Adenocarcinoma of the prostate (CA) is the clinical term for a cancerous tumor on the prostate gland. As prostate cancer grows, it may spread to to sac-like structures attached to the prostate (seminal vesicles), to tissues near the prostate, the interior of the gland, and to distant parts of the body (e.g., bones, liver, lungs).
The prostate gland is located in the pelvis, below the bladder, above the urethral sphincter and the penis, and in front of the rectum in men. It is made up of glandular tissue and muscle fibers that surround a portion of the urethra. The gland is covered by a membrane (called the prostate capsule) that produces prostate-specific antigen.
Symptoms are often similar to those of benign prostatic hyperplasia (BPH). Men observing the following signs and/or symptoms should see their physician for a thorough examination.
Blood in the urine or semen
Frequent urination, especially at night
Inability to urinate
Nagging pain or stiffness in the back, hips, upper thighs, or pelvis
Painful ejaculation
Pain or burning during urination (dysuria)
Weak or interrupted urinary flow
a. Medical Treatment
Treatment for prostate cancer depends on the stage of the disease and the patient's age and overall health. Elderly patients with minor symptoms, early stage cancer, or coexisting illness may be treated conservatively.
Watchful waiting is a reasonable course of action for patients who are elderly, in poor health, or with early stage cancer. Untreated prostate cancer may take years to become problematic. During this time, the physician monitors the patient's condition for any marked or sudden progression of the disease, which may signal the need for more aggressive treatment.
b. Surgical Treatment
Radical prostatectomy
Bilateral Orchidectomy
i. Radical Prostatectomy
Radical prostatectomy is the surgical removal of the prostate gland and surrounding tissues, including the seminal vesicles and the pelvic lymph nodes. Surgeons use one of two surgical techniques, retropubic prostatectomy or perineal prostatectomy. General anesthesia is used in both procedures.
In retropubic prostatectomy, an incision is made in the lower abdomen. This gives the surgeon access to the prostate gland, seminal vesicles, and the pelvic lymph nodes. In perineal prostatectomy, the incision is made in the perineum, the space between the scrotum and the rectum. With perineal prostatectomy, a second procedure is required to remove the pelvic lymph nodes (lymphadenectomy).
