EN 
AR In one American census in 1996, there were (317,000) infected patients
Prostate cancer compared to (244,000) patients in 1995, while the statistics indicated that (8,500) patients were infected in the year 1985. The same percentage of increase was found in Britain, about 66% for the years 1979-1990. In Canada, the increase was 50% compared to 1969, while in Japan, the increase was three-fold in the last ten years.
The introduction of screening for early signs of cancer, such as (P.S.A.), has had a positive impact on diagnosing cases and documenting them more accurately as a diagnostic survey for the disease. Infection with the disease does not primarily mean death, even though it is considered one of the main causes of death in Switzerland in the list of causes of death.Studies indicate that the long life and death of people with cardiovascular disease increases prostate cancer as one of the causes of death.
Various analyzes facilitated the task of diagnosing the disease early. This analysis is called (P.S.A.)
(Prostate Specific Antigen), which is available in all hospitals, helps in early diagnosis and treatment and reduces the death rate. However, this analysis has some disadvantages. By diagnosing the disease and using some drugs that are considered premature and unnecessary, some side effects may appear.
Genetic study helps diagnose a person susceptible to the disease. It has been found that the black race is 37% more infected than the white race, in addition to diet, especially for people who eat a high amount of fat. Therefore, the percentage of patients in Japan and China is small, but after the introduction of Western foods to Japan, the incidence of colon, breast, and prostate cancer increased, and this has been proven among Japanese people living in the United States, where they have the same percentage as Americans.
The problem with prostate cancer is that infected men refrain from talking about their disease because of its effect on their sexual potency. Many of them refrain from routine examination of the gland through the anus. Some of them mistakenly believe that prostate cancer is the result of an increase or decrease in sexual potency, especially among Filipinos and islanders. Caribbean.
Men can be infected with the disease without any symptoms, including pain, weakness, and urination problems, and when they are discovered, we find that the condition has reached the stage of the spread of prostate cancer, and in its late cases it is difficult to treat.
The P.S.A. test began in the 1980s. It is a blood test to determine the protein secreted by the prostate gland, which must not exceed 4 and is calculated at 1 mg per 1 milliliter of blood. New studies have found that this number may increase slightly with age to more than 4.After 50 years of age, every person needs a rectal examination, followed by an ultrasound examination, a PSA, and a biopsy of the prostate gland, if necessary. After the operation, there is usually a disturbance in the functioning of the urination valve, and it may be completely lost in 1-2%, and approximately 20-50% have difficulty controlling urination with involuntary dribbling of urine.
Sexual dysfunction is another problem that may occur that can be treated by preserving the nerves, and this is possible when there is no spread of prostate cancer. Deep radiation therapy for several weeks with multiple sessions may help to shrink the prostate and reduce the PSA level, but recurrence is possible. In 10 years, 20-25% is considered cured, but in 70-80% it is found that the PSA increases gradually. 50% of them suffer from impotence after five years of treatment.Focused radiation therapy to the prostate may also cause inability to control urination for weeks, in 5% permanently, and 15% suffer from impotence by the age of seventy, which increases with age.
The prostate through the ages
What is the prostate gland?
The first person to discover the prostate gland more than two thousand years ago was the French physician Herophile, who lived in Alexandria and who was interested in anatomy. He gave the name (prostate) to the gland, which means (the gland located before the penis).The prostate is a gland the size of a walnut, weighing about 15-20 grams. It is located around the neck of the bladder. It is flexible unless it becomes enlarged. It grows gradually from birth and reaches maturity, then stops until the age approaches forty, then it begins to increase gradually or steadily, which may lead to symptoms or difficulties in urination.
The benefit of the prostate gland is to nourish the semen to increase its quality and strength in fertilization. But it is not useful after the age of 60 years. The disease usually begins after the age of 40, but its effects begin at the age of 55 or older.Many celebrities have been afflicted with prostate cancer, and some of them have died because of it. For example, French President François Mitterrand, who died after undergoing a prostate augmentation operation that was found to be cancerous. Also, Former French President Charles de Gaulle was also infected with it.As for Spain, the first king of Spain and emperor of Germany was afflicted with prostate cancer, and he was Charles Kent, whose doctor used stinging candles inside the urinary tract, as stated by Brantôme, the historian who wrote his biography.
As for King Henry IV, he used a urinary probe (catheter), and another doctor used a sharp object to open the stone.The early death of Emperor Peter the Great (Tsar of Russia) at the age of 53 was caused by prostate cancer, and his English doctor had placed several urination probes on him.As for Napoleon III, the Emperor of France, he suffered from bladder disorders in 1853. He had refused the operation for political reasons so that the French would not know about his illness. He used opium for pain, which causes profound drowsiness. His crazy war against Prussia in 1870 cost him Alsace and Lausanne, where France paid the price.
Treatment of Prostate gland cancer
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- Hormonal therapy
Testosterone is found to increase the size of prostate cells, so substances that reduce the effect of this hormone in the blood may help in treatment, as it reduces the size so that it is ready for the operation. Therefore, the situation requires follow-up and repeated biopsy of the gland.
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- Surgical intervention
It is usually the best treatment that may lead to uncontrolled urinary incontinence and sometimes erectile dysfunction of the penis. There are two main methods of surgery: it is performed either laparoscopically or surgically, according to the opinion of the treating physician, which is best for the patient.
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- Laser treatment
It is the same method as laparoscopy, but using a laser to cut the gland.
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- Cryotherapy
By inserting the iron probe and using nitrogen at (-126 degrees Celsius), which creates a snowball from the prostate cells, as well as freezing the nerves around the prostate. This leads to an effect of up to 60% when frozen, but it does not affect urination as long as the urination tube remains during cryotherapy. Among its harms are It was found that some cells remain alive around the tube, which help build a new gland and a new tumor later.
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- TUMT Thermal Therapy
It is the use of a thermal catheter to a certain degree to reduce the size of the gland. But its results are not encouraging.
Dr. Nabih Karim
Consultant Urologist