admission of liability by defendants it is no surprise that the law firm that handled this matter was able to report such a significant settlement.

Take That Prostate Psa Test To Prevent Prostate Cancer

One of the most widespread types of cancer that affects males is prostate cancer. In the U.S.A. , in fact , there is one case for every 6 men. The cancer grows gradually and is typically concentrated on the prostate gland. There are patients who do not show any symptoms as their tumor grows too gradually while others grow so quickly that they immediately need to be treated .

One way to identify prostate cancer is throughout the measurement of the prostate PSA level. Prostate Specific Antigen (PSA) is the protein in nature present and produced by the cells in the prostate gland. Average men have small amounts of the PSA while men with cancer have high levels of this serum.

The test is managed through blood sampling where the PSA is measured. Prostate PSA is the most effective method to detect prostate cancer and is necessary in order to treat the cancer at the beginning phases of its development .

Nearly all of the therapies for prostate cancer will trust on the prostate PSA level. If the outcome of the checks reflect high prostate PSA level, the physician will prescribe a series of blood tests and extra tests to make a verified and exact diagnosis.

Depending on the outcome of the tests prescribed , the physician will order any or mixture of the most ordinary treatments for this cancer. One such method is watchful waiting, which involves no more but meetings to monitor the enlargement of the cancer cells. By means of this method, the doctor will keep track of the prostate PSA levels of the patient. Rectal tests are required for any variations in the size of the organ.

Because the growth for some is in fact slow, there really is no need to intervene. It is just recommended that the patient keep his schedules for permanent examination. Patients have to be conscious about the signs especially where their urination is concerned. The majority of the indications are found through some troubles with urinating.

Men aged 50 and above are recommended for prostate PSA tests to discover cancer. These older men are more at possibility of developing the cancer cells because prostate glands grow bigger as they become old and they also become more apt to the cancer.

The normal prostate PSA level for men 60 years old and below is around 2.5 ng/ml. If older than 60, a man may have as high as 4.0 ng/ml because the prostate gland may have by now enlarged at this time . Enlarged prostate glands create more PSA. Cells affected with cancer can produce up to 10 times more PSA than a regular, normal prostate gland cell. So, after the cancer cells grow, there will be higher levels of PSA that go into the bloodstream and that is why a PSA test is likely to discover prostate cancer.

There are cases when the PSA levels are high but the patient has no cancer. The reason of the spike in the prostate PSA is because to Benign Prostatic Hypertorphy (BPH) or inflammation of the prostate, which may also increase the production of PSA.

Overcome Your Heart Diseases And Diabetic Complications

The countries like the United States are suffering with a number of death cases due to heart disease every year. The term of this disease has many types and segments that generally affect the heart. Some of the heart disease that are very common like heart disease due to high blood pressure , Coronary Heart Disease , Ischemic Heart Disease , Tachycardia , heart murmurs etc. The heart diseases like the vascular heart disease, colonial heart disease and others can be cured completely. The main cause of a heart disease is mental stress, high blood pressure or hypertension, high level of cholesterol, overweight and/or obesity and many cases the heart disease also occurs due to stress. The habit of excessive smoking or a heavy intake of alcohol is also a great reason of heart diseases. The occurrence of heart disease is also affected by gender and sex. It also occurs due to hereditary issues. In many cases, it has been observed that if in a family , one of the parents are suffering with any sort of heart disease, the children can also be affected. Nowadays, the occurrence of heart disease also has roots in the growing environmental changes and pollutions and other toxins. Many of the stressful situations help to increase the blood clotting in the heart and also lead to hypertension. Some of the sex hormones are also responsible for a heart disease. The women who are in the age of sixty-five or seventy or in the menopausal condition face a drastic change in the sex hormones and have severe kinds of sickness in the heart.

The PSA tests are done especially in case of a cancer in the prostrate in males. The PSA is actually a type of protein, which is known as Prostrate-specific antigen. Antigen is manufactured in the prostrate. The test actually measures the level of this type of protein in the human blood. Thus, this test is done by taking a blood sample. The PSA medically is also known as tumor marker or biological marker. The US Food and Drugs Administration or FDA also has approved the medical use of PSA test. In the test process, the physical experts take blood from the veins, usually from the elbows. Here, the medical experts first clean the place from where he is going to take the blood and the enfold the upper portion of the arm with a band, then he gives pressure on the affected part to let the veins swell with blood and then he takes a particular amount of blood from the body. The medical experts say that the test can be useful if done including a Digital rectal Exam or DRE, especially in case of a prostrate cancer in those patients who are either 50 years old or more than that. In the DRE test process, the medical experts verify the prostrate gland the rectal wall to check the blisters and other abnormal growths. The FDA has also approved that the PSA test also can be useful if a person has a case of re-occurrence of prostrate cancer.

The person who suffers with a high level of blood sugar is diagnosed with diabetes. The condition of diabetes can also interrupt in the functioning of other body parts. The reason of the various complications of diabetes has its roots in some of the other body functions and some of the medicinal affects on the body. It is very widespread in the United States. Many of the patients do not even know that have the sickness. This is a sickness where the human body faces problem to keep a balance between the sugars and is not able to use insulin in an adequate amount. The insulin is a type of hormone, which helps the body to convert the level of starches, sugar and many of the other food into energy to boost the other body cycles. If a person has an invariable level of high amount of glucose, it is been said that the person has diabetes. The diabetic person will also have difficulties in the functions of eyes, heart, feet and even on the liver and kidney. The diabetes Mellitus mainly cause the condition of diabetes. The sickness generally is of three types, Type 1 diabetes, and Type 2 and Gestational diabetes.

What Women Need To Know About Prostate Cancer Symptoms And Treatment

Statistics show that one in six men will be diagnosed with prostate cancer in their lifetime; 220,000 men are diagnosed every year in the United States alone. Thats why it is critical for men to be well-versed on the disease’s symptoms and treatment options.

What may be even more important is the role mens wives play in ensuring that men are regularly screened. It is common knowledge that men aren’t always the best at taking care of and managing their health. It seems that men have every excuse in the book for ignoring regular doctor visits. But this is where a mans wife plays a crucial role. Generally speaking, women make sure that the men in their lives go to the doctor. And thats why it is important for them to be knowledgeable about prostate cancer, even though it is often referred to as “a man’s disease.”

What should Wives know about Prostate Cancer?
First, wives should know that prostate cancer is extremely common. Also, it is usually a slow-growing cancer, which means that symptoms oftentimes do not appear until the cancer is in more advanced stages.

Prostate cancer is also curable, and the earlier it is detected, the better the long-term chance of cure. This is why women must encourage the men in their lives to get screened annually for prostate cancer–early detection and the choice of treatment are the keys to cure of prostate cancer.

Screenings include a PSA blood test (a small amount of blood is taken and then analyzed), as well as a Digital Rectal Exam (DRE). The prostate is a gland that exists only in men, and sits below the bladder, adjacent to the rectum and the position of the prostate is why most men avoid prostate screenings like the plague–the doctor must press against the rectum to feel the prostate. It is admittedly not a very “fun” procedure; however, a few seconds of discomfort are certainly worth your husband’s life.

Many men don’t even know what the prostate is, and therefore don’t see how it could be a big problem. That’s why it is important that women learn about prostate cancer. Women who care about the welfare of their family know about this tiny gland and the big problems prostate cancer can cause.

Wives’ Guide to Prostate Cancer Symptoms:
Since the prostate sits near the bladder, symptoms of prostate cancer include many urinary difficulties, such as:
– Difficulty starting urination
– Weak urine flow
– Inability to empty the bladder completely
– Frequent nighttime urination
– Sudden urges to urinate

Recognizing these symptoms is very important for you and your husband. He may think that his frequent urination is due to “middle/old age” and may dismiss his symptoms as just that. You should know that these symptoms can be very serious.

It is much more common for a man who has been diagnosed with prostate cancer to not have any symptoms at all. In fact, if a man does have these symptoms, more likely than not, his prostate cancer has progressed. This further illustrates why it is critical for a man to be screened annually–remember, early detection and the choice of treatment are the two biggest factors in being cured of this disease.

Prostate Cancer Diagnosis:
Prostate cancer, since it is so often present in men, is usually screened for in physical exams for men age 50 and older. But men in their 40s can also get prostate cancer, so don’t think your husband’s age necessarily precludes him from developing this disease. In fact, African-American men, and men that have a family history of prostate cancer should begin their annual screenings at age 40.

The PSA blood test and the DRE will determine whether a man requires additional testing. A man is officially diagnosed with prostate cancer after a biopsy is conducted.

If your husband is diagnosed with prostate cancer, more than anything, you need to be his support and help him make an informed decision about how he should be treated for his prostate cancer. Research all the available treatment options and then go and consult with two, three, four, or more physicians who offer those different options, until you and your husband are both confident and comfortable with your decision. Do not make a snap decision about the course of treatment; many of the options out there carry risks of permanent side effects, including impotence and incontinence. A cancer diagnosis is scary for everyone, and men especially may balk at the idea of prostate cancer surgery and other treatments due to these fears of the side effects.

What you should know is that there are a variety of prostate cancer treatments available that can be very effective.

Unfortunately, the prospect of impotence and erectile dysfunction due to removal of the prostate cancer lead some men to decide to live with, and ultimately die from, prostate cancer. However, today’s treatment options are leaps and bounds more sophisticated than those your husband may remember. No longer is prostate cancer a sentence to sexual issues.

As a woman, you are more likely to pay attention to and take care of your husbands health. With prostate cancer being such a prevalent issue for men, you should be paying special attention to your husband’s health to ensure prostate cancer will not be a devastating diagnosis.

Settlement After Doctor Failed To Notify Patient Tests Showed Possibility Of Prostate Cancer

Male patients tend to have a scant awareness of prostate cancer, their own chances for the cancer, and the methods available for detecting whether they have prostate cancer. Most male patients are not aware of what it means to screen for prostate cancer or that screening needs to be done before they begin to show symptoms. Yet, far too often, physicians detect the cancer only after it is past the early stages because of deficient of screening.

There are several different circumstances that may result in a delayed diagnosis. This article will consider the following pattern: the doctor (1) orders a PSA blood test, (2) finds that the man has a high PSA level, but (3) fails to inform the patient, does not refer the patient to a specialist, and fails to get a biopsy to confirm whether the elevated PSA is due to prostate cancer. The case below illustrates this situation.

A physician, an internist, found that his male patient had a PSA of 8. (anything above a 4.0 is generally viewed as high). The doctor said nothing to the patient. The physician did not refer the patient to a specialist. The doctor failed to order a biopsy. Two years later the physician repeated the PSA test. This time the PSA level had gone up to 13.6. Again, the physician did not inform the patient. Again, the doctor did not refer the patient to a urologist. And again, the physician did not order a biopsy. Two years later the doctor repeated the PSA test. It was not until three years after first knowing about the patients raised PSA level that the physician finally advised him that he most likely had cancer. By the time he was diagnosed he had metastatic prostate cancer and surgery was not among the treatment options. Treating doctors alternatively recommended radiation therapy and hormone therapy. Neither of these would eliminate the cancer but they might slow the cancers advancement and additional spread. The law firm that handled this matter reported that they took the lawsuit to mediation where they were able to obtain a settlement of $600,000.

But not following up after noting abnormal test results brings about a situation in which those patients who do in fact have prostate cancer may not discover they have it until it has spread outside the prostate, restricting the patients choices for treatment, and substantially decreasing the possibility that the patient will be able to survive the cancer.

This lawsuit illustrates a sort of error that can lead to the delayed diagnosis of a patients prostate cancer. It comes about when the doctor actually follows the guidelines and screens male patients for prostate cancer yet does not follow through when the test results are abnormal.

How Did Chuck Kinsey Cure His Grade 3 Prostate Cancer

Last summer Chuck first discovered that he might have a problem when he got turned down for life insurance. Sure enough, a biopsy confirmed that he had cancer. His prostate had swelled up bigger than a baseball.

Chuck decided not to have surgery at least until January when his insurance would change. In November, he started following a recipe I came up with to cure my own stage 4 cancer 10 years ago.

When January arrived, his urologist examined him again and found that his prostate had shrunk quite a bit – down to the size of a small plum, according to his doctor.

His PSA score improved to 3.1 from a high of 5.8. His free PSA improved some as well, climbing from a paltry 12% to 21%…27% to 100% is considered normal.

His doctor was intrigued, telling Chuck he would be following his case closely, and took Chuck into his office to look up the hubpage where Chuck saw the recipe.

The recipe was simple. A habaneros pepper and two cloves of garlic plus an oil. In Chuck’s case, he used emulsified cod liver oil. Others might need evening primrose oil instead.

Chuck ate the recipe twice a day. I ate it once a day.

Chuck had another biopsy last Monday (March 2), on Thursday his report said he had no malignant tissue….he was cancer free. While there have been some tremendous improvements in other people with cancer who are eating the recipe…some more dramatic than Chuck’s…Chuck is the first who has a “before” and “after” biopsy confirming a cure.

When Chuck received the biopsy report, the doctor included an unusual note above his name, “Wow. I’m going to go get some more hot sauce.”

That’s probably the first time a note of that nature has ever appeared on a biospy report. But it might not be the last.

Prostate Cancer

Copyright 2006 Radoslaw Pilarski

Etiology

Etiology of prostate cancer development is not completely known. Factors that can influence the creation and development of this type of cancer include:

genetic factors increase in risk of falling ill among men with a positive family history regarding the prostate cancer. Mutations of suppressor genes are also taken into consideration (p53)

dietetic factors food rich in saturated fatty acids probably increases the risk of falling ill whereas the consumption of soya and rice may have a beneficial protective effect racial and geographical factors Afro-Americans are 100% more likely to fall ill, whereas the lowest death rate is reported in Japan and in China

occupational factors cancerogenous influence of heavy metals and toxins infectious factors viral infection may lead to/ be the cause of anaplasia of adenocyte cells of prostate

Histopathologically, 95% prostate cancer cases occur in the form of adenocarcinoma. Other types (primary intracellular cancer, squamous carcinoma, anaplastic carcinoma, and sarcoma) are rarely met. Adenocarcinoma usually develops in the peripheral area of the prostate (85%), in the transition area (25% ) and in the central area (5%).

Symptoms

In symptomatology of the prostate cancer, 4 clinical forms are distinguished:

1) visible form with distinct pathological symptoms 2) latent form (carcinoma latens) with no distinct pathological symptoms found 3) hidden form (ca occultum) which is detected in the case of distinct ailments caused by the existence of remote metastases, however changes in prostate are not found in the course of per rectum examination 4) accidentally detected form – based on histopathological test of the gland that was removed because of prostate overgrowth, or based on biochemical tests (PSA) During the development of prostate cancer, an induction phase that lasts about 30 years which is clinically invisible can be distinguished. During the next stage – in situ phase (5-10 years) and invasive phase (1 year), ailments connected with the local growth of tumour start to appear. During this period, symptoms connected with sub bladder obstacle appear including mainly: – pallakiuria – nycturia – weak urine stream – painful vesical tenesmus – impression of incompletion of bladder emptying The above-mentioned symptoms are typical of cancer and in some cases they may suggest mild overgrowth of prostate, or neurogenic or athermatous bladder disorders. During the dissemination phase (about 5 years), prostate cancer develops continuously infiltrating surrounding organs, such as: urinary bladder, rectum, ureters, pelvic walls and leading to urinary retention in kidneys and to secondary failure of function. Ailments typical for this period include: – haematuria – dysuria – urinary incontinence – erection disorders – aches of perineum, lumbar area and anus – haematospermia Metastases spread through the lymphatic vessels and the vascular system. Symptoms caused by the existence of remote metastases are as follows: – osteodynia and pathological fractures – pressure symptoms and spinal paralysis – lymphadema of limbs – clotting disorders – cachexy – coma

DIAGNOSTICS

In order to diagnose the prostate cancer, patient should undergo per rectum tests (DRE), PSA concentration (prostate specific antigen) in blood serum should be determined, ultrasonography per rectum examination (TRUS – transrectal ultrasound) should be done and if there is a suspicion of prostate cancer, histopathological test of the material obtained through a per rectum thick-needle biopsy done under the ultrasound control should take place. Histopathological test is the only test that confirms the presence of cancerous cells in the prostate gland area. DRE, which is an examination of sensitivity of 80% sensitivity and of specificity of 60%, enables to seize changes in the area of the prostate such as consistency change, palpable nodules and hardenings. It is the base for sending a patient to a diagnostic biopsy. At present, it is believed that cytological diagnosis achieved through a fine-needle biopsy is not sufficient to make a right diagnosis. It results from the fact that the assessment according to Gleasons classification is an important prognostic factor for the prostate cancer (see: prognostic factors). That is why a thick-needle biopsy is performed. Ultrasound use enables to take precise samples from suspicious foci. If there are no changes in TRUS picture, “sextant biopsy” is done (samples got for several places).

Recommendations for the biopsy of prostate gland: 1) palpable suspicion of the prostate cancer 2) PSA value over 15ng/ml regardless of DRE or TRUS tests 3) PSA value between 4 and 15 ng/ml with abnormalities detected during DRE or TRUS tests 4) PSA value exceeds the norm for a given age in the case of a positive family history regarding the prostate cancer

Recommendations for TRUS: 1) PSA between 4 and 12 ng/ml with abnormalities detected 2) questionable result of DRE test 3) necessity of a thick-needle biopsy Other diagnostic tests, such as CT and urography are not routinely performed because their value is questionable as far as the assessment of local stage and invasion of adjacent lymph nodes is concerned. Nowadays, magnetic resonance tomography done using transrectal coli (endorectal coil MRI – ERMR) to observe the prostate arouses great interest. Despite the increased sensitivity of the degree of the local stage, costs of the test do not allow for its routine use in the prostate cancer diagnosis. Scintigraphy of the skeleton is the most sensitive test (97%) in bone metastases detection. It is assumed that a patient with PSA under 10 ng/ml does not undergo scintigraphy because the probability of metastases is low.

Screening:

Screening: It is recommended that patients aged over 50 should undergo per rectum tests and PSA level tests every year.

PROGNOSTIC FACTORS:

Three groups of prognostic factors can be distinguished in the case of the prostate cancer:

1) development stage according to TNM 2) differentiation degree of the cancer based on the classification of Gleason and Mostofi 3) PSA level (prostate-specific antigen) in serum TNM classification

Preoperative assessment of the stage of the prostate cancer is made based on the above-mentioned tests.

T-stage: primary tumour

Tx – primary tumour cannot be assessed T0 – no evidence of primary tumour T1 – clinically unapparent tumour; not palpable or visible by per rectum imaging T1a – incidental tumour found in histopathological tests after transurethral resection of the prostate or after operational adenectomy: found in 5% or less resected tissue T1b – as above; found in more than 5% resected tissue T1c – tumour identified histopathologically by a needle biopsy (because of high PSA) T2 – tumour confined within the prostate gland T2a – tumour involves less than half of one lobe T2b – tumour involves more than half of one lobe only T2c – tumour involves both lobes T3 – tumour extends through the prostatic capsule T3a – extracapsular extensions (unilateral) T3b – extracapsular extensions (bilateral) T3c – tumour invades seminal vesicles T4 – tumour is fixed, invades adjacent structures other than seminal vesicles T4a – tumour invades bladder neck and/or external sphincter and/or rectum T4b – tumour invades levator muscles and/or pelvic wall N-stage: regional lymph nodes

Nx – regional lymph nodes cannot be assessed N0 – no regional lymph node metastases N1 – metastasis to a single regional lymph node with the diameter under 2cm N2 – metastasis to a single regional lymph node with the diameter > 2cm but

Mx – remote metastasis cannot be assessed M0 – no remote metastases M1 – remote metastases M1a – non-regional lymph nodes M1b – bones M1c – other sites According to Whitmor-Catalon classification, grades A, B, C, and D correspond to T1, T2, T3 and T4 of TNM classification respectively.

Degree of cancer differentiation:

Degree of differentiation is defined according to 2 classifications: by Mostofi and by Gleason.

Mostofis classification uses a 3-grade assessment of differentiation dependent on the degree of cell anaplasia grading (G1-G3). The higher grade, the lower differentiation of cancer tissue, the greater atypy and at the same time, malignancy. In the case of a 10-grade Gleason system, the two extreme histological images in the preparation are assessed and then, added to produce a final grade.

PSA is a proteolyctic enzyme responsible for sperm melting. It is mainly produced by glandular epithelium, it might be also produced in organs such as salivary glands, pancreas and mammary gland and by clear cell carcinoma. Commonly used norm is the following: 0-4 ng/ml. Such concentration of PSA is found among 97% of men over 40. The level over 12 ng/ml is always connected with pathology. Difficulties with diagnosis are found among patients who have this level between 5-10 ng/ml because it may both stem from the prostate cancer or a mild overgrowth of the prostate, which causes the necessity of diagnostic methods use, such as TRUS. This test makes it possible to determine PSA density (PSAD – PSA density) – PSA concentration converted to prostate volume unit. It should be under 0.15 ng/ml/g. In the case of prostate cancer differentiation and mild overgrowth of prostate, free to total PSA (PSA F/T) is used. If it is over 20%, one may assume the presence of cancerous cells in the gland. PSA level does not correlate well enough with the natural development of the prostate cancer. However, it is useful as a prognostic factor after the treatment applied and in prognosis determination. However, high final levels indicate low survival rate.

TREATMENT

Proceeding strategy in patients with the prostate cancer depends on the degree of histological malignancy, the degree of local stage of development, coexisting diseases and age of a patient. There are many controversies as far as the choice of treatment is concerned. Radical treatment is possible in T1, T2 and N0 and Mo stages. In advanced cases (T3, T4, N-+, M-+), the procedure is restricted to delay the cancer progression and mitigate its effects (palliative treatment).

Surgery treatment – radical prostatectomy

The surgery consists in the prostate gland removal together with spermatic vesicles and adjacent tissues. Surgery is done through retropubic, transcoccgeal, perineal approach or through laparoscopy. Lymphadenectomy constitutes an integral part of the surgery. If the approach makes it impossible to remove the gland and lymph nodes (perineal approach) at the same time, a separate surgery is carried out. It precedes the operation proper. It is believed that cancerous cells found in the removed lymph nodes are the reason why prostatectomy cannot be performed. Invasion of lymph nodes to a certain extent suggests PSA level over 40ng/ml together with grade >7 in Gleasons scale.

Recommendations for surgery:

1) cancer limited to the prostate gland (T1BN0M0Gx – T2N0M0Gx, T1AN0M0G3) 2) predictable life span over 10 years 3) consent of a patient If positive chirurgical margins, capsule infiltration or cancerous changes in the removed lymph nodes are found in postoperative microscopic assessment, the prognosis is worse such patients are qualified for palliative treatment. The death rate in the postoperative period does not exceed 5%. Intraoperative complications first of all include: bleeding from Santorinis plexus, damage of rectum wall, underpinning of ureter. Early complications after surgery: thrombotic and embolic complications (phlebothrombosis 3-12%, lung embolism 2-5%) and lymphocele. Late postoperative complications after prostatectomy include: urinary incontinence, erection disorders and narrowing of urethro-vesicular junction).

Radiotherapy

Apart from radical prostatectomy, radiotherapy is an effective method of treatment for patients with regional advanced prostate cancer. In radical treatment, the most frequently done using radiation from external sources, the dose of 50-70 Gy in fractions continuing over 5-7 weeks are given. T1ABC – T2ABCG1 and T1ABCG2 stages require radiation limited to the prostate. In other cases, area that is radiated includes adjacent lymph nodes as well. In recent years, multidimensional imaging with CT (3D conformal radiotherapy) is used in the treatment planning.

Brachytherapy constitutes another method that is used.

Recommendations for radical radiotherapy of the prostate:

1) prostate cancer confined with the organ 2) sufficiently long predictable survival span 3) no disorders in lower urinary tract 4) no disorders in rectum and colon 5) consent of patient to carry out treatment 6) early complications of radiation energy treatment (30% of patients) include dysuria, haematuria, diarrhoea, rectal tenesmus, inflammation of large intestine and rectum. Among later complications (11% of patients) chronic diarrhea, ulceration of rectum, bladder neck stenosis and intestinal fistula stenosis are observed.

Control of patients after radical prostatectomy and radical radiotherapy:

– per rectum test, PSA level in blood serum each 3 months. PSA level should be lower than 1 ng/ml (after radical prostatectomy it should be near to 0). Increase over 0.5 ng/ml within a year means failure of radiotherapy. Hormonotherapy

Hormonal therapy is mainly used as palliative treatment in advanced prostate cancer. It makes it possible to stop symptoms of the disease for some time and then, further progression of the disease takes place. Nowadays, the use of therapy in pulsation system is considered as it delays the development of hormone-resistant cell clones.

Ways of hormonal treatment include: 1) surgery castration (orchidectomy) 2) anti-androgens a) non-steroid b) steroid 3) analogues LH-RH 4) oestrogens, progestogens, inhibitors of androgens synthetase Hormonotherapy by analogues LH-RH is also recommended before planned radical radiotherapy. In the case of hormone-resistant cancer, treatment with combined cytoctatic and hormone (estramustine), however without significant effects.

PROGNOSIS

Prognosis depends on the development stage, degree of differentiation and PSA level (see: prognostic factors).

In T1A, B stage prognosis is good. 10-years survival 35-80%, death rate of the cancer 7-30%. In T2 stage, overall survival equals 34-85%, death rate equals 8-26%. In T3 stage, among patients who undergo non-invasive treatment for 9 years, overall death rate equalled 63%, from cancer 30%. Depending on the degree of cancer differentiation, 10-year survival of patients is the following: for cells well differentiated – 81%, for cells moderately differentiated – 58% and for cells poorly differentiated – 26%.

Learn How To Identify The Signs And Symptoms Of Prostrate Cancer

Prostrate cancer is a type of cancer that effects the Prostrate gland in the male reproductive system. It is the second most common type of cancer found in men as skin cancer is number one. Each year, there are over 186,000 men across our country who are diagnosed with this disease. The symptoms of Prostrate cancer are not noticed during the early stages of the condition. The tests that are used to determine if you have signs of this condition are the PSA test or the rectal examination. A cancer tumor causes the prostrate to enlarge and it starts to push in the urethra and this makes you feel different and causes you to have difficulty urinating.

It is a known fact that as men get older, their Prostrate enlarges and this causes them to have trouble with the urethra and bladder. The majority of Prostrate cancer cases occur in men who are over the age of 75, but it also can effect men at other ages. If you are experiencing any of the symptoms that we have talked about thus far, then you should call your doctor and make an appointment to get yourself checked as early detection is a key factor in fighting this disease.

Signs of this condition include the urge to urinate frequently at night and the urge to go more often, trouble starting and stopping the flow of urine, not being able to go at all, small streams of urine , pain or aches while going and blood in the urine, and pain during ejaculation.

If you feel like you are in the high risk category for developing this disease, then you should call your doctor and setup an appointment with him to discuss your condition so he can schedule some tests for you. A PSA or DRE test can be a great way to detect the cancer at an early stage before it becomes too advanced. On the negative side, these tests can sometimes cause false alarms and they can also detect other cancers that may not be a threat to you.

The bad news on Prostrate cancer is that in most of the cases, the disease cannot be detected until it spreads out beyond the glands as there are no signs and symptoms that can be detected during the early stages of the disease. This is why it is so important for you to undergo a Prostrate specific antigen examination . If cancer is detected, this means that it has already started to spread. Not all cancers grow at the same rate as some grow gradually while others grow more rapidly, so make sure that you discuss this condition with your doctor. The earlier that Prostrate cancer is detected, the more chance you have for a full recovery and a healthy life.

I hope that you found this information useful and if you would like more information on ways to live healthy, then please visit my healthy living web site where you will find great information to help you live a long and healthy life.