PROSTATE CANCER : TYPES, STAGES, SYMPTOMS, CAUSES AND MORE

OVERVIEW

Prostate cancer is cancer that occurs in the prostate. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm.

It is one of the most common types of cancer. Many prostate cancers grow slowly and are confined to the prostate gland, where they may not cause serious harm.

However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.

TYPES 

The type of prostate cancer tells about the type of cell the cancer started in. Knowing this helps your doctor decide which treatment you need. Below listed are some common types of it :

• Acinar adenocarcinoma

Adenocarcinomas are cancers that develop in the gland cells that line the prostate gland. They are the most common type of prostate cancer. Nearly everyone with prostate cancer has this type.

·         Ductal adenocarcinoma

Ductal adenocarcinoma starts in the cells that line the ducts (tubes) of the prostate gland. It tends to grow and spread more quickly than acinar adenocarcinoma.

·         Transitional cell (or urothelial) cancer

Transitional cell cancer of the prostate starts in the cells that line the tube carrying urine to the outside of the body (the urethra). This type of cancer usually starts in the bladder and spreads into the prostate. But rarely it can start in the prostate and may spread into the bladder entrance and nearby tissues.

·         Squamous cell cancer

These cancers develop from flat cells that cover the prostate. They tend to grow and spread more quickly than adenocarcinoma of the prostate.

·         Small cell prostate cancer

Small cell prostate cancer is made up of small round cells. It’s a type of neuroendocrine cancer.

 

STAGES 

The stage of cancer will help doctor and patient determine the most appropriate options for treatment. Prostate cancer stages range from 1 through 4.

Stage 1 :

• Stage 1 means the cancer is on one side of the prostate. Stage 1 cancers usually grow slowly.
• In this stage, the PSA level may not be high and the cancer may not be felt during a DRE.
• There is no lymph node involvement nor metastasis.
• Some cancers that are felt during a DRE may still be classified as stage 1 if the Gleason score is 6 or less and the PSA is lower than 10.

Stage 2 :

• Stage 2 means the cancer remains confined to the prostate gland. It has three sub stages:

1. Stage 2A: The cancer is on one or both sides of the prostate gland, the PSA blood test level is between 10 and 19, and the Gleason score is 6 or less.
2. Stage 2B: The cancer is on one or both sides, the PSA is lower than 20, and the Gleason score is 7.
3. Stage 2C: The cancer is on one or both sides, the PSA is lower than 20, and the Gleason score is 7 to 8.

Stage 3 :

• Stage 3 means the cancer is locally advanced. The tumor has progressed and is more likely to grow and spread, with both the Gleason score and the PSA being high. This stage also has three substages:
• Stage 3A: The cancer is on one or both sides of the prostate, the PSA is 20 or higher, and the Gleason score may be as high as 8
• Stage 3B: The cancer has spread outside the prostate gland to nearby tissues but not to the lymph nodes. The PSA may be any level, and the Gleason score may be up to 8.
• Stage 3C: This stage is similar to 3B, but the cancer may not be growing beyond the prostate and has a Gleason score of 9 or 10.

 

Stage 4 :

• Stage 4 means the cancer has spread to lymph nodes or to other parts of the body. It is further divided into two substages:

1. Stage 4A: The cancer has spread to nearby lymph nodes but may or may not have spread to nearby tissues.
2. Stage 4B: The cancer has spread to another area of the body, such as the bones or distant lymph nodes.

 

SYMPTOMS 

Prostate cancer may cause no signs or symptoms in its early stages.

Prostate cancer that’s more advanced may cause signs and symptoms such as:

• Trouble urinating
• Decreased force in the stream of urine
• Blood in the urine
• Blood in the semen
• Bone pain
• Losing weight without trying
• Erectile dysfunction

 

CAUSES OF 

On a basic level, prostate cancer is caused by changes in the DNA of a normal prostate cell. DNA is the chemical in our cells that makes up our genes, which control how our cells function. We usually look like our parents because they are the source of our DNA. But DNA affects more than just how we look.

Doctors know that  how it begins when cells in the prostate develop changes in their DNA. A cell’s DNA contains the instructions that tell a cell what to do. The changes tell the cells to grow and divide more rapidly than normal cells do. The abnormal cells continue living, when other cells would die.

The accumulating abnormal cells form a tumor that can grow to invade nearby tissue. In time, some abnormal cells can break away and spread (metastasize) to other parts of the body.

DIAGNOSIS 

Testing healthy men with no symptoms for prostate cancer is controversial. There is some disagreement among medical organizations whether the benefits of testing outweigh the potential risks.

• Screening test for prostate cancer
• Digital rectal exam
• Prostate – specific antigen
• Ultrasound
• Magnetic resonance imaging (MRI)
• Collecting a sample of prostate tissue
• Gleason score
• Genomic testing
• Positron emission tomography scan (PET)

 

TREATMENT 

Your prostate cancer treatment options depend on several factors, such as how fast your cancer is growing, whether it has spread and your overall health, as well as the potential benefits or side effects of the treatment.

Following are some treatment methods that can be used to treat it :

Surgery to remove the prostate

• Making several small incisions in the patient’s abdomen
• Making one long incision in the patient’s abdomen

Radiation therapy

• Radiation that comes from outside of the patient’s body (external beam radiation)
• Radiation placed inside the patient’s body (brachytherapy)

Freezing or heating prostate tissue

Hormone therapy

• Medications that stop your body from producing testosterone
• Medications that block testosterone from reaching cancer cells
• Surgery to remove the testicles (orchiectomy)

Chemotherapy

Immunotherapy

• Engineering the patient’s cells to fight cancer
• Helping the immune system cells to identify cancer cells

Targeted drug therapy