PROSTATE AND PSA

Prostate Gland Anatomy

• The prostate gland is a small, walnut-sized gland located in front of the rectum and below the bladder in men.
• It surrounds the urethra and plays a crucial role in the male reproductive system.
• The prostate gland has three main zones:
  • Peripheral zone (75% of the gland): This is the outermost layer and is where most prostate cancers originate.
  • Transition zone (25% of the gland): This is the middle layer and is where benign prostatic hyperplasia (BPH) occurs.
  • Anterior fibromuscular stroma: This is the innermost layer and consists of smooth muscle and fibrous tissue.

PSA Definition

• Prostate-specific antigen (PSA) is a protein produced by the prostate gland.
• It is secreted into the seminal fluid and is present in small amounts in the blood.
• PSA is used as a biomarker to detect and monitor prostate cancer.

Physiological Role of PSA

• PSA plays a role in the liquefaction of semen after ejaculation, allowing sperm to swim more freely.
• It also helps to neutralize acidic environments in the female reproductive tract.

Significance of PSA as a Biomarker

• Elevated PSA levels can indicate prostate cancer, BPH, or prostatitis.
• A digital rectal examination (DRE) and PSA test are often used together to screen for prostate cancer.
• PSA levels can also be used to monitor the effectiveness of treatment and detect recurrence.

Homoeopathic Therapeutic Medicines

• Indications:
  • Saw Palmetto: For enlarged prostate, urinary frequency, and difficulty urinating.
  • Berberis: For urinary frequency, urgency, and pain.
  • Cantharis: For painful urination and urinary retention.
  • Sarsaparilla: For prostate enlargement and urinary frequency.

Surgical Anatomy of Prostate Gland

• The prostate gland is surrounded by the following structures:
  • Bladder neck
  • Urethra
  • Prostatic sinus
  • seminal vesicles
  • Vas deferens
  • Rectum
• The prostate gland is supplied by the following arteries:
  • Dorsal artery of the penis
  • Inferior vesical artery
  • Middle rectal artery
• The prostate gland is innervated by the following nerves:
  • Pelvic splanchnic nerves
  • Pudendal nerve

Management and Treatment

• The management of prostate cancer depends on the stage and grade of the cancer.
• Treatment options include:
  • Active surveillance: Monitoring the cancer with regular PSA tests and DREs.
  • Surgery: Radical prostatectomy to remove the prostate gland.
  • Radiation therapy: External beam radiation therapy or brachytherapy to kill cancer cells.
  • Hormonal therapy: Medications that block testosterone production to slow cancer growth.
• The treatment of BPH includes:
  • Watchful waiting: Monitoring the symptoms and waiting for them to progress.
  • Medications: Alpha-blockers or 5-alpha-reductase inhibitors to reduce symptoms.
  • Surgery: Transurethral resection of the prostate (TURP) to remove excess tissue.