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Cancer—Prostate (PCa)
Published in Charles Theisler, Adjuvant Medical Care, 2023
The prostate is a small walnut-shaped gland in men located in front of the rec tum and behind the bladder. It surrounds the urethra which passes through it and produces seminal fluid to nourish and transport sperm. Prostate cancer is the most common cancer in men over 50 and is the second only to lung cancer as a cause of cancer death among men in the U.S. Prostate cancer usually grows very slowly so there are often no early prostate cancer symptoms. It can often be treated successfully. When symptoms do develop, they are similar to BPH and can include nocturia, hesitancy (i.e., difficulty commencing and maintaining a urine stream), blood in the urine, painful urination, and difficulty achieving or maintaining an erection.
Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
I would begin with a urine analysis using a urine dipstick to look for positive leukocytes, nitrites and haematuria. Obstruction complicated by infection would need prompt intervention. For bloods, I would request an FBC to look for anaemia, raised WCC and neutrophils suggesting an infection. I would look at urea and electrolytes to examine for raised urea and creatinine, suggesting renal failure or hydronephrosis. A PSA test may also be helpful in this patient who is likely suffering from BPH, but also perhaps a more sinister pathology. For more invasive tests, I would consider a renal ultrasound to support renal compromise secondary to an obstructive cause. A CT KUB is ideal for patients with a history suggestive of a renal stone.
Benign prostatic hyperplasia
Published in Alexander Trevatt, Richard Boulton, Daren Francis, Nishanthan Mahesan, Take Charge! General Surgery and Urology, 2020
Benign prostatic hyperplasia (BPH) is the newer, histologically accurate term for what was formerly known as benign prostatic hypertrophy. The enlargement of the prostate gland is caused by an increase in the number of cells, not their size. It may also be referred to as benign prostatic enlargement (BPE). The symptoms seen in BPH occur when it causes bladder outflow obstruction. BPH is asymptomatic when hyperplasia has not resulted in obstruction.
Integrative exploration of the mutual gene signatures and immune microenvironment between benign prostate hyperplasia and castration-resistant prostate cancer
Published in The Aging Male, 2023
Fei Wu, Hao Ning, Yang Sun, Haihu Wu, Jiaju Lyu
Clinically, BPH is not treated as a premalignant lesion. But BPH and CaP share multiple biological features [9]. The etiology of BPH remains largely elusive [10]. Cellular senescence, metabolic disruption, genetic variation, and chronic inflammation are common risk factors for BPH and CaP [2,11]. In addition, the PI3K-Akt pathway and CDK4 play a critical role in both BPH and CaP [12–14]. Preclinical evidence supports the potential role of chronic inflammation in the malignant transformation of epithelial cells in the prostate [15]. In keeping with that, epidemiological evidence revealed that prostatitis and BPH lead to escalating risks of CaP [16]. Chronic inflammation leads to the accumulation of proinflammatory mediators, infiltration of immune suppressor cells, and activation of immune checkpoint pathways in effector T cells, which facilitate the formation of an immune suppressive microenvironment in the “cold” tumors. However, the difference of the immune microenvironment among BPH, CaP, and CRPC remains poorly understood.
Reduced sleep duration increases the risk of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in middle-aged and elderly males: a national cross-sectional study
Published in The Aging Male, 2022
Yang Xiong, Yangchang Zhang, Fuxun Zhang, Changjing Wu, Feng Qin, Jiuhong Yuan
In CHARLS, male participants were further interviewed that “Have you ever been diagnosed with a prostate illness, such as prostate hyperplasia (excluding prostatic cancer)?” The symptoms of BPH were interpreted to the participants as follows: “The main symptoms of benign prostatic hyperplasia are difficulty in urination. For mild cases, patients get up at night for urinating more frequently than their healthy counterparts. Moreover, mild cases also have increased frequency and urgency of voiding. In severe cases, it is noted that patients have a slow urinary stream, even urine retention, generally accompanied by backache, limb weakness, spermatorrhea, etc.” If positive, the respondents were noted as LUTS/BPH cases. The same approaches were also used in previous studies [1,6,15].
Development and optimization of a tamsulosin nanostructured lipid carrier loaded with saw palmetto oil and pumpkin seed oil for treatment of benign prostatic hyperplasia
Published in Drug Delivery, 2022
Rana B. Bakhaidar, Khaled M. Hosny, Imman M. Mahier, Waleed Y. Rizq, Awaji Y. Safhi, Deena M. Bukhary, Muhammad H. Sultan, Haitham A. Bukhary, Osama A. Madkhali, Fahad Y. Sabei
Currently, the treatment options for BPH are pharmacotherapy and surgical interventions. The pharmacotherapies used are α-blockers such as tamsulosin (TM), alfuzosin, doxazosin, or terazosin; 5α-reductase inhibitors such as finasteride and dutasteride; and antimuscarinic drugs such as tolterodine, solifenacin, oxybutynin, and mirabegron. TM is extensively used either alone or in combination with others of these drugs. TM is the drug of choice for BPH or LUTS and acts via a blockade of the adrenergic receptors leading to the relaxation of prostatic smooth muscles and improvement in the overall symptoms (Skinder et al., 2016). TM offers a 20 to 38 times higher affinity for the α1A receptors than the α1B receptors and is used by more than 80% of clinicians to manage and treat BPH (Narayan & Tunuguntla, 2005). Various clinical trials have established the clinical efficacy of TM when used at doses of 0.4 mg and 0.8 mg (Lepor, 1998; Narayan & Tewari, 1998). Despite the significant clinical outcome of TM, its use is limited by pharmacodynamic and pharmacokinetic limitations. As proven, inflammation is one of the critical pathological contributors in the etiology of BPH, and TM is devoid of any anti-inflammatory effect. Also, the use of TM is associated with a negative impact on sexual life by causing priapism (Khater et al., 2020).