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Over 95 percent of malignancies arising in the prostate are adenocarcinoma. The remaining types include urothelial carcinoma, basal cell carcinoma, small cell carcinoma, lymphoma and sarcomas.
Core needle biopsy of the prostate is used to determine whether or not cancer is present in men with an elevated serum PSA level and/or an abnormal digital rectal examination.
The recommendation is to take multiple core biopsies under transrectal ultrasound guidance.
Primary diagnosis of prostate cancer by using fine needle aspiration is not acceptable.
When positive, the combined Gleason score, based upon architectural features of the prostate cancer cells, should be reported because it correlates closely with clinical behavior and has been incorporated into the tumor node metastasis (TNM) prognostic group staging system.
One should also report number of positive cores, the percentage (or length) of cancer in the positive core, the presence of perineural invasion or extraprostatic extension, and the presence of histologic types other than conventional adenocarcinoma.
The accuracy of pathological diagnosis of prostate cancer can be improved by using immunohistochemistry markers.
I am having frequent urination say every ten minutes mostly in the morning hours. I am a diabetic but under good control.I had done x-ray of prostrate also but no enlargement is seen. I am 55 years male. Please advise what should I do?
There are more than hundred varieties of blood cancer, but the most common ones are leukemia, lymphoma, and myeloma. Acute myeloid leukemia (AML), a type of leukemia, is when the white blood cells in the marrow begin to grow uncontrollably. This is an acute condition and both the onset and progress are very rapid. The cause is not known, and given the rapid progress, even treatment is often difficult. A more severe form of AML is the APML which is acute promyelocytic leukemia, which leads to reduced number of white and red blood cells and plasma.
This causes the following symptoms:
- Increased incidence of infections
- Excessive bleeding from even minor cuts
- Bleeding from nose and gums
- Easy bruising
- Blood in the urine
- Extreme paleness and tiredness
What is different about APML?
There is one distinguishing factor with APML, which is that they contain a protein which when released into the bloodstream can cause severe bleeding, which may be very difficult to control. Chemotherapy kills these cells and so releases the proteins into the bloodstream. These cells need to be managed without chemotherapy, as the patient can even die of uncontrolled bleeding. With medical advances, two non-chemotherapy agents have been identified – all-trans retinoic acid (ATRA, vesanoid, or tretinoin) and arsenic trioxide (ATO or trisenox).
- ATRA: This is a type of vitamin A which is used either alone, in combination with chemo, in combination with arsenic trioxide, and also in combination with both chemo and arsenic trioxide. The effect is different in different people – helps control spread, helps prevent recurrence, and helps control symptoms. In many people, it has been successfully used instead of chemotherapy. ATRA is also used as a long-term maintenance agent. Side effects from ATRA include fever, dry skin, rashes, mouth sores, increased cholesterol, and swollen feet. These go away with stoppage of the drug.
- ATO: Arsenic is poisonous when given in large amounts. However, it was discovered that it could be used to treat APML with effects similar to ATRA. It is used alone, in combination with chemotherapy, with ATRA, or with both. It helps control the growth of cells and also helps in long-term maintenance therapy. ATO dosage needs to be monitored as it can cause heart rhythm issues.
With both these drugs, there is a significant side effect, known as differentiation syndrome - symptoms include fever, breathing difficulty. Often seen during the first cycle of treatment, this happens when the leukemia cells release a protein into the blood. Symptoms include fever, breathing, kidney damage, and severe fluid buildup. With these two drugs being widely used effectively, chemotherapy is not the only treatment option for APML. In case you have a concern or query you can always consult an expert & get answers to your questions!
Feeling a lump on your breasts can be a terrifying moment. 'Cancer' is the first thing that comes to mind but in reality, most lumps in the breast are not caused by cancer. Apart from cancer, breast lumps can be caused by non-cancerous growths, injuries and infections. The only way to correctly diagnose the cause of a lump in the beasts is through a biopsy. Hence, this is the first step towards treating a breast lump. From here on, treatment will depend on the cause identified.
Mastitis or Breast Infection
Mastitis is a painful infection of the breast tissue often faced by women who are breastfeeding. It can be treated with heat treatment and antibiotics. Massaging the breast while taking a warm shower or applying a warm compress. This will open up the milk ducts and should be followed by nursing the baby or using a breast pump to relieve the swelling and pain.
Antibiotics are the first line of treatment against an abscess but this is effective only if given in the initial stage of the infection. In later stages, an abscess will need to be surgically drained.
This is a non-cancerous tumour often found in young women. It is often difficult to distinguish between a Fibroadenoma and a cancerous tumour and hence these are usually surgically removed.
In some cases, the breast itself is composed of knotted, rope like tissue. This is known as having fibrocystic breasts. If a new lump presents itself on fibrocystic breasts, a mammogram and an ultrasound are performed to evaluate the lump. In most cases fibrocystic changes do not require any medication or surgery.
Cysts can be defined as fluid filled lumps. In some cases, these cysts become apparent at the time of ovulation and disappear after the period. In other cases, it may need to be drained with a thin needle. Cysts often recur and need to be re-drained.
Fat Necrosis and Lipoma
Fat necrosis is a lump caused by an injury to the fatty tissue in the breast. Lipoma is a fatty growth within the fatty tissue. In both these cases, no treatment is required but if it causes any problems, it can be removed.
If the biopsy reveals the presence of a cancerous tumour, you must immediately consult an oncologist. Treatment options for breast cancer include chemotherapy, radiation, surgery and hormone treatment.