Prostate Cancer: Types, Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Outlook

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Illustration of prostate cancer

Overview

The prostate gland that is shaped like a walnut that is responsible for the production of a fluid called seminal fluid to allow the sperm to move freely.

Prostate cancer is the second leading cause of death in men, the tumor can grow in a slow-paced manner and is usually confined to the prostate. The tumor grows within the layers or tissues of the prostate and can spread to other parts of the body if the cancer cells grow aggressively.

Just like other cancers, the survival rate of the patient having this type of cancer depends on the stage where it is detected.

Types

The most common type of prostate cancer is adenocarcinoma and it is usually found in the glandular cell.

Ductal adenocarcinoma

The abnormal cells are usually found in the lining of the ducts of the prostate gland and it is usually spreading in the nearby tissues rapidly and to the other parts of the body like the bones.

Acinar adenocarcinoma

According to researchers, this is the most common type of prostate cancer and is found exactly in the lining of the prostate gland.

Squamous cell cancer

Squamous cells are flat cells that are found all over the gland and compared to adenocarcinoma, squamous cell cancer spreads faster.

Small cell prostate cancer

This type of cancer is neuroendocrine cancer that is made up of round cells under the microscope.

Transitional cell cancer

This is cancer that starts in the lining of the urethra but in some cases, the cancer cells grow in the prostate gland.

Prostatic sarcomas

About less than 0.1 percent of prostate cancer is in the form of sarcoma. This cells can develop into connective tissues and vessels that cells are originally from the smooth muscles of the prostate gland.  This type cancer can be localized and can also spread to other parts of the body like the urinary bladder and rectum.

Some tumors are pre-cancerous like: 

Prostatic intraepithelial neoplasia

From under the microscope, the structure of the cell is just like a cancer cell but is not able to spread or metastasize, the tumor starts in the early 20’s. Prostatic intraepithelial neoplasia is classified into two types according to the pattern of the cell.

Low-Grade PIN: the structure of the cell looks almost normal.

High-grade PIN: the structure appears like abnormal cells.

Proliferative inflammatory atrophy

Classified as non-cancerous, the proliferative inflammatory atrophy is a small cell that manifests inflammation around the area. The PIA can lead to a High-grade PIN or a cancerous tumor sometimes according to researchers.

Symptoms

In the early stages of prostate cancer, the signs and symptoms are very minimal that the person does not even notice it but when cancer gets into the advanced stage, the symptoms will start showing like:

Difficulty in urinating

The person may experience difficulty in passing out his urine and maintaining the flow during urinating.

Frequency of urination

The feeling the need to urinate frequently is because of the increasing pressure imposed on the bladder by the growing tumor.

Urinary retention

Sometimes the bladder is unable to let the urine pass out completely because of the increasing size of the tumor inside the prostate.

Urinary incontinence

The sudden urination while doing activities like laughing, sneezing and even coughing.

Blood in urine or the semen

The presence of blood in the urine indicates that there is a trauma in the urinary tract system like the urethra or the bladder. Presence of blood in the semen can tell us that the there is an abnormal growth

Erectile dysfunction

The prostate gland is one of the organs in the reproductive system, when the prostate gland has tumors it will affect the function of the reproductive system.

Abnormal rectal examination

One of the ways to determine if there are any abnormal growths in the prostate gland.

Sudden weight loss

Abrupt weight loss can pose a concern for the patient

Fatigue is evident after a simple activity

Even simple activities may seem too tiring and exhausting.

Causes

There is no exact cause for having prostate cancer but the researchers found out that the DNA in the prostate gland changes that causes an abnormal growth of the cells and can spread. The DNA is the one that makes up a gene.

It contains the code on how the human body’s work if there any changes in the DNA, it will reflect on the organs.

Our DNA came from our parents, thus it can be passed down to the future generations, and some inherited genes have been discovered that can increase the risk of developing prostate cancer. The BRCA 1 and BCRA 2, RNASEL, HoxB13 and DNA mismatch genes.

Risk Factors

Some predisposing factors are considered in acquiring prostate cancer like:

Race or Ethnicity

Asian men and Hispanic men are less likely to have prostate cancer than those men who are Jamaican and African-American men.

Family History

Those who have a family member who was diagnosed with prostate cancer will have twice the risk of acquiring same cancer.

Age

Men who are 65 years old and older tend to have a higher risk of having prostate cancer. For those men ages, 40 and below the chances of having prostate cancer is rare.

Nationality

People living in Asia, Africa and Central and South America have fewer cases of prostate cancer than in Europe, Australia, and the Caribbean.

Genetics

DNA mutations can happen and can put the person at a higher risk of developing cancer. BCRA 2 gene is a part of the DNA where is a precursor to having prostate cancer.

Diet

Foods like red meats, low intake of fruits and vegetable and high intake of fats can lead to obesity.

Complications

Having been diagnosed with prostate cancer, there will be complications that will arise like:

Metastasis

The tendency of the cancer cells to spread is very high. It can go to the nearby organs or structures like the urethral tube, the urinary bladder and it can also spread to the bones and that can cause extreme pain and also it puts the bones in a state that it will be fragile and can easily be broken.

Problems in the reproductive system

Functions of the reproductive organs can be affected by cancer and even during treatments like chemotherapy and radiation like erectile dysfunction.

Incontinence

Like the erectile dysfunction, urinary and sometimes bowel incontinence happens because of cancer itself and also the treatments.

Diagnosis

There are screening tests that can be done to determine any abnormalities in the prostate gland like:

Prostate-specific antigen test (PSA)

Prostate-specific antigen is a substance that is produced by the prostate gland. A small blood sample will be obtained to test for the level of PSA in the blood. High levels that are present in the blood indicates a trauma or damage to the gland.

Digital rectal exam (DRE)

During the rectal exam, the doctor will insert a finger into the rectum of the patient to examine the condition of the prostate if there are any lumps or tenderness.

There are also diagnostic tests that are readily available when the doctor is suspecting any abnormality in the gland.

Transrectal ultrasound

A probe, which uses sound waves to see the structure of the organ, will be inserted into the rectum for a better visualization of the prostate gland and to determine if there are any tumors present in the gland.

Prostate biopsy

The doctor will obtain a sample tissue of the prostate gland, and this will be sent and analyze in the laboratory.

Treatment

Active surveillance

If the cancer is at a low-risk prostate cancer stage, active surveillance is recommended by the doctor. Routine check-up and blood tests must be done to see if the cancer is spreading, if it is, some treatments will be available for surgery or chemotherapy.

Surgery

It is done if the cancer is progressing. Radical prostatectomy is done in two ways – with the use of a robot to assist in the procedure or the doctor will make an incision in the abdomen to access the prostate gland.

Chemotherapy

It is the use of a chemical that is introduced into the body through the veins or by oral (pill).

Radiation therapy

Radiation therapy has two options which the patient may choose from, one is by external using a machine or by brachytherapy which uses a small device that is inserted in the prostate tissue and delivers ample amount of radiation to destroy the tissue.

Hormone Therapy

Using drugs that can lower or stop the production of testosterone which the cancer cells use to grow.  Medications that can block the male hormone from getting into the cancer cells can also be an option.

Cryosurgery

An alternate cold and hot gas are introduced into the tissue that has the cancer cells. This will destroy the abnormal cells even the surrounding healthy cells.

Outlook

When the patient is diagnosed with prostate cancer, the outlook depends on the stage of prostate cancer. The survival rate of this type of cancer is at least five years after the diagnosis has been made.

Early stage diagnosis has the highest survival rate of almost 100 percent. The chances would be below 30 percent if cancer metastasized to the different parts of the body like the Metastasis, urinary bladder, and lymph nodes.