Prostate cancerProstate cancer

Prostate cancer kya hai

Prostate mardon mein masanay ke bilkul neechay aik chhoti gilti (gland) hai, jo urethra, yaani peshab bahar le jane wali nali, ke gird hoti hai. Is ka kaam maniyy (semen) ke fluid ka aik hissa banana hai. Prostate cancer ka matlab hai ke gilti ke kuch cells bay-qaboo ho kar barhna shuru ho gaye hain.

Prostate cancer har shakhs mein bohat mukhtalif tareeqay se kaam karta hai. Kuch cancer itne aahista barhte hain ke shayad zindagi bhar koi masla paida na karein. Kuch tez barhte hain aur prostate ke bahar phail sakte hain, aksar qareebi lymph glands aur haddiyon tak. Isi liye aap ke urologist kuch tajweez karne se pehle aap ke cancer ko ghaur se dekhte hain.

Prostate cancer barhay hue prostate (BPH) jaisa nahi hai. BPH aik aam, cancer ke baghair barhna hai jo peshab ki alamaat deta hai. BPH hone ka matlab yeh nahi ke aap ko prostate cancer hoga, aur yeh aap ko is se bachata bhi nahi. Hamari barhay hue prostate ki guide mein BPH ki tafseel hai.

Yeh kitna aam hai

Prostate cancer mardon mein aam cancers mein se aik hai. Umar ke saath is ka imkaan barhta hai aur yeh zyada tar 50 saal se oopar ke mardon mein milta hai.

Kuch cheezein is ka imkaan barhati hain:

• Umar. Mard jitne bade hotay hain, imkaan utna barhta hai.
• Khandani tareekh. Walid ya bhai ko prostate cancer hona, khaas tor par kam umar mein, imkaan barhata hai. Kuch aur cancers ki khandani tareekh, jaise chhati ya ovary ka cancer, bhi ahmiyat rakh sakti hai.
• Nasli pas-e-manzar. Kuch giroohon mein khatra doosron se zyada hota hai.

Koi bhi is se bachao ka wada nahi kar sakta, aur khatre ki kisi wajah ka hona is ka matlab nahi ke aap ko yeh zaroor hoga. Prostate cancer ke bohat se mardon mein koi maloom wajah nahi hoti.

Aam alamaat

Shuruati prostate cancer mein aksar koi alamat nahi hoti. Yeh sirf PSA khoon ke test ya kisi aur wajah se kiye gaye scan mein pakda ja sakta hai. Jab alamaat aati hain, to in mein yeh shamil ho sakti hain:

Peshab ki alamaat

• Kamzor ya sust dhaar, ya peshab karne ke liye zor lagana.
• Peshab ke liye zyada baar jana, khaas tor par raat ko.
• Yeh mehsoos hona ke masana khali nahi hua.
• Peshab ya maniyy mein khoon.

Zyada barhi hui beemari ki alamaat

• Kamar, kulhon ya doosri haddiyon mein dard jo theek na ho.
• Thakan aur bila wajah wazan kam hona.
• Taangon mein soojan.
• Taangon, masanay ya paikhane par kamzori, sunn-pan ya qaboo na rehna. Yeh emergency hai (neechay dekhein).

Peshab ki alamaat cancer ke muqablay mein kaheen zyada aksar barhay hue prostate ya infection ki wajah se hoti hain. Lekin alamaat aik jaisi lag sakti hain, is liye in ko kabhi nazar-andaz na karein. In ki jaanch karwayein.

Tashkhees kaise hoti hai

Koi aik test is sawal ka faisla nahi karta. Aap ke urologist aap ki alamaat, muaina aur kuch tests ko mila kar dekhte hain. Aam tor par qadam yeh hain:

• Baat cheet aur muaina. Urologist aap se alamaat, khandani tareekh aur aam sehat ke baare mein poochte hain. Prostate ka muaina aam tor par pichhli sharamgah ke raaste ungli se narmi ke saath kiya jata hai.
• PSA khoon ka test. PSA aik protein hai jo prostate banata hai. Khoon ka test napta hai ke aap ke khoon mein kitna hai. Zyada level cancer ki alamat ho sakta hai, lekin bohat si aur cheezein bhi PSA barhati hain, jaise barha hua prostate, infection, catheter, aur haal hi mein cycling ya inzaal. Aur normal PSA bhi cancer ko poori tarah radd nahi karta. Aap ke urologist batayein ge ke aap ka result kaise samajhna hai aur dobara kab karwana hai.
• Prostate ka MRI scan. Agar PSA ya muaina fikr ki baat dikhaye, to MRI scan gilti ki tafseeli tasveer deta hai. Yeh dikhata hai ke koi hissa shak wala lagta hai ya nahi aur biopsy kahan se leni chahiye. Yeh bedard hai, aur aap scanner ke andar saakit letay rehte hain.
• Prostate biopsy. Pakka pata sirf biopsy se chalta hai. Doctor ultrasound ya MRI ki rehnumai mein patli suyi se prostate ke tissue ke chhote namoonay letay hain, aur aik specialist doctor (pathologist) unhein microscope se dekhta hai. Aap ke urologist batayein ge ke biopsy kaise hogi, tayyari kaise karni hai, aur baad mein kya hoga. Baad mein kuch dair peshab, maniyy ya paikhane mein thora khoon aana aam hai. Infection sab se aham khatra hai, is liye baad mein bukhaar ya kanpkanpi par fauran tawajjo chahiye.

Agar cancer mile, to yeh dekhne ke liye mazeed scan, jaise bone scan ya CT scan, kiye ja saktay hain ke kya yeh phail chuka hai. Har kisi ko in ki zaroorat nahi hoti. Aap ke urologist aap ke cancer ki qism ke mutabiq faisla karte hain.

PSA test aur MRI scan ki apni apni guide jald is website par aayegi. Tab tak, BAUS ka raised PSA ka safha (angrezi mein) aam agle qadam samjhata hai.

Aap ke results ko samajhna

Agar biopsy mein cancer mile, to aap ki report kuch cheezein bayan karegi. Yeh aap ke urologist aur aap ko behtareen raasta chunne mein madad deti hain. Aam alfaaz mein:

• Grade batata hai ke microscope mein cancer ke cells kitne abnormal lagte hain, aur is liye cancer ka rawayya kaisa hone ka imkaan hai. Kam grade ke cancer aam tor par aahista barhte hain. Zyada grade ke cancer zyada tez hone ka imkaan rakhte hain.
• Stage batata hai ke cancer kitna phail chuka hai. Localised ka matlab hai ke yeh abhi prostate ke andar hai. Locally advanced ka matlab hai ke yeh prostate ke bilkul bahar tak barh gaya hai. Advanced ya metastatic ka matlab hai ke yeh jism ke doosray hissoon tak phail gaya hai.
• Risk group. Doctor PSA level, grade aur stage ko mila kar cancer ko kam, darmiyani ya zyada risk ke group mein rakhte hain. Is se ilaaj chunne mein madad milti hai.

Apni reports hamesha saath rakhein aur apne urologist se kahein ke woh aasaan alfaaz mein samjhayein. Meherbani kar ke apne numbers ya grade doosray mareezon se na milayein: do afraad jin ko "prostate cancer" hai, un ko bohat mukhtalif ilaaj ki zaroorat ho sakti hai.

Ilaaj ke tareeqay

Sahi ilaaj cancer ki qism aur stage, aap ki umar aur aam sehat, doosri beemariyon, aur is par munhasir hai ke aap ke liye sab se zyada kya ahem hai. Yeh aap ke urologist ke saath mil kar kiya jane wala faisla hai, aur aksar is mein cancer specialist samait aik bari team shamil hoti hai. Aham tareeqay yeh hain:

Ilaaj peshab karne, masanay par qaboo aur jinsi salahiyat ko mutasir kar sakta hai. Kitna, yeh har shakhs aur har ilaaj mein mukhtalif hota hai, aur aksar madad dastiyab hoti hai. Faisla karne se pehle apne urologist se is baare mein poochein taake aap ko pata ho ke kya umeed rakhni hai. Koi dawa khud se shuru, band ya tabdeel na karein.

Follow-up

Prostate cancer ko baqaida follow-up chahiye, chahe aap ka ilaaj koi bhi ho, sirf nigrani samait.

• Har appointment rakhein. Sirf is liye visit na chhorein ke aap theek mehsoos kar rahe hain. Bohat se masail jaldi sirf is liye pakre jatay hain ke kisi ki jaanch ho rahi thi.
• PSA khoon ka test waqt par karwayein. Ilaaj ke baad, PSA hi woh bunyadi tareeqa hai jis se aap ke urologist dekhte hain ke cancer qaboo mein hai.
• Jo scans bataye jayen woh karwayein. Har visit par apne results saath layein.
• Apne kaghazat saath rakhein. Biopsy report, scan reports aur ilaaj ka record aik hi file mein rakhein.
• Nayi alamaat batayein, jaise haddi ka dard, wazan kam hona, peshab mein khoon, ya peshab karne mein nayi mushkil, agli visit ka intezar kiye baghair.
• Apni aam sehat ka khayal rakhein, baqaida halki harkat, mutawazin khoraak aur sigrate se parhez ke saath. Aap ke doctor batayein ge ke aap ke liye kya munasib hai.
• Madad maangein. Cancer ki tashkhees qabool karna bohat mushkil hota hai. Apne ghar walon, doctor ya counsellor se baat karna kamzori nahi, himmat ki nishani hai.

Aam sawalaat

What prostate cancer is

The prostate is a small gland that sits just below the bladder in men, around the urethra, the tube that carries urine out. Its job is to make part of the fluid in semen. Prostate cancer means that some cells in the gland have started to grow in an uncontrolled way.

Prostate cancer behaves very differently from one person to another. Some cancers grow so slowly that they may never cause problems in a person's lifetime. Others grow faster and can spread outside the prostate, most often to nearby lymph glands and the bones. This is why your urologist looks carefully at your cancer before recommending anything.

Prostate cancer is not the same as an enlarged prostate (BPH). BPH is a common, non-cancerous enlargement that causes urinary symptoms. Having BPH does not mean you will get prostate cancer, and it does not protect you from it either. Our enlarged prostate guide explains BPH.

How common it is

Prostate cancer is one of the more common cancers in men. It becomes more likely with age and is mostly found in men over 50.

Some things make it more likely:

• Age. The chance rises as men get older.
• Family history. A father or brother with prostate cancer, especially at a younger age, raises the chance. A family history of certain other cancers, such as breast or ovarian cancer, can also matter.
• Ethnic background. Some groups have a higher risk than others.

Nobody can promise to prevent it, and having a risk factor does not mean you will get it. Many men with prostate cancer have no known risk factor.

Common symptoms

Early prostate cancer often causes no symptoms at all. It may be found only because of a PSA blood test or a scan done for another reason. When symptoms do appear, they can include:

Urinary symptoms

• A weak or slow stream, or straining to pass urine.
• Passing urine more often, especially at night.
• A feeling that the bladder has not emptied.
• Blood in the urine or in the semen.

Symptoms of more advanced disease

• Pain in the back, hips or other bones that does not settle.
• Tiredness and loss of weight without a clear reason.
• Swelling of the legs.
• Weakness, numbness or loss of control of the legs, bladder or bowel. This is an emergency (see below).

Urinary symptoms are far more often caused by an enlarged prostate or an infection than by cancer. But the symptoms can look the same, so they should never be ignored. Have them checked.

How it is diagnosed

No single test settles the question. Your urologist puts together your symptoms, an examination and a few tests. In general the steps are:

• Talking and examination. Your urologist asks about your symptoms, family history and general health. The prostate is usually examined by a gentle finger examination through the back passage.
• PSA blood test. PSA is a protein made by the prostate. A blood test measures how much is in your blood. A higher level can be a sign of cancer, but many other things raise PSA too, including an enlarged prostate, infection, a catheter, and recent cycling or ejaculation. A normal PSA also does not completely rule cancer out. Your urologist will explain how to read your result and when to repeat it.
• MRI scan of the prostate. If the PSA or examination raises concern, an MRI scan gives a detailed picture of the gland. It shows whether any area looks suspicious and where a biopsy should aim. It is painless, and you lie still inside the scanner.
• Prostate biopsy. A biopsy is the only way to be sure. A doctor takes small samples of prostate tissue with a fine needle, using ultrasound or MRI to guide it, and a specialist doctor (a pathologist) examines them under a microscope. Your urologist will tell you how the biopsy will be done, how to prepare, and what to expect afterwards. Some blood in the urine, semen or stool for a while afterwards is common. Infection is the most important risk, so fever or shivering afterwards needs urgent attention.

If cancer is found, further scans, such as a bone scan or a CT scan, may be done to see whether it has spread. Not everyone needs them. Your urologist decides based on the type of cancer you have.

See our guides to the PSA test, MRI of the prostate and prostate biopsy. The BAUS page on a raised PSA also explains the usual next steps.

Understanding your results

If the biopsy finds cancer, your report will describe a few things. These help your urologist and you decide on the best path. In general terms:

• Grade describes how abnormal the cancer cells look under the microscope, and so how fast the cancer is likely to behave. Lower-grade cancers tend to grow slowly. Higher-grade cancers tend to be more aggressive.
• Stage describes how far the cancer has spread. Localised means it is still inside the prostate. Locally advanced means it has grown just outside it. Advanced or metastatic means it has spread to other parts of the body.
• Risk group. Doctors combine the PSA level, the grade and the stage to sort the cancer into a lower, middle or higher risk group. This helps to choose treatment.

Always take your reports with you and ask your urologist to explain them in plain words. Please do not compare numbers or grades with other patients: two people with "prostate cancer" can need very different treatment.

Treatment options

The right treatment depends on the type and stage of the cancer, your age and general health, other illnesses, and what matters most to you. It is a shared decision with your urologist, and often a wider team including a cancer specialist. The main options are:

Treatment can affect passing urine, bladder control and sexual function. How much differs from person to person and from treatment to treatment, and there is often help available. Ask your urologist about this before you decide, so that you know what to expect. Do not start, stop or change any medicine on your own.

Follow-up

Prostate cancer needs regular follow-up, whichever treatment you have, including monitoring alone.

• Keep every appointment. Do not skip a visit because you feel well. Many problems are found early only because someone was checked.
• Have your PSA blood test when it is due. After treatment, PSA is the main way your urologist checks that the cancer is under control.
• Have the scans you are asked to have. Take your results to every visit.
• Carry your papers. Keep your biopsy report, scan reports and treatment record together in one folder.
• Report new symptoms such as bone pain, weight loss, blood in the urine, or new difficulty passing urine, rather than waiting for the next visit.
• Look after your general health with regular gentle activity, a balanced diet and no smoking. Your doctor can advise what suits you.
• Ask for support. A cancer diagnosis is a lot to take in. Talking to your family, your doctor or a counsellor is a sign of strength and not weakness.

Common questions