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Prostate Cancer: Symptoms, Types, Stages, Causes, Medicines & Treatments

Commonly asked questions about prostate cancer:

What Is Prostate Cancer?

The prostate is a gland that is present exclusively in males. It has to do a lot with the functions of the male reproductive system. The gland secretes fluid to add to the secretions that come out during ejaculation.

Prostate gland lies beneath the bladder and measures up to the size of a chestnut. After the age of 50 years, the gland tends to gradually enlarge. According to Patient.info, about nine in 10 men may develop an enlarged prostate gland by the time they reach 90 years old.

When cancer cells grow inside this male reproductive organ, the condition is then termed as prostate cancer. This disease, which is commonly referred to as the carcinoma of prostate, tends to grow slowly. The types that are potentially malignant may spread to involve the bones and lymph nodes, as well.

Prostate Cancer Statistics

According to the National Cancer Institute, prostate cancer is the most common non-skin type of cancer and the second most common cancer in males in the United States. African-American males are reportedly more likely to develop the disease — compared to Caucasian males.

According to the American Cancer Society:

• In the year 2016, approximately 180,890 new cases of prostate cancer are expected to emerge in the United States alone.

• In the same year and country, about 26,120 deaths are expected as a result of prostate cancer.

According to American Cancer Society, the risk of getting prostate cancer is about one in every seven males. About one in 39 males diagnosed with the disease is likely to die from it. That said, in the United States, approximately 2.9 million patients diagnosed with prostate cancer are still alive.

Most men who develop prostate cancer are above the age of 65 years, according to the Centers for Disease Control and Prevention (CDC). It is the fifth most common reason for deaths related to cancer among the male population globally.

What are the Types of Prostate Cancer?

Acinar adenocarcinoma

Acinar adenocarcinoma is a histological subtype of cancer that tends to affect the glands. It makes the most common form of malignancy of the prostate gland. Prostate adenocarcinoma typically occurs in the glandular portion of the organ and mostly occupies the peripheral zone. Approximately 90 percent of diagnosed cases of the disease are of the acinar adenocarcinoma-type.

Ductal adenocarcinoma

Cells that line the ducts of the prostate gland can be affected by cancer, producing a condition known as ductal adenocarcinoma. This prostate cancer subtype tends to spread quickly — compared to its acinar counterpart. Men diagnosed with ductal adenocarcinoma may have an advanced stage at the time of diagnosis.

Squamous cell cancer

Squamous cell cancer tends to spread quicker than adenocarcinoma, as well. As a result, most cases are at an advanced stage at the time of diagnosis.

Transitional cell cancer

Transitional cell cancer is also known as urothelial. This cancer subtype generally affect urethral cells that line the urethra. In most cases, cancer seeds in the bladder and then passes on to the prostate gland.

Small cell cancer

This prostate cancer variety is of the neuroendocrine type and consists of small round cells. Prostate Specific Antigen (PSA) is found to be highly raised in the blood. However, individuals with small cell cancer of the prostate do not have an inflated PSA level. As a result, early diagnosis is not easy and most cases present an advanced stage at the time of diagnosis.

Carcinoid of the prostate

Carcinoid of the prostate begins from the neuroendocrine system. This is a rare subtype of prostate cancer and is slow to grow. When the tumor is asymptomatic, monitoring is advised. However, with a rapid and symptomatic tumor, surgery is oftentimes recommended and carried out.

Prostatic sarcoma

According to Cancer Research Society, this subtype of prostate cancer is responsible for less than 0.1 percent of cases, making it extremely rare. Cells supporting the lymphatic vessels, blood vessels, connective tissue, and the smooth muscles of the gland are affected in prostatic sarcoma. Moreover, it tends to affect men between the ages 35 to 60 years, which is comparatively younger than that seen in other subtypes.

What are Risk Factors and Causes of Prostate Cancer?

The following risks have been linked as causes of prostate cancer:

Age

According to the American Cancer Society, the risk of getting prostate cancer grows significantly in males above the age of 50 years. Moreover, six of 10 prostate cancer cases occur in those over the age of 65 years.

According to Cancer Research UK, in the United Kingdom, approximately 33 percent of prostate cancer cases were diagnosed in men above 75 years of age during 2009 to 2011. Men under 50 years old accounted for one percent.

Family history

The fact that prostate cancer runs in families points out towards the possibility of an inherited mutated gene among generations.

A positive case of prostate cancer — either with the father or brother — doubles the risk of being diagnosed with the disease in men, according to the American Cancer Society. If the affected relatives were young at the time of diagnosis, the risk increases.

Race/ethnicity

African-American men are more prone to develop cancer of the prostate in the United States, compared to Caucasians. This shows a relation between one’s ethnicity and the probability of developing prostate cancer. Asian males are less likely to be affected compared to Caucasians. (Cancer Research UK)

Geographical factors

How a geographical location affects the incidence of this disease is yet unknown. However, according to American Cancer Society, males residing in the Caribbean Islands, Northwestern Europe, North America and Australia may be at greater risk to be diagnosed with prostate cancer than males residing in Asia, South American, and Central America.

South Asians dwelling in the United Kingdom are more likely to be affected by prostate cancer than compared to the men who reside in South Asia, according to Cancer Research UK.

Genes

BRCA 1 and BRCA 2 gene mutations associated with the risk of ovarian and breast cancer in women have also been linked to men diagnosed with prostate cancer.

Diet

This aspect of prostate cancer has yet to be explored, however, it has been found that the risk of a cancer is directly proportional to low levels of blood calcium and vitamin D.

Prostatitis

Prostatitis is defined as inflammation of the prostate gland. A study analysis involving 20 research works in the year 2013 revealed a positive link between prostatitis and risk of prostate cancer. However, this fact is still questionable and requires further research and study.

What are the Symptoms of Prostate Cancer?

Symptoms of prostate cancer may resemble those of benign prostatic hyperplasia — a non-cancerous condition in which the prostate glands enlarges abnormally. Early stages of the disease usually produce no symptoms.

If symptomatic, prostate cancer may produce the following signs and symptoms:

  • Frequent need to urinate
  • Urgency regarding urination
  • Pain during urination
  • Pain in the pelvic bone
  • Blood in urine
  • Pain during ejaculation
  • Pain in the back and hips that do not wane away
  • Blood in semen
  • Facing difficulty in initiating or stopping the urine stream
  • Feelings of incomplete micturition most of the time

Prostate cancer symptoms may be mild or even severe. A person may experience weakness or numbness in their lower limbs or pelvic area. This indicates that the cancer is pressing on the surrounding nerves, which is quite a serious issue. In some cases, cancer may affect the spinal nerves so much so that the bladder or bowel control is lost.

The most common symptom of advanced prostate cancer is bone pain. Prostate cancer cells usually tend to affect the proximal portion of the femur bone.

What Medication or Drugs are Used to Treat Prostate Cancer?

The following list of drugs have been approved by the Food and Drug Administration (FDA) for prostate cancer, according to the National Cancer Institute. The drugs, listed in alphabetical order, includes generic names and brand names. There may be drugs used to treat prostate cancer that are not listed here.

  • Abiraterone Acetate
  • Bicalutamide
  • Cabazitaxel
  • Casodex (Bicalutamide)
  • Degarelix
  • Docetaxel
  • Enzalutamide
  • Flutamide
  • Goserelin Acetate
  • Jevtana (Cabazitaxel)
  • Leuprolide Acetate
  • Lupron (Leuprolide Acetate)
  • Lupron Depot (Leuprolide Acetate)
  • Lupron Depot-3 Month (Leuprolide Acetate)
  • Lupron Depot-4 Month (Leuprolide Acetate)
  • Lupron Depot-Ped (Leuprolide Acetate)
  • Mitoxantrone Hydrochloride
  • Provenge (Sipuleucel-T)
  • Radium 223 Dichloride
  • Sipuleucel-T
  • Taxotere (Docetaxel)
  • Viadur (Leuprolide Acetate)
  • Xofigo (Radium 223 Dichloride)
  • Xtandi (Enzalutamide)
  • Zoladex (Goserelin Acetate)
  • Zytiga (Abiraterone Acetate)

How Do You Treat Prostate Cancer?

Treatment options for prostate cancer may differ with every case:

Making the right choice for the right kind of treatment

Decisions need to be based on whether the cancer is contained within the gland (localized), whether it has affected the neighboring areas (locally advanced), or whether it has metastasized to distant organs (advanced). Please consult a doctor before making a choice for the right kind of treatment.

Active surveillance

Prostate cancer tends to develop and progress slowly, hence, many times, aggressive and immediate treatment is not required (Prostate Cancer UK). Instead, if the patient does not display symptoms, they shall be monitored over a specific period of time. Active surveillance is carried out in those cases where a disease is not interfering with one’s quality of life. Until the tests signify the need of any treatment, active surveillance can be carried out.

Watchful waiting

This treatment option is similar to active surveillance. The patient is monitored for their disease and no treatment is initiated unless necessary.

Radical prostatectomy

Radical prostatectomy is a surgical treatment option for prostate cancer patients. In this procedure, the gland along with seminal vesicles is removed in an effort to eradicate cancer. It is a surgical treatment in which all the glands — along with some of the surrounding tissue — is removed. Radical prostatectomy is performed when the cancer is localized. It is carried out by one of the following four procedures:

  • Retropubic
  • Laparoscopic
  • Robotic surgery
  • Perineal

External beam radiotherapy

In this treatment option for prostate cancer, radiation beams are directed from outside the body on the prostate gland so as to kill the cancer cells. This procedure is more effective when the cancer is localized as well as locally advanced.

Hormone therapy

The growth and functions of the prostate gland are all controlled by testosterone. Hormone therapy for prostate cancer aims at stopping the action of testosterone on the prostate gland so that the cancer cells shrink and die.

Cryotherapy or Cryosurgery

This treatment option works well with localized — as well as locally advanced — prostate cancer cases. In this procedure, the cancer cells are subjected to extremely cold temperatures so that they become unstable and die. This procedure may also serve for the purpose of treatment of recurrent cases of prostate cancer, largely in candidates who have developed the condition again, despite radiotherapy or brachytherapy. (Prostate Cancer UK)

How to Prevent Cancer

Cancer prevention can vary based on different research, and opinionated studies or news reports. However, these simple lifestyle changes can make a difference in the prevention of developing or forming cancer.

  1. Eat healthy
  2. Limit or stop your use of tobacco
  3. Have a balanced lifestyle
  4. Avoid risky behavior
  5. Visit your doctor
  6. Immunization
  7. Protect your skin from the sun

What Drugs are Used to Treat Prostate Cancer?

The following drugs and medications are in some way related to, or used in the treatment of prostate cancer, according to the National Cancer Institute:

  • Abiraterone Acetate
  • Bicalutamide
  • Cabazitaxel
  • Casodex
  • Degarelix
  • Docetaxel
  • Enzalutamide
  • Flutamide
  • Goserelin Acetate
  • Jevtana
  • Leuprolide Acetate
  • Lupron
  • Lupron Depot
  • Lupron Depot-3 Month
  • Lupron Depot-4 Month
  • Lupron Depot-Ped
  • Mitoxantrone Hydrochloride
  • Provenge
  • Radium 223 Dichloride
  • Sipuleucel-T
  • Taxotere
  • Viadur
  • Xofigo
  • Xtandi
  • Zoladex
  • Zytiga

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References

  1. Ruddon, Raymond W. (2007).Cancer biology (4th ed.). Oxford: Oxford University Press. p. 223. ISBN 9780195175431.
  1. Randolph TL, Amin MB, Ro JY, Ayala AG (June 1997). “Histologic variants of adenocarcinoma and other carcinomas of prostate: pathologic criteria and clinical significance”. Pathol. 10(6): 612–29. PMID 9195581.
  1. Struewing JP, Hartge P, Wacholder S, Baker SM, Berlin M, McAdams M, Timmerman MM, Brody LC, Tucker MA (May 1997). “The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews”. Engl. J. Med. 336 (20): 1401–8. doi: 10.1056/NEJM199705153362001PMID 9145676.
  1. Wigle DT, Turner MC, Gomes J, Parent ME (March 2008). “Role of hormonal and other factors in human prostate cancer”. Journal of Toxicology and Environmental Health. Part B, Critical Reviews. 11 (3–4): 242–59. doi: 10.1080/10937400701873548. PMID 18368555.