Prostate cancer is the most common types of cancer among males. It is cancer that afflicts the prostate gland. The prostate is an exocrine gland situated at the base of the urinary bladder in males. It is slightly larger than a walnut and surrounds the urethra. The normal adult prostate weigh between 7 and 16 g and is primarily responsible for producing prostatic fluid. This forms a significant part of the seminal fluid that is expressed during the ejaculation of sperm. It is slightly alkaline and helps sperm cells survive the acidity of the vaginal tract. Prostatic cancer is a cancer caused by abnormal genetic mutation and cellular growth of the prostate cells. While most types of prostatic cancers are slow to develop and can be identified and treated before they spread, some types can develop fast and spread to other organs.
Causes and risk factors
As with most cancers, there is no clear or identifiable cause of prostate cancer. The mechanics of prostatic cancer have broadly been understood, but there is no conclusive evidence as to what specifically causes this to happen. Prostatic cancer begins to develop when some of the cells of the prostate display genetic mutation. Prostate cells are responsible for using zinc to produce citrate which is a part of semen. This process requires large amounts of energy. It has been found that one of the abnormalities of cancerous prostatic cells is that they do not contain zinc. When this genetic mutation takes place, instead of producing seminal fluid, these cells use their energy to grow and spread to other parts of the body.
However, researchers have been able to conclude that there are certain risk factors which can make you more prone to this form of cancer than other people. They have found that prostate cancer risk is greater as one ages. The highest incidence of prostate cancer is in men over 65 years of age. Genetic and race factors are also found to play a role in profiling risk. Prostate cancer is diagnosed more frequently among black men than white or Hispanic men. Men with family history of prostate cancer are more at risk for developing it themselves. Men who are overweight have also been found to be at a higher risk than others for developing prostate cancer. Obesity also tends to delay diagnosis and make treatment more complicated.
Prostate cancer tends to be insidious in its onset and often does not display any symptoms in the early stages. A significant percentage of prostate cancer is actually detected during routine preventive examination or on a detailed laboratory workup. As the cancer progresses or the prostate enlarges, symptoms begin to develop. They may include difficulty with painful urination, difficulty initiating or maintaining a steady stream of urine, increased nocturnal frequency of urination, blood in urine, blood in semen, swollen legs, and bone pain. However, some of these symptoms are identical to those of a less worrisome condition known as benign prostatic hyperplasia which is a noncancerous condition. Your physician will be able to conduct tests that confirm or rule out a malignant or cancerous state.
In most countries, physicians conduct routine screening test for men who are in their 50s to rule out prostatic cancer. Some of the diagnostic processes that are commonly utilized are the digital rectal exam, a prostate specific antigen or PSA test, an ultrasound, and a biopsy. A digital rectal exam is a physical examination by checking the texture, shape and size of your prostate with the help of a lubricated gloved finger (or digit) inside your rectum. A PSA test is done to check if the amount of PSA in your blood. An abnormally elevated number along with physical findings would lead your physician to do an ultrasound imaging and a biopsy. For a biopsy a small amount of prostate tissue is extracted through a thin needle and analyzed to detect the presence of cancerous cells.
Grades, stages, and scores
During discussions about a diagnosis of prostate cancer, you may come across the terms “grade,” “stage,” and “score.” These are commonly used terms to classify the type of prostate cancer you might be looking at. The grade of cancer has to do with the aggressiveness of the cancer, and how likely it is to spread to other parts of the body. The most common way of grading prostate cancer is to use what is known as the Gleason score. This uses a grade of 1 to 5 each for the most common type of tumors detected and the next most common type of tumor detected. Together, they give a value between 2 and 10 which is commonly called the Gleason score, with 2 being the least aggressive type of disease and 10 being the most aggressive. Staging of cancers are an indicator of how far the disease has advanced. For prostate cancer, the disease is broken into four stages, with Stage I being the earliest cancer, and Stage IV being the most advanced, with spread into distant parts of the body such as bones, lymphatic system, lungs, etc.
Treatment of prostatic cancer varies depending on stage and grade, and the risk-benefit ratio of treatment options. For some forms of less aggressive cancer, the physician may suggest watchful waiting, with regular monitoring of progression. Given the nature of some of the milder forms of prostate cancer, some patients end up not requiring treatment for cancer at all. For more aggressive or more advanced cancer, surgery, radiation, and chemotherapy are among options available to the physician. Surgery can be partial or total removal of the prostatic gland followed by biopsy of surrounding tissue to ensure that all diseased tissue has been removed. Radiation can be directed externally through what is known as external bean radiation. It can also be delivered through the surgical implantation of radioactive seeds near the cancerous area that will kill the cancerous tissue with low dose radiation over a long period of time. Chemotherapy is the intravenous or oral administration of anti cancer drugs. Sometimes, chemotherapy is used in conjunction with radiation or surgery. Other forms of treatment for prostate cancer include hormonal approaches such as androgen ablation therapy and cryoablation or freezing off the prostatic tissue.
Since prostate cancer is closely linked with virility, vitality and reproductive health in men, there is a great deal of speculative and unscientific discussion about preventive measures. However, no conclusive studies have proven the success of any measure beyond those that address the known risk factors of obesity and overall fitness and balanced dietary intake. Men who are physically active and maintain ideal weight for height have been found to have lower incidence of prostate cancer. Regular exercise and a diet with abundant fruits and vegetables have been found to lead to lower risk for cancer. In particular, lycopene, the carotene that gives tomatoes their redness, has been found to be playing an important role in the prevention of prostate cancer. It can also be found in carrots, watermelons, and papaya. If you are at a higher risk for prostate cancer, you may want to discuss routine screening and preventive medication with your physician.