[Epidemiology and risk factors of the prostate cancer]. / Epldemiologia oraz crynniki ryzyka rozwoju raka gruczolu krokowego.

Prostate cancer is the most common malignancy of male genital organs. The etiology of the disease is complex and remains mainly unclear. The only established risk factors are advancing age, ethnicity and genetics, including changing in expression of ELAC2, RNASEL, MSR1 and HOXB13 genes as well as low number of CAG repeats in the androgen receptor gene. There are number of coexisting environmental risk factors, such as eating habits mostly diet reach in animal fats. An early sexual initiation and sexually transmitted infections, both viral (HSV-2, HPV-18 and -16, CMV) and bacterial (Neisseria gonorrhoea, Treponema pallidum, Chlamydia trachomatis) were also included. The etiology of prostate cancer also involves the influence of hormones - androgens and estrogens, as well as chronic inflammation of the prostate. In contrast to the incidence rate, which varies significantly depending on the geographic region, the incidence of the malignancy at autopsy is similar.

[Epidemiology and risk factors of the cervical squamous cell carcinoma]. / Epidemiologia i czynniki ryzyka rozwoju raka plaskonablonkowego szyjki macicy.

Neoplasm of the cervix, especially squamous cell cancer, is one of the most common malignancy of female genital organs. It etiology is complex; however, human papilloma virus (mostly HPV type 18, 16 and 45) infection seems to be the most important one. Other risk factors include: early sexual initiation, multiple pregnancies and labors, concomitant infections (Chlamydia trachomatis, Neisseria gonorrhea, HSV2 - herpes simplex virus) of the genital tract, AIDS, immunosuppressive therapy, smoking and low socioeconomic status. The incidence of cervical cancer is particularly high in developing countries, while in countries where government founding for the prevention and health education is high, the diseases is significantly less likely to occur. The incidence and mortality rate of the cervical cancer can be substantially reduced by systematic screening cytological examinations. For such reason a liquid-based cytology is currently preferred. Implementation of HPV vaccines decrease the risk of infection, but effect on rate of the cervical cancer has to be confirmed in long-time prospective clinical and epidemiological studies.

[Diagnostic imaging of the prostate cancer]. / Diagnostyka obrazowa raka gruczolu krokowego.

Diagnosis of the prostate cancer is based on clinical, biochemical and histological examinations, as well as various imaging techniques. From the last listed group, magnetic resonance imaging (MRI) provides precise identification of focal areas and local staging of the cancer. It improves evaluation of the local extracapsular extension and involvement of regional lymph nodes, which has significant implications for a patient management. MRI, supplemented by dynamic contrast enhanced and diffusion-weighted imaging (DWI), is especially useful in detection of small focal lesions. MRI also plays an important role in the evaluation of a local recurrence and monitoring of the early and late response to treatment. Whole-body MRI should be performed in patients with a disseminated disease. In patients with an increased level of prostate specific antigen (PSA), small lesions, local recurrence and distant metastases, not detected by other imaging techniques, a positron emission tomography (PET) should be also performed. Computed tomography (CT) does not play a significant role in the diagnosis of the primary prostate cancer, however new CT scanners improve the accuracy of prostate cancer staging. Diagnostic imaging is also widely used in the screening process. Transrectal ultrasound (TRUS) examination of the organ is applied to obtain systematic core biopsies for a histological examination.

[Contemporary methods of treatment in local advanced prostate cancer]. / Wspólczesne metody leczenia miejscowo zaawansowanego raka gruczolu krokowego.

The prostate cancer is one of the most often cancers amongst males. Its frequency is increasing with age. Thanks to widespread of screening denomination of specific prostate specific antigen (PSA), ultrasonography including the one in transrectal (TRUS), computed tomography, magnetic resonance and especially the awareness of society, the number of patients with low local advance of illness is increasing. The basic method of treatment in such cases is still the surgical removal of prostate with seminal bladder or radiotherapy. To this purpose tele-(IMRT, VMAT) or brachytherapy (J125, Ir192, Pa103) is used. In patients with higher risk of progression the radiotherapy may be associated with hormonotherapy (total androgen blockage-LH-RH analog and androgen). Despite numerous clinical researches conducted there is still no selection of optimal sequence of particular methods. Moreover, no explicit effectiveness was determined. The general rule of treatment in patients suffering from prostate cancer still remains individual selection of therapeutic treatment depending on the age of a patient, general condition and especially patient's general preferences. In case of elderly patients and patients with low risk of progression, recommendation of direct observation including systematical PSA denomination, clinical transrectal examination, TRUS, MR of smaller pelvis or scintigraphy of the whole skeleton may be considered.