Can prostate adenocarcinoma be cured?

Prostate adenocarcinoma is a common cancer in men. The older a man is, the higher the likelihood of developing cancer. Newly formed adenocarcinoma is treatable. The neglected form ends in death.

Adenocarcinoma is a malignant degeneration of prostate tissue. A common pathology that plagues men of mature age and older. A natural question arises: what is it and how long will a person live?

Difference from adenoma

The structure of adenoma and adenocarcinoma differs from each other. Adenoma is a benign tumor formed in the epithelium of the prostate gland. The adenoma grows without causing harm to the tissues. There is no metastasis, only intensive growth is observed. Over time, it may degenerate into adenocarcinoma.

The latter spreads lesions through the bloodstream or lymph nodes. Cancer metastases grow into healthy tissues and organs, causing irreversible damage.

Note: Prostate adenocarcinoma is the most common disease in men after bronchogenic carcinoma (lung cancer).

Myoepithelial carcinoma

Myoepithelial carcinoma has been identified as a separate morphological form in recent decades.
Previously, it was considered as a pleomorphic adenoma. The clinical course of such pleomorphic adenomas was characterized by recurrence, pronounced infiltrative properties in the form of local spread with destruction of soft tissues and bone structures. According to published data, myoepithelial carcinoma accounts for about 2% of all breast cancers in the age range from 14 to 86 years; average age is 55 years. Reports of the low frequency of this tumor are explained by the relatively recent recognition and isolation of it as an independent pathological process. The predominant localization is the parotid salivary gland (75%). The tumor also develops in the submandibular and small SG.

In our observations, myoepithelial carcinoma was diagnosed in patients aged 17 to 67 years in the parotid gland; the average age of patients was 35.6 years. There is a slight predominance of men. The duration of the pre-treatment period is on average 1.5 years.

The clinical picture of myoepithelial carcinoma is characterized by the presence of a dense, limitedly movable tumor node, most often localized in the posteroinferior edge of the gland. When the patient consults a doctor, the size of the tumor ranges from 1.5 x 2 x 1.5 to 3.5 x 2.7 x 4 cm. The function of the facial nerve is not impaired.

We observed myoepithelial carcinoma arising from the parotid duct. A tumor node with a tuberous surface and pseudocapsule infiltrated the gland and masseter muscle. Recurrence and regional metastasis are very common for this tumor. Relapses of myoepithelial carcinoma after surgical treatment are frequent and take the form of dense, non-displaceable tumor nodes, single or multiple, united in a conglomerate, infiltrating the underlying muscles. The clinical picture may look like infiltrative tumor nodes along the surgical scar, measuring 1.5-1.7 cm. Recurrence occurs within 3 months. up to 1.5 years.

Regional metastases were observed in all our patients in the lymph nodes located at the lower pole of the parotid gland, in the submandibular, jugular (all three groups), and supraclavicular. Microscopic and histochemical studies of metastases confirm the identity of the structure of the metastasis and the primary tumor. Areas of proliferation and rare mitotic figures in the tumor and metastases indicate an intermediate degree of differentiation or low grade of myoepithelial carcinoma. The tumor consists of cells with pronounced signs of myoepithelial differentiation.

The glandular tubes are formed by slightly eosinophilic cells with pronounced cytoplasm, an apically located nucleus with serous-type secretory granules. Between the glandular tubes, cells are randomly located without clear boundaries, with light round nuclei and pronounced nucleoli. The cytoplasm of cells contains myofibrils. Thus, the histological structure has the appearance of solid fields of glandular-cribrotic structure with correctly formed glandular tubes.

Causes

Adenoma carcinoma is a consequence of uncontrolled proliferation of atypical cells. A malfunction in the body occurs due to a genetic mutation. It is not yet possible to determine the cause of the mutation. Factors in the development of the disease have been identified. These include:

• hereditary predisposition;
• hormonal imbalance;
• non-compliance with diet (lack of plant foods);
• physical inactivity;
• age of the man;
• excess cadmium in tissues;
• tobacco and alcohol abuse.

The likelihood of developing the disease increases several times if a man lives in a region with poor ecology. Working at a chemical industry enterprise is a contributing factor.

Reasons for the development of ACSM and risk groups

The disease develops under the influence of other causes not related to the human papillomavirus:

• significant damage to the cervix during childbirth;
• hormonal imbalances;
• nicotine addiction;
• uncontrolled use of COCs (oral contraceptives);
• presence of STIs;
• inflammatory process involving the cervix;
• chronic diseases of the genital organs.

The risk group includes women from the following categories:

• girls over 20 years old;
• persons who have unprotected sex;
• frequent change of partner;
• early onset of sexual activity;
• childbirth complicated by injuries and ruptures of the cervix.

Attention! A vaccine has been developed to prevent the development of precancerous conditions and cervical cancer in women.

Risk groups and causes of the disease are determined based on statistical data. Everyone has a risk of developing cervical cancer – adenocarcinoma. But under the influence of these factors it increases. To reduce the likelihood of a hidden course of the disease, you need to undergo regular examinations with a gynecologist.

Kinds

During the process of mutation, cells change. They degenerate into an oncological structure. The mutating cell becomes depersonalized and loses recognition. The less recognizable it is, the more aggressive it is. The following types of adenocarcinoma are known:

• acinar;
• moderately differentiated;
• poorly differentiated;
• highly differentiated.

Recovery depends on the correct diagnosis. Cancer can be aggressive to a greater or lesser extent, it all depends on the type of adenocarcinoma.

Note: malignant neoplasms in the prostate gland can only appear in humans and dogs. Innovative drugs against prostate cancer are tested on dogs.

Acinar

This form of prostate cancer is the most common. The formed tumor is concentrated in the grape-shaped sacs and acini. Acinar adenocarcinoma develops in men over 60 years of age. If the neoplasm is small in size and contains inclusions of parenchymal structures, it is small acinar adenocarcinoma. Large acinar involves most of the prostate gland.

According to its structure, acinar adenocarcinoma is divided into papillary and cribose forms. In the first case, the tumor has a papillary (papillary) structure. Cribriform adenocarcinoma is characterized by a lattice-like appearance of the neoplasm, in which holes have appeared due to the death of malignant cells.

During analysis, biological material is assessed according to the Gleason scale. Aacinar adenocarcinoma 3 3 points is a moderately aggressive form of malignant neoplasm. An index of more than 7 points indicates a high degree of aggression.

Moderately differentiated

This is a tumor characterized by an average degree of differentiation of prostate cells. The prognosis of the disease and the degree of its aggression largely depend on the level of differentiation. During the process of differentiation, the cell acquires functional differences and becomes specialized. A specialized mutated cell should normally die. Cancer, on the contrary, begins to divide. Diagnosis of moderately differentiated adenocarcinoma shows high damage to prostate cells. The probability of a favorable outcome is average.

Note: it is known that an elevated level of the PSA tumor marker in the blood diagnoses prostate adenocarcinoma. In addition, high PSA levels are detected in prostatitis and prostate adenoma. Secondary infections and the man's age also affect the test results.

Poorly differentiated

This is a cancerous tumor formed by undeveloped cells adapted to rapid growth and reproduction. Poorly differentiated tumors are the most aggressive. It is prone to rapid growth and spread of metastases. The recovery rate is extremely low.

Highly differentiated

This type of tumor is dangerous because it develops quite secretly. Very often it is diagnosed at a late stage of cancer development, which significantly complicates the recovery process. Highly differentiated cells are very similar to healthy ones. They differ only in the elongated shape of the nuclei. A well-differentiated tumor develops slowly, the likelihood of metastases is extremely low. The disease is treatable.

Clear cell adenocarcinoma

Clear cell adenocarcinoma was isolated from the group of adenocarcinomas and described by Spiro et al.
in 1973. The glandular structures are composed of columnar cells, similar to those found in colon carcinoma (intestinal adenocarcinoma). The predominant localization is the small glands of the oral cavity: palate, cheeks, tongue, floor of the mouth, lips. The literature provides an observation of such adenocarcinoma in the oropharynx (tonsil). We describe the observation of a tumor in a 9-year-old child with damage to the parotid salivary gland and involvement of regional lymph nodes in the process. The highest incidence was observed among people 40-70 years old. The duration of the medical history before diagnosis varies widely - from several months to 15 years. The main clinical symptom is a tumor no more than 3 cm. Pain and ulceration of the mucous membrane are observed much less frequently. Clear cell adenocarcinoma is a rare type of adenocarcinoma, sometimes presenting significant difficulties in differential diagnosis with other clear cell tumors (AK and MK) due to their morphological similarity. Sometimes their structure is similar to clear cell breast cancer. Clear cell adenocarcinoma usually develops in the parotid gland as a dense, nondisplaceable single nodule (rarely as multiple nodules).

Clinical observations confirm proliferative properties. Clear cell carcinoma tumor cells are medium-sized, with a round or oval nucleus. The poor, water-colored cytoplasm does not contain mucus or lipids. The cells form solid nests, trabecular or solid-tubular structures with small gaps in the center. Individual nests and trabeculae are surrounded by narrow stripes of fibrous and hyaline stroma. Tumor cells or small, solid nests of them infiltrate the surrounding tissue, which undergoes fibrotic and hyaline degeneration.

The division of adenocarcinomas into types is descriptive. Some types are highly malignant, with high proliferative and destructive activity. Other types are classified as low-grade tumors.

Degrees and stages according to the Gleason scale

The prognosis of the disease is determined by the Gleason score. Developed by histologist Donald Glisson in 1974, the scale still has no analogues. The technique helps to measure the degree of neglect of the pathological process and the level of aggressiveness of the tumor.

For histological examination, pieces of prostate tissue are taken. Then the following parameters are defined:

• presence of metastases;
• tumor maturity;
• intensity of cell growth;
• degree of aggressiveness.

The effectiveness of laboratory research depends on the quality of the material being tested. If the tissue for analysis was collected correctly, the effectiveness of the method will be high. Biomaterial for research is taken from the most modified areas of the prostate gland. The Gleason table characterizes cell transformation.

Gleason score classification

The scale is divided into five parts. Laboratory material is compared with healthy prostate tissue. The result is assessed on a scale from one to five points:

1 – The structure of the cell is not disturbed, a change in the cell nucleus is observed.

2 – The distance between the prostate cells is increased, the stroma is noticeable.

3 – Uneven cell structure, disappearance of stroma.

4 – High concentration of atypical cells.

5 – Accumulation of undifferentiated tissue.

The higher the differences, the more points are given on the scale. If the affected cells differ little from healthy ones, 1 point is given. If the cells are highly mutated, 5 points are given.

Degrees of tumor aggression

Cancer affects the prostate gland in several places. For research, material is taken from different tissue samples. Each of them is assessed separately. Then the indicators are summed up. With a Gleason score of 2 to 6, adenocarcinoma is considered indolent; a Gleason score of 7 indicates an average level of aggressiveness. An indicator of 8 points according to Gleason indicates stage 3 development of oncology. In the latter case, the prognosis is disappointing.

The sum of indicators 3+4 indicates a lesser degree of aggression than the sum of 4+3. Cells with a value of 3 are considered less atypical than cells of level 4. In the sum of 3+4, less atypical, and therefore less malignant, cells predominate.

Thus, a patient diagnosed with grade 3-4 adenocarcinoma has a better chance of recovery than a patient with grade 4-4 adenocarcinoma.

Mucinous adenocarcinoma

Mucinous adenocarcinoma is a distinctive form of tumor consisting of glands lined by papillary and cystic structures.
The cells lining the glandular cavities are cubic, full, or cylindrical, the secretion of which is mucus. In the lumen of the cysts, the cellular remains of destroyed epithelial cells combine with the mucous substance. The most common sites of mucinous adenocarcinoma are the soft palate and sublingual gland, followed by the labial mucosa and submandibular salivary gland. This tumor is very rare in the parotid gland. The clinical picture is represented by a dense, protruding formation with slow growth. The tumor is usually painless, but in some cases patients are bothered by a dull pain.

Symptoms and signs

The insidiousness of the disease lies in the fact that adenocarcinoma at an early stage is practically asymptomatic. A comprehensive examination of the prostate will help to detect oncology in a timely manner.

With malignant growth, the following symptoms and signs of the disease appear:

• pain when urinating;
• local pain in the groin;
• impotence;
• blood clots in the urine;
• swelling of the lower extremities;
• overwork, lack of appetite.

An advanced form of oncology is characterized by fever, dizziness, nausea, diarrhea, and pain during bowel movements. The patient begins to rapidly lose weight.

Diagnostics

Initially, prostate cancer develops asymptomatically. As a rule, the patient goes to a medical facility when pain appears. To accurately determine the diagnosis, the following studies are necessary:

1. Rectal examination.
2. Clinical analysis of blood and urine.
3. Analysis of prostate secretions.
4. TRUS (transrectal examination of the prostate gland).
5. Ultrasound of the abdominal organs.
6. Magnetic resonance imaging.
7. Biopsy.
8. Radioisotope technique.

When making a diagnosis, the doctor takes into account the results of a rapid blood antigen test (PSA), as well as blood and urine test results. The urologist performs external palpation to determine the location of the pain. Only a large tumor can be determined by palpation.

MRI diagnostics helps to detect early prostate adenocarcinoma. The glandular region of the prostate is divided into central, transitional and peripheral parts. The latter occupies about 75% of the entire gland. This is where prostate adenocarcinoma most often develops. The prostate gland is examined locally using magnetic resonance imaging. Additionally, a tissue sample is taken from the peripheral zone of the left lobe and the right lobe of the prostate gland for biopsy.

Treatment

Today, prostate cancer is successfully treated. Many treatment programs have been developed. The treatment method depends on the stage of cancer, the patient’s age and general health. Minimally invasive methods are popular. This is chemotherapy, ablation. If the localization of the pathological growth is suitable, an operation is possible during which the prostate gland is removed.

Surgical treatment

Surgical intervention is necessary if the pathological tissue growth has reached medium size and signs of metastasis are observed. Before surgery to remove the prostate, the doctor calculates the possible consequences. The patient must undergo the following examinations:

• blood test for PSA tumor marker;
• Magnetic resonance imaging;
• general blood and urine analysis;
• consultation with a cardiologist.

The doctor examines the results of the study. It determines how the operation will be performed. During a prostatectomy, the organ is completely removed. Sometimes an additional orchiectomy (removal of the testicles) is performed as an additional measure to prevent relapse of the disease.

Nutrition

During treatment, patients are prescribed dietary nutrition. A balanced diet strengthens the immune system. The body needs strength to heal. Taking into account the patient’s health condition and the stage of oncology, the diet is compiled individually. The menu is formed taking into account the following principles:

• reduced calorie content;
• limiting animal fats;
• limiting foods rich in calcium;
• inclusion in the diet of substances that stop the onset of cancer.

The diet limits the content of red meats (pork, beef, etc.) to 70 grams. per day. Meat is replaced with fish and poultry. The daily diet includes fresh vegetables, fruits and herbs. Low-fat fermented milk products are beneficial, including kefir, fermented baked milk and organic yogurt.

Treatment of colon adenocarcinoma with folk remedies

Traditional therapy for intestinal cancer is used as an auxiliary therapy. Before starting to use traditional therapy, you should consult your doctor.

1. Mix 1 spoon of calamus root, 3 and a half spoons of potato color, 1.5 spoons of calendula flowers and 4 spoons of wormwood root. Pour boiling water over the mixture and leave for 5-6 hours. Strain the resulting infusion and take 100 ml before meals.
2. Enema – widely used for tumor lesions. It is necessary to take purified water and copper sulfate in a ratio of 2 liters of water per 100 ml. vitriol. Treatment should not last more than 14 days.
3. 1 tbsp. Pour a spoonful of celandine into 1 cup of boiling water. Leave for 20-30 minutes. Strain the broth and take 1 tbsp. spoon 2-3 times a day.

Read here: Adenocarcinoma of the cecum

What is prohibited

During treatment, cancer patients are strictly prohibited from drinking alcohol and smoking.

It is not recommended to eat foods high in carbohydrates (bakery products, pastries), as they feed cancer. Completely exclude foods containing carcinogens from the diet. These are smoked products, semi-finished products, canned food and fast food.

Stages of spread of colon adenocarcinoma

Stages of adenocarcinoma:

1. First stage. The intestinal mucosa and submucosa are affected; due to weak symptoms, it is difficult to diagnose.
2. Second stage. Cancer cells penetrate the muscle tissue of the intestine and push inward. Cancer cells do not affect nearby organs and lymph nodes. At this stage, the patient begins to suffer from constipation, mucus and blood appear.
3. Third stage. The cancerous tumor grows through the intestinal wall. The tumor spreads metastases to nearby lymph nodes. At this stage, the patient suffers from severe pain.
4. Fourth stage. The tumor is enormous in size, growing into nearby organs and lymph nodes.

Read here: What is diffuse cerebral astrocytoma?

The time interval between stages of the disease can be 12 months.

Forecast

The prognosis may be favorable if the malignancy is detected at an early stage. The survival rate at different stages of prostate cancer is presented in the following table:

The last, terminal stage of the disease is characterized by an unfavorable prognosis. In this case, treatment is not aimed at eliminating foci of pathological growth, but at improving the patient’s quality of life. The dying person is prescribed medications to relieve suffering.

Why is it dangerous?

Prostate adenocarcinoma does not manifest itself in any way in the early stages. Symptoms appear only when the disease becomes active. Meanwhile, adenocarcinoma is successfully cured in the initial phase of its development. The process is considered irreversible if metastases appear. A metastatic tumor cannot be treated. Everything ends in death.

To avoid a sad fate, a man must pay due attention to his health. Timely diagnosis will help to recognize oncology at an early stage, when it can be successfully treated.

Forecast for future life

With adenocarcinoma, a person can live on average 5 years, but the chances increase or decrease depending on the grade of the cancer, the area affected and the stage of development.

• A well-differentiated neoplasm is cured in 90% of cases, because the cells are non-aggressive and do not spread metastases.
• The moderately differentiated process is 50% amenable to therapeutic and surgical manipulations.
• Life expectancy is significantly reduced by low-grade cancer, with a five-year survival rate of no more than 15%. There is a high risk of relapse.