We’ll see with time if I’ve chosen the best approach – By an anonymous author, 59 years old
- Men of Courage
- We’ll see with time if I’ve chosen the best approach – By an anonymous author, 59 years old
- Anatomy
- Structure
- Function
We’ll see with time if I’ve chosen the best approach – By an anonymous author, 59 years old
Nous sommes en 1996. J’ai 59 ans. Lors de mon rendez-vous médical annuel, on m’annonce les résultats de mon taux d’ASP: 4,3. L’urologue recommandé par mon médecin me suggère alors de subir une échographie transrectale et des biopsies. Les résultats révèlent l’existence d’un cancer de la prostate et d’un grade de Gleason de 3/10, occupant environ 10% de l’échantillon #3.
Le fragment de cancer détecté est de taille insuffisante pour établir le stade de la maladie de façon précise. Avant de subir cet examen diagnostique, mon urologue m’avertit que les risques de cancer de la prostate s’élèvent à 90 %. Je trouve sa mise en garde plutôt étrange et désagréable. Prévenu, je n’ai pas été surpris de la nouvelle lorsque le diagnostic est tombé.
Il est tout à fait naturel d’être angoissé à l’annonce de la présence d’un cancer. La plupart des gens savent peu de choses sur les implications potentielles du cancer de la prostate et réagissent différemment. Lorsque je fais face à l’inconnu, je préfère être bien renseigné pour mieux comprendre la situation. J’ai donc fait des recherches intensives dans des ouvrages et dans des sites Web. J’ai aussi contacté une infirmière spécialisée qui travaille dans un hôpital de Montréal. Garde Grégoire est fondatrice d’un groupe de soutien pour les hommes atteints du cancer de la prostate. En assistant aux rencontres de groupe, j’ai pu discuter avec d’autres hommes dont l’expérience était semblable à la mienne. Grâce à des conférences données par des professionnels de la santé, j’ai acquis une foule de connaissances sur ce type de cancer, ses traitements et les effets secondaires des thérapies. Un grand nombre d’hommes chez qui on vient de diagnostiquer un cancer de la prostate veulent rapidement se faire opérer ou subir une radiothérapie. Mais, par la suite, ils éprouvent des effets secondaires qui affectent leur qualité de vie à divers degrés. Que fallait-il faire dans mon cas?
Je devais prendre une décision très importante et je tenais à consulter un autre spécialiste. L’infirmière m’a alors fixé un rendez-vous avec un autre urologue. Il me recommanda de ne pas réagir immédiatement, mais de continuer à suivre l’évolution de la maladie à l’aide d’analyses sanguines et d’examens rectaux numériques. Savoir que mon cas n’était pas urgent m’a soulagé. Je pouvais attendre avant de me faire opérer ou de subir une radiothérapie. Tous les six mois, j’ai donc continué à passer des tests d’ASP, dont les taux tombaient aussi bas que 0,9 et ne dépassaient jamais la barre des 4,0.
Aujourd’hui, j’ai 66 ans. En raison d’une hausse subite de ma concentration d’ASP, j’ai dû subir une deuxième série de biopsies en janvier 2003. Cette fois, une infection était responsable de l’augmentation de mon taux d’ASP. Ce taux est revenu à la normale en très peu de temps. La deuxième biopsie révélait l’existence d’une néoplasie intra épithéliale prostatique de grade élevé dans l’échantillon #3 et d’un cancer de la prostate avec un grade de Gleason de 3 + 3 = 6, dans 5% de l’échantillon #1. Depuis, mon ASP se maintient à 2,1. Mon urologue me recommande de continuer à subir des analyses de sang et de surveiller mon état.
Bref, je ne pense pas au cancer de la prostate et je ne suis pas inquiet. Ma famille croit que je devrais prendre mon état plus au sérieux et tenter d’éliminer le cancer. C’est ce que je ferai un jour, si on me le conseille. Pour le moment, je me dis qu’on verra bien avec le temps si j’ai choisi la meilleure approche.
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Sources and references
Last medical and editorial review: April 2024. See our web page validation committee and our collaborators by clicking here.
On this page:
Discover our animated video!
Symptoms, risk and screening
Are you over 50 years old, or have you been having urinary problems for some time now? This video is for you! Several diseases can affect your prostate, and it’s important to detect them early. Let’s take a closer look.
Anatomy
What is the prostate
The prostate is a gland:
- Located between the bladder and the penis, just in front of the rectum;
- Formed of 2 lobes which surround the urethra, a canal that runs through the center of the prostate, from the bladder to the penis, letting urine and sperm flow out of the body;
- The size of a walnut, which grows larger in size in your forties;
- That has a soft, spongy texture to the touch like a small, ripe plum.
The prostate is made of:
- Gland cells that secrete liquids for ejaculation;
- Muscle cells that participate in the evacuation of your sperm during ejaculation;
- Fiber cells that maintain the structure of the gland.
Around the prostate, we find:
- The seminal vesicles, glands that produce sperm and that are located on either side of the prostate;
- The vas deferens, the tube that carries sperm from the testicle to the seminal vesicles;
- The nerve bundles that control your bladder and erectile function and that are located on either side of your prostate.
Structure
Three main zones of the prostate
Peripheral zone
- The peripheral zone is the largest area of the prostate. It can easily be felt by the doctor during a digital rectal exam (DRE).
- Most prostate cancers start in the peripheral zone.
Transition zone
- This is the area located in the middle of the prostate, between the peripheral and central areas. It surrounds your urethra that runs through the prostate.
- With age, the transitional area increases in size until it becomes the largest portion of your prostate. This is called benign prostatic hyperplasia (BPH) or enlarged prostate.
Central zone
- It is the part of the prostate that is farthest from the rectum. This is why prostate tumors located in this area can not be felt by the doctor during a digital rectal examination.
- If the doctor is in doubt, the following information will help decide if additional investigation is necessary:
- Your PSA level
- Your age and family history
- Your ethnic origin
Fonction
In short
Your fertility and natural fertilization
- It produces … a prostatic fluid rich in enzymes, proteins and minerals that nourishes and protects your spermatozoa.
- It makes … a protein (APS) that is used to liquefy your sperm to facilitate the mobility of your spermatozoa.
- It allows … ejaculation by contracting.
- It promotes … fertility through its enzymes facilitating the penetration of sperm through the cervix.
- It is not related to the mechanism of erection. Therefore, the origin of erectile dysfunction lies elsewhere.
Additional details
Exocrine Function
The prostate is made up of thousands of tiny fluid-producing glands. Specifically, the prostate is an exocrine gland. Exocrine glands are so-called because they secrete through ducts to the outside of the body (or into a cavity that communicates with the outside). Sweat glands are another example of an exocrine gland.
The fluid that the prostate gland produces forms part of semen, the fluid that carries sperm during orgasm. This fluid, produced in the prostate, is stored with sperm in the seminal vesicles. When the male climaxes, muscular contractions cause the prostate to secrete this fluid into the urethra, where it is expelled from the body through the penis.
Urine Flow
The prostate wraps itself around the urethra as it passes from the bladder to the penis. Prostatic changes can affect urine flow. Increasing the size of the prostate or muscle tone may impede the flow of urine due to the close anatomical relationship between the urethra and the prostate.
Prostate Specific Antigen (PSA)
The prostate also produces a protein called prostate-specific antigen (PSA). PSA is released with the ejaculatory fluid and can also be traced in the bloodstream. The testing of PSA levels in the blood is used to detect prostate cancer. The level of PSA in the blood is usually measured in nanograms of PSA per milliliter of blood (ng/mL).
A raised PSA level
Usually, a PSA rate of less than 4 nanograms per milliliter of blood is normal, but age should also be taken into consideration as PSA levels gradually increase with age. A rise in PSA concentration may indicate the presence of:
- An enlarged prostate (benign prostatic hyperplasia)
- An inflammation or infection of the prostate (prostatitis)
- A prostate cancer
Your doctor will have you undergo other tests to determine the exact cause of the increase in your PSA.
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Also take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease, our expert lectures, our section on available resources, the support that is offered to you, our events and ways to get involved to advance the cause..
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The medical content and editorial team at PROCURE
Our team is composed of urologists, and nurses certified in uro-oncology with a deep knowledge of prostate cancer and other diseases related to the genitourinary system. Meet our staff by clicking here.
Sources and references
- Prostate Cancer – Understand the disease and its treatments; Fred Saad, MD, FRCSC and Michael McCormack, MD, FRCSC, 4th et 5th editions
- Canadian Cancer Society
- Prostate Cancer Foundation-PCF.org
- National Cancer Institute-USA
- American Cancer Society
- Memorial Sloan Kettering Cancer Center
- Prostate Cancer UK
Last medical and editorial review: September 2023
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