PROSTATE CANCER - Introduction

Introduction To The Prostate Gland

The prostate is a glandular organ present only in males.  It surrounds the neck of the bladder & the first part of urethra and contributes a secretion to the semen. The gland is conical in shape and measures 3 cm in vertical diameter and 4 cm in transverse diameter. It has got five lobes anterior, posterior, two lateral and a median lobe. Since the first part of the urethra passes through it any lesion in the prostate will produce difficulty in passing urine.

Diseases of the prostate gland

1) Prostatitis
This is the inflammation of the prostate gland due to bacterial infection.

2) Benign enlargement of the prostate
This is a non cancerous tumour of the prostate seen after the age of 50.

3) Cancer of the prostate
This is the 4th most common cause of death from malignant diseases in males.

Cancer of the prostate

Cancer of the prostate is directly linked with the male sex hormones (androgens). If the levels of sex hormone increase the growth rate of cancer also increases. It is found that after the removal of testes there is marked reduction in the size of tumour.

Site of tumour
Prostate cancer is seen mainly in the posterior lobe. Non cancerous enlargement is seen in other lobes.

Changes in the gland with cancer
The gland becomes hard with an irregular surface and loses normal lobulation. Histologically prostate cancer is an adeno carcinoma (cancer of the epithelial cells in the gland).

Growth
Growth rate is very fast in prostate cancer. The tumour compresses the urethra and produce difficulty in urination.

Spread of tumour
Metastasis (the spread of cancer) in cancer of the prostate occurs very early on.

• Local spread
  From the posterior lobe the cancer cells go to the lateral lobes and seminal vesicles. Tumour cells also move to the neck and base of the urinary bladder.
• Lymphatic spread
  Through the lymph vessels cancer cells reach the internal and external illiac group of lymph nodes. From there cells move to retroperitoneal (behind the peritoneum) and mediastinal lymph nodes (in the chest).
• Spread through the blood
  Spread of cancer cells take place through the periprostatic venous plexus and reaches the vertebral veins while coughing and sneezing and finally enders the vertebral bodies of the lumbar vertebrae.

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