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<! - <span class = "titulo_noticia"> DIAGNсSTICO AND TNM </span>->

<br/> <span class = "texto_noticia"> <div align = "justify"> <strong> Š <u> CСmo it goes over to diagnСstico of cАncer of prСstata? </or> </strong> <br/> <br/> Before the suspicion of cАncer of prСstata, (generally before increase of PSA or of urinal problems) ═el mИdico he practises a rectal tact. This one exploraciСn allows to mИdico experienced to recognize any irregular Аrea or of hard consistency in prСstata that could correspond to one cАncer. <br/> <br/> not to cause excessive inconveniences, mИdico it uses, for the rectal tact, a rubber glove and introduces to travИs of the year a finger previously lubricated, so that her exploraciСn it is not painful. <br/> <br/> If the suspicion is confirmed, there must be practised a biopsy, which estА indicated, in principle, in men with PSA superior to 4 ng/ml or with aberrations in prСstata. With the biopsy and the study of the extirpated textile, descartarА or confirmarА the presence of one cАncer of prСstata. <br/> <br/> to realize the biopsy, there is used a needle of the calls of sampling, which introduces it to travИs of the low rectum guМa of ecografМa trans-rectal, to be able to locate perfectly the area or areas to biopsiar. ══ <br/> <br/> to realize it ecografМa trans-rectal it is necessary to place previously a probe of ecografМa inside the rectum which colocaciСn it is a little incСmoda, just as his presence. But, at all times, the person fastened exploraciСn must remind to that it is realized by his good and that, despite the inconveniences, it should burden nothing can happen to him. ═ <br/> <br/> Nevertheless it can be supported perfectly and mАs bearing in mind that between colocaciСn of probe ecogrАfica and biopsy and realizaciСn of the biopsy, it is taken in whole between 10 and 20 minutes. To bear in mind that the biopsy occupies a very little time. <br/> <br/> The sampling needle allows it extracciСn of textile cylinders of prСstata. When there is no area or suspicious areas those that to direct the needle, usually practise one on themselves mМnimo of 6 punctures up to one mАximo of 14 or 15, to cover it everything extensiСn of prСstata. <br/> <br/> The samples extraМdas are sent to patСlogo, so that it establishes diagnСstico and, if it is a question of one cАncer, the Gleason grade (vИase earlier, in the paragraph "C+ncer of prĐstata".<br/> <br/> <u> <strong> ŠSe they practise other tests for diagnСstico? </strong> </or> <br/> <br/> When he gets ready already of diagnСstico of cАncer of prСstata there is realized a series of complementary, conducive proofs to be known the general state of health of the person and to try to detect if the illness has spread mАs allА of prСstata. <br/> <br/> AsМ, they are requested anАlisis of blood (finished hemogram and thrombocytes) and studies of bioquМmica sanguМnea (fosfatasa alkaline, transaminasas, gamaGT, bilirrubina, urea and creatinina, cholesterol, glycemia). They face towards the state of health of the person and towards the possible presence of metАstasis in bones. <br/> <br/> For objetivar if there is afectaciСn of the ganglions of the pelvis and to discard it afectaciСn of hМgado, a TAC is requested (tomografМa axial computerized) abdominal. Alternatively, there can be preferred the RNM (nuclear resonance magnИtica) <br/> <br/> Another test of big importance is her gammagrafМa of the bones. It is realized by means of administraciСn intravenous of radioactive material that has it caracterМstica of settling in the bones. This way one is obtained "mapa" of the skeleton. The differences of captaciСn of the radioactive material allow to detect, if they exist, metАstasis in the bones. The radioactive material tends to be received mАs for metАstasis than for the normal bones. <br/> <br/> To seЯalar that the radioactive material that is used expresses very short waves and of an average life tambiИn very short. <br/> <br/> The first one caracterМstica, short waves, they do that it is exploraciСn, aЗn using radioactive material, it is not dangerous for the persons who surround the patient (relatives, friends). <br/> <br/> The second one caracterМstica, average life cuts, it means that at a few hours the radioactivity has become extinct soon, with what the safety is entire. <br/> <br/> <u> <strong> In this moment, from the point of view mИdico, Ša quИ conclusiСn or conclusions we can come? </strong> </or> <br/> <br/> We Are in situaciСn of establishing the called one diagnСstico of extensiСn, that is to say, we already know the quantity of cАncer that has a person determined with cАncer of prСstata. Namely all that has spread the tumor in prСstata, to the nearby textiles, to the ganglions linfАticos and to other Сrganos. DiagnСstico of extensiСn is the factor pronСstico mАs important and essentially to choose the treatment. <br/> <br/> <strong> Š <u> Is the same diagnСstico of extensiСn, stadiums and TNM? </or> </strong> <br/> <br/> SМ, but both stadiums and TNM are classifications that use them mИdicos so much to express diagnСstico of extensiСn of every patient as to facilitate it comunicaciСn between mИdicos. <br/> <br/> The system TNM it diseЯС in 1944 one mИdico francИs, the doctor Pierre Denoix. It had one big aceptaciСn and extendiС to the whole world. <br/> <br/> TNM is based on the survival of the patients in each of the situations. It serves to plan the suitable treatment and to establish pronСstico. <br/> <br/> In cАncer of prСstata TNM uses it clasificaciСn and not her in stadiums. The stadiums (in general 4) are as sМntesis of the diverse situations TNM, but, in cАncer of prСstata it is considered mАs Зtil the TNM. <br/> <br/> <strong> The TNM, <u> Štiene only one form? </or> </strong> <br/> <br/> There Are two types of TNM, clМnico (that is established by the described tests and her exploraciСn of mИdico) and called TNM patolСgico or pTNM. <br/> <br/> The pTNM aЯade, ademАs, quite her informaciСn collection to the microscope for patСlogo, when it examines the extirpated textiles. <br/> <br/> <strong> Š <u> CuАles are the possible situations of the TNM in cАncer of prСstata? </or> </strong> <br/> <br/> There Are the following ones: <br/> <br/> T1: Tumor not detectable nor palpable to the rectal tact, but in which they are cИlulas cancerous, is in one resecciСn transuretral of prСstata, in a biopsy or in one prostatectomМa. <br/> <br/> The T1 subdivide in: <br/> <br/> T1a: It is a T1 in which the study to the microscope shows that sСlo 5 % of the extirpated textile contains cИlulas cancerous, while 95 % remainder is benign. The PSA was normal. <br/> <br/> T1b: A T1 with mАs of 5 % of cancerous textile. Normal PSA. <br/> <br/> T1c: Any of the previous ones, but with carcinoma PSA sugerente. <br/> <br/>-----------------------------------------------------<br/> <br/> T2: The rectal tact has allowed to feel a tumor in prСstata, but inside glАndula; that is to say, it has not spread towards out to the textiles and structures of around. <br/> <br/> The T2 subdivide in: <br/> <br/> T2a: The tumor is sСlo in the right side or in the lefthander of prСstata. <br/> <br/> T2b: Both sides, right and lefthander affects the tumor. <br/> <br/>---------------------------------------------------------<br/> <br/> T3: The tumor has extended mАs allА of cАpsula that surrounds it prСstata. <br/> <br/> The T3 subdivides in: <br/> <br/> T3a: ExtensiСn extracapsular unilateral or bilateral, but not to other textiles or Сrganos. <br/> <br/> T3b: AfectaciСn of vesМculas seminal, but not to other Сrganos. <br/> <br/>--------------------------------------------------------<br/> <br/> T4: The fixed tumor (adhered to external structures) or it invades them. </div> <div align = "justify"> </div> <div align = "justify"> ═════ The T4 splits in: </div> <div align = "justify"> </div> <div align = "justify"> T4a: The tumor invades the neck of the urinal bladder, the external sphincter or the rectum. </div> <div align = "justify"> </div> <div align = "justify"> T4b: The tumor═invade them mЗsculos elevators or estА I fix in the side wall of the urinal bladder. ═ <br/> <br/>---------------------------------------------------------<br/> <br/> <strong> Š <u> CСmo one classifies it afectaciСn of the ganglions linfАticos near to prСstata? </or> </strong> <br/> <br/> Hay═tres situations: <br/> </div> <div align = "justify"> NX: The ganglions cannot be valued. <br/> </div> <div align = "justify"> N0: CАncer it does not affect to the ganglions. <br/> </div> <div align = "justify"> N1: AfectaciСn of one or mАs ganglions linfАticos nearby (regional). <br/> <br/> <strong> Š <u> And them metАstasis? </or> </strong> <br/> <br/> In a way similar to the ganglions: <br/> <br/> MX: them metАstasis over a distance they cannot be valued </div> <div align = "justify"> </div> <div align = "justify"> M0: cАncer it has not spread mАs allА of the ganglions of regiСn. <br/> <br/> M1: extensiСn from the illness to ganglions linfАticos mАs allА from the pelvis and/or to bones, hМgado, lungs, brain, etc. <br/> <br/> </div> </span> <br/> </div>

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