Prostate cancer (prostate cancer) is the most common cancer of the man.
The frequency peak is around the age of 72. – through the increased use of screening studies studies prostate cancers are discovered but always more frequently in younger men. From the age of 50 are more likely to develop prostate cancer.
Therefore, all men from the age of 45 in Germany are entitled to a prostate cancer screening every year. The doctor begins with a rectal examination. So, he can touch a large part of the prostate carcinoma in the rear part of the prostate. At the time at which a prostate cancer is palpable, has made it however often already Tochtergeschwulste (metastases) in remote places, or has grown about the prostate also.
With a subsequent TRANS = Ultrasound (TRUS), the doctor can determine the size and shape of the prostate and scan the gland by krebsverdächtigen Division. A PSA test determines the amount of a protein (protein), formed only in the prostate tissue. The PSA in a certain way can be elevated in prostate cancer. This test is however outside the scope of the statutory early detection of prostate cancer.
Previous studies have shown the suspicion of prostate cancer may the prostate biopsy likely confirm him or exclude.
Generally, there are no early signs for prostate cancer in the form of physical ailments so that only regular medical check-ups can detect the disease at an early stage. As long as the tumour is small and confined to the prostate, the chances of cure are very good. If pain already refer to the disease, prostate cancer can be advanced already so, that a complete cure is no longer possible. The legal investigation of screening studies therefore represents the best way to detect prostate cancer at an early stage and to treat successfully.
Implementation
From the age of 45. all men in Germany entitled to an early detection of prostate cancer each year. Here, the implementation of the early detection of prostate cancer is composed of various examinations.
Rectal exam
For the digital rectal exam, the patient relies on knees and forearms on the examination table from (knee elbow position). The doctor scans the finger (lat.: digitus) the rectum (Latin: rectum) of the patient out – hence the name “digital rectal exam”. The investigation is not dangerous and usually painless. This examination techniques is therefore particularly suitable because a large part of the prostate cancers at the back – so facing the gut – the prostate. Clearly, cancerous tissue is much harder and less elastic than the surrounding tissue, and therefore by keys.
However, the rectal palpation is no prostate cancer screening in the literal sense: it has made often already Tochtergeschwulste (metastases) in remote places at the time at which a prostate cancer is palpable, or has grown about the prostate also.
TRANS rektaler Ultrasound (TRUS)
When the trans = Ultrasound (TRUS), the doctor introduces a ultrasonic probe in the rectum (rectal). So, he can determine the size and shape of the prostate and scan the gland by krebsverdächtigen Division. At the ultrasound, it is exposed to the examined patient of no radiation exposure and the investigation is risk – and usually painless.
PSA test
The prostate-specific antigen (PSA) is a protein (protein), formed only in the prostate tissue. It is included in the ejaculate (semen) and in the blood of healthy men and the liquefaction of sperm. The PSA in a certain way can be elevated in prostate cancer. A PSA test is however outside the scope of the statutory early detection of prostate cancer.
Doctors routinely employ the PSA test for therapy planning and historical monitoring of prostate cancer: it comes to a renewed increase of PSA, for example certain time an operative removal of the tumour is suspected on a return of the disease (so-called relapse). Some doctors offer the PSA test to the provision; in this case, the patient must pay but even the test. In addition to prostate cancer, various diseases of the prostate can lead to an increase of PSA in the blood. The most important are the benign prostate enlargement (benign prostatic hyperplasia, BPH) and the inflammation of the prostate (prostatitis). Even after long bike rides, sexual intercourse, and constipation, the PSA levels in the blood can be increased and incorrectly show a suspicion of cancer. Before blood collection, these activities therefore should be omitted or exclude a blockage.
Biopsy
Previous studies have shown the suspicion of prostate cancer may the prostate biopsy likely confirm him or exclude. However, the doctor must exactly discuss this method with the concerned man and always carefully consider the decision to perform a biopsy. From the rectum or from the dam stands the examiner under ultrasound with a needle in different areas of the prostate and can refer to prostate tissue. The pathologist then examines this sample under the microscope on tumor cells. If he finds a prostate cancer, he can at the same time determine the exact type of tumor.
The biopsy is usually not or only slightly painful and conducted in outpatients. Rare complications include increased bleeding and an acute inflammation of the prostate (prostatitis). In the days after the prostate biopsy, often some blood in the semen or – somewhat more rarely – in urine can be found in the examined.
To prevent infection, the patient receives an antibiotic already on the eve of the tissue removal. That cancerous cells spread through the piercing and again herausziehen of the needle in the body and form Tochtergeschwulste (metastases), is no reason to fear.
Areas of application
The probability of disease for a prostate cancer rises steeply from the age of 50. Therefore there is an annual entitlement to a prostate cancer screening already from the age of 45. – the study is so useful at this age for each man and is not limited to certain fields of application. If already a brother or father suffering from a prostate cancer, prostate cancer screening worthwhile even earlier.
About the benefits of a PSA provision as the so-called method of screening for prostate cancer is discussed continually. Screening means that rows healthy persons undergo a test to detect a specific disease. Critics see the danger that the PSA test more and more so-called dumb prostate cancers would – uncover so Neoplasms of the prostate, which grow very slowly and probably never would have caused problems. The affected men would have no benefit in the sense of a higher life expectancy by diagnosis – current studies show that. However, psychological and sometimes also physically negative effects could arise for those affected by indiscriminate and unnecessary circumstances further examinations or therapy.
Proponents of the PSA test argue that it is possible, taking into account the findings and the situation of the person concerned, to decide which approach for the patient is the best individually very precisely and very reasonable. You assume that thus false tests and treatments often avoid could be. Then, the big advantage of PSA determination to discover those men, where a more aggressive prostate cancer and who would benefit from the discovery and the possibility of a treatment very would be.
Finally, every man should discuss with his physician, whether he would like to make the PSA test as “Individual health benefits” (IGeL) and what impact could have a striking result.
Risks and complications
The probing and the ultrasound examination of the prostate in the context of the early detection of prostate cancer are investigations without risks and complications. They are usually painless and not burdening the organism. The doctor with a striking key findings on prostate performs a biopsy, there may be here in rare cases complications such as bleeding.
From the age of 45. all men in Germany entitled to a prostate screening every year. In this country, there is approximately 58,000 new cases of prostate cancer each year. Probably, the number of men with prostate cancer is still higher. During autopsies of men who died for other reason, a prostate cancer found in about 30 percent of men over 50. These prostate carcinomas were microscopically small, so-called dumb or latent cancers which grow very slowly and probably never would have caused problems.
The causes of prostate cancer are not yet fully understood. The tumor in some families and in certain sections of the population frequently occurs, a genetic component in the development of the disease is considered secured. Also hormonal factors play a role in the development of cancer. A very high-fat diet also seems to promote prostate cancer. The benign enlargement of the prostate (benign prostatic hyperplasia, BPH) does not increase the risk of cancer.
Prostate cancer prevention in the form of food supplements, vitamins or drugs for healthy men without special risk factors is from scientific point of view currently unproven and therefore not recommended.
