Treatment of stage 4 prostate cancer with metastases. Prostate cancer of the fourth stage: the possibilities of modern medicine. How to protect yourself what you need to know

Allergy is one of the most unpleasant ailments that accompanies many people, while an allergic reaction occurs upon direct contact with an allergen (dust, plants, chemicals). The most common is an allergy to animal hair, in particular to cat hair. Contact with animals is an integral part of every person's life, but what if an allergic reaction is haunting.

In order for the allergic reaction of the body to manifest itself, pathogens are needed. Most often, an allergic person reacts to the animal's fur. Therefore, many people who have a high risk of allergies choose smooth-haired cats or sphinxes.

Reference! Cases of allergic manifestations after contact with cats are recorded several times more often than after contact with dogs.

However, the absence of hair in an animal is not a guarantee that the body will not react. This is explained by several factors:

1. Cat urine or saliva contains proteins. Each allergic person has a correspondingly reduced immune function, the body reacts very sensitively to an irritant. The body strengthens the protective reaction to the appearance of the allergen, in case of weakened immunity, there are pronounced signs of allergy (there is an adverse reaction to the active confrontation of the body with the irritant).
2. If the animal has access to the street, then after a walk on the wool, more aggressive allergens (dust particles, mold, plant residues, fluff) are brought.

Therefore, allergy sufferers can suffer not only from cat hair, but also from the pollution that accumulates on it.

Symptoms

It is not so difficult to determine the first symptoms indicating an allergy. It is worth paying attention that for each person an allergic reaction manifests itself in different ways - only one symptom may be present, or signs may appear in a complex.

The main signs of an allergic condition:

• nasal congestion may initially occur, then a runny nose may appear;
• frequent sneezing (no dry or wet cough);
• eyes suffer from tearing, there is constant irritation of the mucous membrane;
• asthmatic symptoms (shortness of breath, hoarseness) may occur;
• skin manifestations (redness) where there was direct contact with the animal are not excluded.

Frequent sneezing is one of the most common signs of a cat allergy.

Symptoms may occur immediately after contact or appear after a few hours. According to medical statistics, almost 30% of people with asthma experience a pronounced exacerbation of asthmatic symptoms after contact with a cat.

Note! Children are recommended to communicate with cats, because when in contact with the allergen, the child's body develops a protective reaction and the allergy does not appear in adulthood. But, it is worth considering the fact that if a child has a predisposition to allergies, then it is necessary to protect him from animals.

How does an allergy develop?

In allergology, four main reactions of the human body to an allergen are noted:

1. Immediate type of reaction.
2. cytotoxic reaction.
3. Damage to the tissue structures of the body due to the influence of the immune complex.
4. Slow reaction of the body to the allergen.

Cat allergens provoke an extremely immediate type of reaction, since symptoms begin to appear twenty minutes after contact with the pet. The reaction of the body is provoked as follows - the allergenic molecule penetrates the respiratory tract, attaches to the cells, which guarantees immune protection, the latter begin to produce inflammatory mediators, which cause reactions in the body's tissue structures.

Attention! At the first contact with a cat, an allergic reaction does not always occur in an allergic person.

Gradual development of allergies

1. Stage I. Antibodies are produced in the body, which are responsible for blocking the antigen, in this case, cat allergens. The body gets acquainted with antigens for further impact on it.
2. Stage II. There is a direct interaction of the allergen and the produced antibodies. An immunological reaction develops. At this stage, inflammatory mediators are produced, which provoke a reaction on the skin and mucous membranes.
3. Stage III. The stage of the consequences of the action of inflammatory mediators (impaired hematopoietic function, the occurrence of bronchospasm).

Note! If after the appearance of a pet in the house there are indirect signs of a cold that lasts more than one week, you need to go for a consultation with an allergist.

How to identify an allergic reaction to a cat?

At the initial manifestation of symptoms, you should not blame the animal. To begin with, you should go for a consultation with an allergist and, if necessary, do allergy tests, so you can accurately determine the allergen. When an allergic reaction in a person occurs when a pet appears in the house, then for a start, the doctor may recommend temporarily resettling the cat to relatives in order to trace the pattern of the body's reaction. If the condition of the allergic person immediately improves in the absence of the animal, then the next stage is the delivery of tests (blood tests and skin tests). Upon confirmation of the allergy and identification of the exact allergen, the specialist will select the necessary therapy.

Treatment Methods

The therapy is based on the standard method of treating allergy sufferers. The main problem is that it will not be possible to get rid of the disease forever (only blocking seasonal exacerbations). First of all, the allergic person will have to say goodbye to the animal, since they will not be able to get along in the same area without harm. Then the patient needs to normalize the moral state, since any stressful shocks only aggravate the course of the allergy.

Approximate drug treatment regimen

Drug group	Sample drug	Image
Antihistamines	Benadryl, Claritin (help block the manifestations of allergic symptoms, improve the patient's condition, among the main side effects is drowsiness)
Decongestants	Sudafed, Allegra-D (very often, after contact with a cat, swelling of the nasopharynx occurs, in order to eliminate it, you should take special means that quickly relieve swelling)
	Since the protective functions of the immune system are significantly reduced in allergy sufferers, the allergist can choose an immuno-strengthening course of therapy.
Sorbents	Polysorb (an agent that helps to remove allergens from the body, and therefore eliminates the cause of the disease)

In especially severe cases of allergies, the doctor may insist on a course of antiallergic injections.

Non-traditional ways to eliminate allergies to a cat

As an adjunct therapy, treatment with herbal remedies, as well as bee products and various products can be used.

Advice! A decoction of motherwort, to minimize exposure to allergens, you can bathe your pet. During the period of exacerbation of allergies, bathing is carried out regularly - once a day.

Video - How to treat allergies with folk remedies

How to contact with a cat in order to avoid allergies?

If it is not possible to refuse the animal, then certain rules of communication should be followed:

• minimize contact with the animal, do not stroke it;
• exclude the possibility of cat access to the place of sleep of an allergic person (do not let into the room);
• carry out daily cleaning of the premises (housing), preferably wet;
• change the long-haired floor covering to a smoother one (so that the pile from the carpet does not collect allergens);
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Any allergy is an unpleasant phenomenon that largely limits a person’s life. Each of us once wanted to taste exotic dishes, enjoy the smell of fresh flowers or get a pet, but allergies do not allow everyone to do this ...

Causes

An allergy to cats becomes a huge problem for a person, because even being in a room where an animal lived can turn into an unpleasant reaction of the body for him. And even buying a short-haired cat does not solve the problem. The reason lies in the fact that there is no allergy to cat hair as such. The reaction is caused by a special cat protein that enters the air with dead skin cells and saliva particles of these animals. However, wool, of course, also plays a role, because it absorbs these substances and carries allergens on itself.

In this case, the animal does not even have to be around all the time. Particles of his skin, the smallest drops of his saliva and urine, settling on surfaces and soaking into the fabric parts of the interior, can make staying indoors unbearable for an allergy sufferer.

Cat Allergy Symptoms

Each allergy sufferer reacts differently to contact with cats, but there is a list of common symptoms that indicate that this is the type of allergy we are talking about. Mild or pronounced, the symptoms can make themselves felt both immediately after contact with the animal, and after a few hours. Allergies are indicated by the following symptoms:

• Rash;
• tearing;
• Frequent sneezing;
• Shortness of breath, wheezing, cough;
• Swelling of the nasopharynx or runny nose.

Many parents wonder what is different from the manifestations of this disease in adults. In fact, you should not expect that the child will have any specific symptoms, because he will have the same reaction to allergens as an adult. However, the immune system in babies is weaker: bronchial asthma or allergic rhinitis may develop. Therefore, it is better for such children to avoid contact with cats.

Neighborhood with a cat. Ways to relieve symptoms

Those who decide to be close to the source of the allergy should follow the following rules:

Define territory. When it comes to allergies, you have to become a really strict host. It is necessary to forbid the cat not only to climb into your bed, but also to go into the bedroom.
Get rid of dust collectors. Pillows, soft toys, carpets and woven interior items should be kept to a minimum, because allergens can settle and accumulate on them.
Limit contacts. All games with a cat should exclude tactile contact. It is very important to minimize all your contact with the animal, and if necessary, wash your hands thoroughly.
Do daily cleaning in your room. Wash floors frequently and ventilate rooms.

Treatment

Many people wonder how to cure a cat allergy, but it is impossible to get rid of allergies once and for all, it is only about getting rid of the symptoms. Despite this, drug treatment can significantly improve the quality of life of an allergic person. Of course, the treatment should be comprehensive, and the doctor should select the drugs for you. Each of the drugs performs its function:

Antihistamines stop the development of allergic inflammation and relieve it by blocking the action of histamine.
Decongestant drops relieve redness and inflammation of the eyes.
An ointment or cream for skin irritation will help get rid of the rash and ensure safe healing.
remove allergens from the body, eliminating the very cause of the allergy.

POLYSORB

Polysorb is one of the most effective modern absorbents. It comes in the form of a powder that must be dissolved in water. The effect is noticeable within four minutes after its application. The sorption capacity of the drug is 300 mg / g (Doctor of Medical Sciences, Prof. Lutsyuk N.B., Candidate of Medical Sciences, Associate Professor Kevorkov N.N. Materials of the scientific and practical conference. Perm, 1994.)

Polysorb is not absorbed into the blood and acts exclusively in the intestines. The drug does not harm the mucosa of the gastrointestinal tract. These qualities make the drug absolutely safe, practically depriving it of contraindications and allowing it to be sold without a prescription. It can be used by pregnant and lactating women, as well as children from birth.

Let us explain the principle of action of Polysorb. Everyone knows that from the venous and lymphatic vessels surrounding the intestines, harmful substances from all over the body constantly come to the surface of the mucous membrane of this organ. A gradual increase in their concentration in human blood causes the development of various diseases. It is this problem that this drug solves. The smallest particles line up around allergens, toxins and viruses, after which, glued together with an absorbent, harmful substances are removed from the body. The improved mechanism of action allows it to collect particles of different sizes, making it head and shoulders above porous absorbents.

For effective and its prevention, a two-week course of the drug every three months is sufficient. Polysorb must be taken three times a day, dissolving the amount of powder calculated by weight in a quarter to a half glass of water. But with manifestations of acute allergies, the dose increases to two tablespoons of the drug in half a glass of water for an adult. In this case, the course of treatment lasts from five days. The use of Polysorb will bring several pleasant side effects: due to the release of the intestines from toxins, the skin and well-being noticeably improve. In addition, this device is useful to have in the first aid kit in case of illness or ailments that require a deep and safe bowel cleansing.

Life without allergies

It should be said right away that it is impossible to get rid of allergies for good. Unfortunately, science has not yet reached a level sufficient to defeat allergies forever. However, the combined effects of several drugs at once, which include Polysorb, can help you live without looking back at this problem. A prophylactic course every three months will make you forget about allergies and its manifestations. And compliance with the above rules of cohabitation will make a comfortable life possible with a fluffy pet, and no illness will interfere with your happiness!

Application of Polysorb

Indications

Why Polysorb MP?

Safety

Polysorb MP does not contain any additives and flavors, so the drug does not have a toxic effect and does not cause allergies. The drug is not absorbed into the blood, and does not pass through the liver and kidneys, so it has practically no contraindications. Enterosorbent Polysorb MP has a high safety, it is prescribed for children from birth and pregnant women.

Efficiency

The sorption surface of Polysorb MP for internal use is 300 m2/g, which is significantly higher than that of most enterosorbents available on the Russian and foreign markets. The drug is able to bind any harmful substances.

immediacy

During treatment, the first minutes of the disease play a special role, when it is necessary to promptly provide assistance to the victim, remove intoxication, and improve overall well-being. Here Polysorb MP again comes to the rescue, which, thanks to its unique spatial structure, begins to act immediately after entering the intestines and is able to radically change the situation in a matter of moments.

Operating principle

Harmful substances such as allergens, toxins and all kinds of pathogenic bacteria provoke the development of diseases and a general deterioration in well-being;

Polysorb, getting into the intestine, surrounds harmful bacteria and removes them from the body;

Polysorb sorbs toxins and allergens of different sizes, which allows you to equally effectively cope with various poisonings and allergies;

Instruction

Dosage and administration

Indications for use

pharmachologic effect

Side effects and contraindications

Polisorb - dosage and method of application

Firstly, Polysorb is always taken in the form of an aqueous suspension, that is, the powder is mixed with 1/4 - 1/2 cup of water, and never taken dry inside.

Secondly, the amount of powder to be taken depends on body weight, that is, you need to know the approximate weight of an adult or child who will drink it. There can be no overdose, which removes concerns when determining the dose.

Patient weight	Dosage	Water volume
up to 10 kg	0.5-1.5 teaspoons per day	30-50 ml
11-20 kg	1 teaspoon "without a slide" for 1 reception	30-50 ml
21-30 kg	1 teaspoon "with a slide" for 1 reception	50-70 ml
31-40 kg	2 teaspoons "with a slide" for 1 reception	70-100 ml
41-60 kg	1 tablespoon "with a slide" for 1 reception	100 ml
over 60 kg	1-2 tablespoons "with a slide" for 1 reception	100-150 ml

Patient weight

The specific dosage of Polysorb is calculated depending on the indication for use (see below), the patient's weight and symptoms. In case of difficulty with the calculation, you can get a free consultation by phone: 8-800-100-19-89 , or in the section .

1 teaspoon of Polysorb "with a slide" contains 1 gram of the drug.
1 gram is the most recommended single dose for children.
1 tablespoon of Polysorb "with a slide" contains 2.5-3 grams of the drug.
3 grams is the average single adult dosage.

How to use Polysorb for the main indications

Disease	Mode of application	Reception features	Number of receptions	Duration
		During meals or immediately after	3 times a day	10-14 days
	Mix powder according to body weight in ¼-1/2 cup of water		3 times a day	10-14 days
	Washing stomach with a 0.5-1% solution of Polysorb ((2-4 tablespoons per 1 liter of water)	Next - ingestion of Polysorb suspension depending on body weight	3 times a day	3-5 days
	Mix powder depending on body weight in ¼-1/2 glass of water: 1 day - take every hour. 2 days - four times a day according to the dose.		3-4 times a day	5-7 days
	From the first days of illness Mix powder according to body weight in ¼-1/2 cup of water		3-4 times a day	7-10 days
	Mix powder according to body weight in ¼-1/2 cup of water		3 times a day	7-14 days
	Mix powder according to body weight in ¼-1/2 cup of water	Admission as part of complex treatment	3-4 times a day	25-30 days
	Mix powder according to body weight in ¼-1/2 cup of water	One hour before meals or one hour after meals	3 times a day	10-14 days
	1 day - take 5 times a day in an hour. 2 days - take 4 times a day in an hour.	Drink more liquid	1 day - 5 times. 2 days - 4 times.	2 days
	Take 1 dose: before a feast, at bedtime after a feast, in the morning.		1 per day	3 days

Disease

food allergy

Mode of application:
Reception features: During meals or immediately after
Number of receptions: 3 times a day
Duration: 10-14 days

Chronic allergies, urticaria, hay fever, atopy

Mode of application: Mix powder according to body weight in ¼-1/2 cup of water
Reception features: One hour before meals or one hour after meals
Number of receptions: 3 times a day
Duration: 10-14 days

Poisoning

Mode of application: Gastric lavage with 0.5-1% Polysorb solution (2-4 tablespoons per 1 liter of water)
Reception features: Next - ingestion of a suspension of Polysorb MP, depending on body weight
Number of receptions: 3 times a day
Duration: 3-5 days

Intestinal infections

Mode of application: Mix powder depending on body weight in ¼-1/2 glass of water: 1 day - take every hour. 2 days - four times a day according to the dose.
Reception features: Admission as part of complex treatment
Number of receptions: 3-4 times a day
Duration: 5-7 days

Viral hepatitis

Mode of application: from the first days of illness. Mix powder according to body weight in ¼-1/2 cup of water
Reception features: Admission as part of complex treatment
Number of receptions: 3-4 times a day
Duration: 7-10 days

Cleansing the body

Mode of application: Mix powder according to body weight in ¼-1/2 cup of water
Reception features: One hour before meals or one hour after meals
Number of receptions: 3 times a day
Duration: 7-14 days

Chronic renal failure

Mode of application: Mix powder according to body weight in ¼-1/2 cup of water
Reception features: Admission as part of complex treatment
Number of receptions: 3-4 times a day
Duration: 25-30 days

Toxicosis of pregnant women

Mode of application: Mix powder according to body weight in ¼-1/2 cup of water
Reception features: One hour before meals or one hour after meals
Number of receptions: 3 times a day
Duration: 10-14 days

Hangover

Mode of application: 1 day - take 5 times a day in an hour. 2 days - take 4 times a day in an hour.
Reception features: Drink more liquid
Number of receptions: 1 day - 5 times. 2 days - 4 times.
Duration: 2 days

Polysorb is a modern sorbent with a wide spectrum of action that binds harmful substances and removes them from the body. Polysorb is used for diseases such as,. Polysorb is also used for toxins and harmful substances. Approved for use from birth.

If you have any difficulty in calculating the individual dose of Polysorb, you can getfree consultation by phone:8-800-100-19-89 , or in the sectionconsultations .

You can buy Polysorb at any pharmacy in your city. For your convenience, you can use the serviceapteka.ru , which will deliver the drug to a pharmacy convenient for the location.

A powerful new generation sorbent based on natural silicon, effective for the treatment of diarrhea, poisoning, allergies, toxicosis, hangover syndrome and for cleansing the body.

Indications for use:

Acute and chronic intoxications of various origins in adults and children;

Acute intestinal infections of any origin, including food poisoning, as well as diarrheal syndrome of non-infectious origin, dysbacteriosis (as part of complex therapy);

Purulent-septic diseases, accompanied by severe intoxication;

Acute poisoning with potent and toxic substances, including drugs and alcohol, alkaloids, salts of heavy metals, etc.;

Food and drug allergies;

Viral hepatitis and other jaundices (hyperbilirubinemia);

Chronic renal failure (hyperasotemia);

Residents of environmentally unfavorable regions and workers in hazardous industries, for the purpose of prevention.

What are the main advantages of Polysorb?

The highest sorption surface among sorbents is 300 m2/g.

High safety profile - 18 years of experience in the use of Polysorb in Russia.

Instantaneous speed of action immediately after entering the gastrointestinal tract, relief occurs 2-4 minutes after ingestion.

Storage conditions: At a temperature not higher than 25°C. After opening the package, store in a tightly closed container. The shelf life of the aqueous suspension is not more than 48 hours. Keep out of the reach of children.

Terms of dispensing from pharmacies: Without a prescription.

Telephone free hotline for consultations:8-800-100-19-89

Inorganic non-selective polyfunctional enterosorbent based on highly dispersed silica with particle sizes up to 0.09 mm and with the chemical formula SiO2.

It has pronounced sorption and detoxification properties. In the lumen of the gastrointestinal tract, the drugbinds and removes from the body endogenous and exogenous toxic substances of various nature, including pathogenic bacteria and bacterial toxins, antigens, food allergens, drugs and poisons, salts of heavy metals, radionuclides, alcohol.

It also sorbs some metabolic products of the body, incl. excess bilirubin, urea, cholesterol and lipid complexes, as well as metabolites responsible for the development of endogenous toxicosis.

It has pronounced sorption and detoxification properties. In the lumen of the gastrointestinal tract, the drug binds and removes harmful toxic substances from the body, including pathogenic bacteria and bacterial toxins, antigens, food allergens, drugs and poisons, heavy metal salts, radionuclides, alcohol. Polysorb like a magnet also attracts some metabolic products of the body, including excess bilirubin, urea, cholesterol and lipid complexes, as well as metabolic products responsible for the development of endogenous toxicosis. The drug is not split, not absorbed, is excreted unchanged.

In comparison with the old generation sorbent activated carbon, the powder is a new generation enterosorbent with a high speed of operation - the action is already 2-4 minutes after ingestion (no time is required to dissolve the tablets). 1 tablespoon of Polysorb powder replaces 120 activated charcoal tablets by the volume of its sorption surface, envelops the gastrointestinal tract as thoroughly as possible and collects all harmful substances, respectively, the quality of its work is much higher. In addition, drinking a small amount of powder with water is much more pleasant than swallowing dozens of tablets several times a day, which is why patients prefer Polysorb's aqueous suspension. For two decades, Polysorb "settled" in every third family. Doctors know the drug well, thanks to its long experience of use in Russia and the CIS countries and the maximum qualities by which the enterosorbent is evaluated.

Rarely- allergic reactions, dyspepsia, constipation. With prolonged, more than 14 days, taking Polysorb, malabsorption of vitamins, calcium is possible, and therefore it is recommended to take prophylactic multivitamin preparations, calcium.

Interaction with other drugs. It is possible to reduce the therapeutic effect of concomitantly taken orally drugs.

Contraindications: 3 gram sachet Banks of 12, 25, 35, 50 grams

sachet3 grams- single dose in a convenient pocket pack.
Jar:
12 grams- the volume of the full course of treatment for the child.
25 grams- a necessary tool in the home first aid kit for any occasion for the whole family.
35 grams- a three-day course for the treatment of diarrhea in an adult.
50 grams– a full-fledged course of treatment for an adult in an economical package.

Text: Irina Sergeeva

The so-called allergy to cats is extremely common. Well, if you knew about this misfortune in advance, and never asked for a fluffy kitten for your birthday. But what about those who have already settled a meowing creature in their house, and suddenly found obvious signs of allergies in themselves? How to get along side by side with your beloved pet, if it literally hurts even to look at it?

Allergy to cats: where is the "dog buried"?

Strictly speaking, there is no allergy to cats. More precisely, their coat, which is usually blamed for all the most unpleasant allergic symptoms, has absolutely nothing to do with it. An allergic reaction in a person is caused not by the animal's fur itself, but by its saliva and, sorry, urine. And also - the smallest particles of the skin. And in saliva, and in urine, and in the skin there is a special kind of protein - that's what is the allergenic culprit of all troubles.

So the belief that hairless cats, or cats with super short dense hair are not dangerous for an allergic person, is fundamentally wrong. There are no hypoallergenic cats - they all "wash" and go "to the toilet" as one, which means that they are all capable of causing painful symptoms in humans.

The most common symptoms include:

• coughing and wheezing, difficulty breathing;
• Skin rash such as urticaria;
• Redness and irritation of the eyes (so-called allergic conjunctivitis), watery eyes;
• Redness of the skin and itching (it can be especially pronounced with direct contact with the animal);
• Runny nose, and often nasal congestion without signs of a runny nose;
• Sneeze.

How would you like to be treated?

It is difficult to predict the manifestation of symptoms in advance: they can appear both immediately after contact with the pet, and after a few hours. Moreover, a person can not see the animal itself in the eyes! But even his mere presence in the room where the animal lives can provoke the occurrence of allergic reactions. Asthmatics are especially sensitive to cats - most of them only need to spend a few seconds in a cat's company to feel a sharp exacerbation of the disease.

Most often, the treatment of allergic reactions to cats comes down to a standard set of measures (as with any other allergy itself) - namely, taking antihistamines that block the action of allergens, and eliminating edema (if any).

My friend is my enemy

Naturally, few people would think of having a meowing friend in their own home if they have an obvious allergy to cats. But what if you have already been imbued with all your soul to a murka or a snow leopard, and only in the process of living together that very notorious allergic reaction was discovered? Is it possible in some way, as they say, not to leave the cat, and not to suffer yourself? An allergist will help you find a healthy compromise in this situation. It is he who is able to determine how high the chances of getting along with this particular allergy sufferer with this particular cat are. I must say that in almost half of the cases, allergy sufferers and cats at the very least get along. True, the first must strictly monitor the implementation of the following rules:

• Try to avoid direct contact with the animal whenever possible. Washing, preening and stroking your pet, alas, will not be for you personally, but for someone from the household.


• Make sure your pet never enters the bedroom.


• If you do not live in an apartment, but in your own house, equip your pet with a “home” as far as possible from those rooms that you use most often.


• Keep your house clean. Despite the fact that the animal's hair itself is non-allergenic, it is she who is the main "carrier" of saliva, urine, and skin particles. Therefore, carefully clean all places in the house where your pet may have left his hair.


• Try to get rid of fluffy long pile carpets, thick curtains and other "dust collectors". Firstly, they perfectly collect cat hair, and secondly, they also collect dust, which in itself can cause unpleasant allergic symptoms.


• Finally, the most important thing: about once a month, visit an allergist and monitor your well-being.

By the way, it is likely that your stubbornness and unwillingness to part with your beloved pet will turn out for you ... the most effective way to get rid of cat allergies. Science knows many cases when an allergy was cured precisely by the "wedge - wedge" method: the body gradually, over the years, got used to the constant presence of the allergen and eventually simply stopped responding to it.

Prostate cancer can have varying degrees of spread. There are 4 stages of its development. Stage 1 is the least dangerous, and grade 4 prostate cancer is characterized by the fact that cancer cells spread to nearby and distant organs. In this case, the life expectancy of the patient is significantly reduced.

Extent of each stage

In stage 1 prostate cancer, the size of the tumor is small. It is impossible to detect it by standard diagnostic methods. If the disease is detected at this stage, then with proper and timely treatment in 100% of cases, the minimum life expectancy of patients is 5 years. However, only with regular examinations and the implementation of all the recommendations of doctors.

At stage 2 of development, a cancerous tumor is localized within the gland. The main way to detect it is transrectal ultrasound. If a course of therapy is adopted at this stage, then the duration of the patient will be at least 5 years.

When the tumor spreads beyond the prostate, it is stage 3 cancer. The tissues surrounding the prostate are the first to be affected. In a little more than half of the cases, the patient lives for at least 5 years, if he undergoes the prescribed course of therapy.

At stage 4 of the development of the disease, metastases affect various organs. Most often it is the liver, bones, lungs. The life expectancy of a patient in whom the disease is diagnosed at this stage of development is on average 1-3 years. Patients rarely live more than 3 years.

Causes of prostate cancer

Doctors have no consensus on what can cause prostate cancer. Molecular studies in this area have allowed physicians to identify the gene responsible for the transmission of this disease along the hereditary line. Another reason for the appearance may be a decrease in the activity of those DNA regions that inhibit the development of this disease.

There are factors that in themselves cannot cause the development of the disease, but increase the likelihood of its occurrence:

• age;
• negroid race;
• unfavorable heredity;
• unhealthy lifestyle, bad habits and unhealthy diet.

Prostate cancer treatment stage 4

This disease can be treated in various ways. Completely possible in case of early diagnosis. The prognosis for stage 4 prostate cancer is less optimistic, but it can be eliminated. But in any case, the progression of the disease can be delayed if the most appropriate therapy is applied. At the same time, the life expectancy of the patient will increase, and the pain caused by this disease will decrease or completely disappear.

It is difficult to determine exactly which of the methods of treatment is most effective. One or another type of therapy is chosen by the doctor, taking into account many different factors. Among them are age, the presence of chronic diseases, the risk of side effects that are dangerous to health and life.

Each of the methods has a number of features. Surgical treatment is considered to be the main one. It has been known to medicine for a century, but it has become popular only with modern advances in medical science, which make it possible to minimize complications after treatment.

Radioactive radiation has the ability to destroy malignant tissues, which allows the use of radiation therapy to treat cancer. Most often, this method is used in cases where it is impossible to perform an operation for some reason or in the last stages of the development of the disease, when there are metastases in other organs.

Brachytherapy is a type of radiation exposure in which the emitter is implanted directly into the cancerous tumor. It is irradiated from the inside, this allows you to minimize the side effects of the treatment and achieve its maximum effectiveness.

Cryotherapy is the effect on cancer cells of low temperatures. As a result, they are destroyed. The effectiveness of cryotherapy is not lower than the effectiveness of radiation therapy.

Hormone therapy is prescribed for those patients who are contraindicated in other methods of treatment or whose disease is at a stage when other methods of treatment no longer help to stop the growth of the tumor. Therapy is aimed at suppressing the production of testosterone or protecting the prostate from its effects. It is impossible to achieve complete recovery by using this method, however, hormonal therapy is very effective as part of a comprehensive treatment.

Chemotherapy is prescribed to reduce pain and fight metastases, as well as in cases where the growth of the tumor does not stop under the influence of hormonal therapy.

Thus, stage 4 prostate cancer is a direct threat to life. It is necessary to consult a doctor who will help to accurately determine the optimal methods of treating the disease. The average life expectancy of patients with this diagnosis is 3 years. However, the psychological and emotional mood of the patient decides a lot. In any case, you should not try to diagnose the disease and predict life expectancy on your own. Only practicing oncologists can do this. If a man has any complaints, be sure to consult a doctor, this will allow you to diagnose the disease in the early stages and completely.

Prostate cancer (PC) is one of the most common oncopathologies detected in men over the age of 50 years. This diagnosis is in second place among oncological causes of death in men. About 25% of newly diagnosed prostate cancer is the fourth stage of the disease.

Despite the fact that this is the last and incurable stage, modern medicine has ways to stabilize the process, transfer it to a chronic course, subject to control. Prostate cancer of the 4th stage can and should be treated, life expectancy is significantly increased by several years.

Criteria for Stage 4 PCa

• Local distribution index T4, that is, tumor invasion beyond the borders of the gland capsule and its germination into the surrounding structures: bladder, seminal vesicles, rectum, anal sphincter, pelvic diaphragm (T4N0M0).
• Any form of T, but with screening to nearby lymph nodes (T1-4N1M0).
• Existing malignant screenings in other organs, regardless of the local spread of the tumor (T1-4N0-1M1).

In establishing the 4th stage, only the criteria described above are taken into account. PSA level and Gleason grade are not important here. Another name for this stage is generalized prostate cancer.

Reasons for late detection

• Asymptomatic course of the disease in the early stages.
• Insufficient screening studies and the lack of clear recommendations for the early detection of prostate cancer.
• The reluctance of many older men to be regularly observed and undergo scheduled examinations as part of the "wait and see" approach.

Clinical picture of metastatic prostate cancer

Symptoms of stage 4 prostate cancer can be divided into several groups:

Symptoms of infravesical obstruction

Narrowing of the urethra exiting the bladder due to compression by a growing tumor:

• Difficulty in urination.
• Feeling of dissatisfaction after going to the toilet, the impossibility of completely emptying the bladder.
• Sluggish stream of urine.
• Ischuria - constant leakage of urine with an overflowing bladder.
• Acute or chronic urinary retention, the appearance of renal failure against this background.

Symptoms associated with tumor invasion into surrounding organs

• Hematuria is the appearance of blood in the urine when it spreads to the walls of the urethra and bladder.
• Blood in the semen - with invasion of the seminal vesicles and ejaculatory ducts.
• Pain in the perineum. In case of involvement of nearby nerve trunks, it can radiate to the penis, scrotum, inner thigh.
• The appearance of blood in the feces, tenesmus in case of tumor damage to the walls of the rectum, the development of intestinal obstruction is possible.
• Edema of the lower extremities with damage to the pelvic lymph nodes and blockage of lymph flow. At the same time, edemas are characterized by density, asymmetry, lack of response to taking diuretics.
• With obstruction by tumor growth of the ureters, pain in the lower back appears, the development of renal failure begins.

Paraneoplastic symptoms

Due to the toxic effect of tumor metabolites on the entire body.

• Anemia is a decrease in the concentration of hemoglobin and red blood cells in the blood.
• Drop in body weight.
• Appetite disturbance.
• General weakness, asthenia.
• Polyarthritis.
• Polyneuropathy - a violation of sensitivity, a decrease in strength in the limbs.

Metastases in prostate cancer: a clinical picture in the pathology of distant organocomplexes

• Bone metastases in prostate cancer are most often localized in the lumbar spine and pelvic bones. Pain increases in dynamics, increases at night, does not correlate with the intensity of the load, is poorly relieved by available analgesics and NSAIDs.
• Spontaneous fractures of the vertebrae, against this background, there may be compression of the spinal cord: impaired movement, urinary and fecal incontinence.
• Cough, hemoptysis, shortness of breath, chest pain with lung metastases.
• Symptoms of brain damage are migraine-like pains, nausea, convulsions, paralysis and paresis of the limbs.
• Jaundice, ascites, bleeding, pruritus - in the presence of liver metastases.

Stage 4 cancer may first manifest itself with local symptoms, followed by the development of a clinic characteristic of damage to other organs, but quite often there are situations when the symptoms, due to distant metastases in prostate cancer, become the first signs of the disease. That is, prostate cancer may first manifest itself as a vertebral fracture, metastatic pneumonia or jaundice.

Diagnostics

Inspection and instrumental methods

• Digital rectal examination (DRE). The prostate gland in most cases can already be palpated through the wall of the rectum. The prostate in cancer, especially at stage 4, is enlarged, dense, immobile, its surface is uneven, bumpy, the tumor can strongly protrude into the lumen of the rectum. Sometimes the edges of the gland cannot be palpated, it is defined as a dense diffuse infiltrate. The intestinal wall is soldered to the tumor, its ulceration and bleeding are possible.
• TRUS. Transrectal ultrasound. During this examination, the tumor itself is revealed - a nodular formation, with uneven contours, of a heterogeneous structure. Ultrasound can show the germination of the capsule of the gland, the expansion of the tumor to neighboring organs, and the defeat of regional lymph nodes.
• Biopsy of the prostate. Necessary for an accurate diagnosis and the degree of malignancy of the tumor. It is carried out under the control of a transrectal ultrasound sensor: biopsy needles are inserted through the perineum. Columns of tissue (from 8–12 points) are collected into the needle and sent for histological examination.
• The morphological type is determined (in 90% - adenocarcinoma of the prostate) and the level of differentiation according to Gleason. The higher the score on this scale, the more malignant the tumor and the worse the prognosis.
• CT or MRI of the pelvis. These examinations are necessary to accurately determine the stage of the disease. These imaging methods allow you to assess the size, spread of the tumor, damage to nearby organs and lymph nodes. MRI in these cases is more informative than CT.
• Osteostigraphy. The study is based on the ability of metastatic foci in the bone tissue to intensively accumulate a radioactive isotope, which is detected during subsequent scanning. Prostate cancer screens out in the skeleton in 50-65% of cases. Most often - these are the bones of the pelvis, lumbar vertebrae. Perhaps a generalized lesion of the skeleton.
• X-ray or computed tomography of the chest. Detects lung metastases. It is carried out for all patients, regardless of the presence of bronchopulmonary symptoms. It is preferable to CT, it allows you to visualize foci with sizes from 5 mm.
• CT scan of the abdomen and brain. It is prescribed to detect metastases in the liver, other organs, and the brain.
• Pelvic lymphadenectomy. Surgical intervention, pursuing, in addition to therapeutic and diagnostic goals. It is carried out with doubts about the defeat of the pelvic lymph nodes to accurately establish the stage of the disease and develop treatment tactics.
• PET CT. The latest method of examination, combining radionuclide and radiation diagnostics. Allows you to explore the whole body and see even the smallest screenings of a malignant tumor. The method is informative, but so far inaccessible, it is carried out only in large specialized centers.

Laboratory methods

• A complete blood count usually diagnoses a decrease in hemoglobin and red blood cells, leukocytosis and an increase in ESR are possible.
• In the general analysis of urine, there is hematuria (blood cells), proteinuria (protein).
• Biochemical analysis reveals an increase in the level of creatinine and urea with a complication such as renal failure. An increase in the concentration of alkaline phosphatase is an indirect criterion for bone metastasis.
• PSA (prostate-specific antigen) is a glycoprotein produced by the secretory cells of the prostate. It is a tissue marker, a small amount of it is determined in the blood serum. Increases with malignant tumors of the organ, benign adenomas, prostatitis. There is a correlation between carcinoma size and PSA levels. In stage 4 cancer, the PSA concentration is almost always greater than 20 ng/ml. A figure > 100 ng/ml is considered a reliable criterion for the presence of distant lesions.

Treatment

The fourth stage of prostate cancer includes both prostate cancer with regional metastases, and with distant ones. Accordingly, the treatment tactics for these groups of patients will be different. For locally advanced cancer (T4N0M0 or T1-4N1M0), the following treatments are applicable:

1. In patients with resectable tumors - radical prostatectomy (RP) + adjuvant radiation therapy + hormonal therapy.
2. Remote beam beam + treatment by hormones.
3. Isolated hormone therapy.

If we are talking about prostate cancer with distant metastases (a generalized form of cancer, which is mainly associated with the fourth stage for everyone), then the only effective method of treatment is hormone therapy - androgen deprivation.

Stage 4 prostate cancer with metastases is radically incurable. The impact on it is considered palliative and has the following goals:

• Eliminate or reduce the intensity of symptoms.
• Slowing tumor growth.
• Prevention of further metastasis.
• Improving the quality and duration of the patient's life.

hormone therapy

PCa is a hormone-dependent carcinoma. It has been proven that the male sex hormone testosterone and its more active form, dihydrotestosterone, stimulate the growth of glandular tissue cells of the organ, both malignant and benign. And if the production of androgens is sharply reduced, the growth of the tumor slows down or stops, in some cases there is even a regression of the existing malignant foci. The main types of hormone therapy:

• Bilateral orchiectomy - surgical castration. The most simple, affordable and effective way to reduce the amount of testosterone in the body. Hormone levels drop within a few hours after surgery. This intervention is simple, can be performed under local anesthesia and in elderly and debilitated patients. There are almost no contraindications for him. The only difficulty is to overcome the psychological opposition of the patient, since the very concept of "castration" causes a sharp negative reaction. But in this case, we are talking about prolonging life by an average of 2–3 years, sometimes more, which should well motivate patients to consent.
• Medical castration. It is possible to achieve an antiandrogenic effect with the help of drugs. They belong to the group of luteinizing hormone releasing hormone (LHRH) agonists. Goserelin, Triptorelin, Leuprorelin or Buserelin are used. They must be entered at intervals of 1 time in 28 days. There are deposited forms, the validity of which lasts 3-6 months. Treatment is lifelong or until tumor resistance is achieved.
• LHRH antagonist. The most studied drug is Degarelix, which is also administered once a month. Unlike the previous group, it does not cause a flash effect.
• Antiandrogens are drugs that block male sex hormones. They are used both independently and in combination with surgical or medical castration (maximum androgen blockade - MAB). They are also prescribed in the first weeks after the start of treatment with LHRH agonists - to prevent the "flare" effect. The most used are Bicalutamide, Flutamide, Cyproterone acetate.
• Estrogens. By the type of feedback mechanism, they indirectly block the production of androgens. Historically, these are the very first drugs that began to be used for hormonal therapy for prostate cancer. However, estrogens also have the most pronounced side effects (cardiotoxicity, thromboembolic complications), so they are not currently used as first-line drugs.

The main side effects of hormone therapy:

• Impotence.
• Tides.
• Swelling and soreness of the mammary glands.
• Osteoporosis (decrease in bone density) and a tendency to spontaneous fractures.
• Gastrointestinal disorders (diarrhea, nausea).
• Atherosclerosis and cardiovascular complications.

Chemotherapy

As a drug for the treatment of prostate cancer in patients with a high prevalence of the process, Docetaxel is used intravenously every 21 days (up to 6 courses). A study has been conducted that the combination of castration (surgical or medical) with chemotherapy significantly increases the survival of patients compared with hormonal therapy alone. But such treatment is tolerated worse.

Hormone resistance in PCa and second-line treatment

During HT, the tumor inevitably acquires refractoriness to castration. After a certain period (on average 2 years), it begins to progress, despite the continuing low level of testosterone. Progression is recorded by the increasing concentration of PSA, the growth of the primary focus, and the increase in the number of metastases.

The appearance of signs of tumor resistance is a signal for a review of treatment. There are many treatment options for patients with advanced prostate cancer due to HT:

• Cancellation of antiandrogens in patients receiving them leads to an improvement in performance in 1/3 of cases.
• Substitution of one drug for another (for example, flutamide is replaced by bicalutamide and vice versa).
• Administration of ketoconazole. It is an antifungal drug with the effect of suppressing the production of androgens by the adrenal glands.
• The use of estrogens. Contraindicated in cardiovascular diseases.
• Adding chemotherapy. If progression occurs after docetaxel, cabazitaxel, abiraterone, or enzalutamide is given in combination with prednisolone.

Palliative care methods

This treatment is designed to reduce symptoms and improve quality of life. Unlike hormone therapy, it does not affect the tumor itself and overall survival.

• Bisphosphonates (zoledronic acid) in combination with calcium and vitamin D preparations. They are used for bone metastases, contribute to the repair of destruction foci and reduce pain.
• Radiation therapy for bone metastases dropout. Introduction of radioactive strontium Sr-89 or samarium Sa153.
• The use of bone cement in fractures.
• Adequate anesthesia. NSAIDs, non-narcotic analgesics are prescribed, opioids may also be needed. Often, once palliative radiotherapy or bisphosphonates begin to work, the need for pain relief decreases.
• Transurethral resection (TUR) as a method to eliminate problems with urination.
• Epicystostomy in case of refusal or impossibility of performing TUR.
• If signs of spinal cord compression appear, decompression surgery may be performed. The alternative is high doses of corticosteroids and radiation therapy.
• Antidepressants when indicated.

Observation

After the start of HT, follow-up examinations should be carried out every 3-6 months. Deadlines are usually set individually. The goal is to fix the moment of development of castration resistance and the onset of progression of the disease, as well as to neutralize the side effects of HT.

Minimum examinations:

• Questioning (increased symptoms).
• General clinical analyses.
• PSA level (increases with progression).
• According to the indications - ultrasound, osteoscintigraphy, CT or MRI, PET CT.

Forecast

Stage 4 prostate cancer has a poor prognosis. It depends on the degree of spread of the tumor at the time of its detection, the amount of points on the Gleason scale (the higher, the less life expectancy), the initial concentration of PSA, the intensity of its growth, and the presence of distant malignant foci.

Hormone therapy is the main treatment for metastatic PCa. On average, it slows down and stabilizes the disease for 24-36 months. 7% of patients after the start of HT live 10 years or more.