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Prostate Cancer

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Overview

Prostate gland is present only in males and it is present below the bladder. It is responsible for secretion of a fluid that protects the sperms [1] . According to the Globocan 2018 report, the incidence rate of prostate cancer was reported to be 4.5% in men. There were 19,676 cases of death reported from prostate cancer in 2018. The 5-year prevalence rate was found to be 6.8% in 2018, India.

Types of Prostate Cancer

Acinar adenocarcinoma

This type of prostate cancer starts developing in the cells lining the ducts of the prostate gland. This is the most common form of prostate cancer.

Ductal adenocarcinoma

It starts spreading from the cells lining the prostate gland tubes. It spreads much faster than acinar adenocarcinoma.

Transitional cell cancer

This prostate cancer develops in the cells lining the tube carrying urine to the urethra. It starts from the bladder and spreads into the prostate.

Squamous cell cancer

This prostate cancer develops from the flat cells covering the prostate. This type of cancer usually spreads at a faster rate than acinar adenocarcinoma.

Small cell prostate cancer

It is a type of neuroendocrine cancer and it is made up of small round cells.

Causes

BRCA1 and BRCA2: Mutation in these genes is associated with a increased risk of developing prostate cancer.

HOXB13: Mutation of this gene is rare and is linked to early-onset prostate cancer.

CHEK2, ATM, PALB2, and RAD51D:Mutation in these genes is also associated with hereditary prostate cancers.

RNASEL: This increases the risk of developing prostate cancer as a mutation in this gene leads to the longevity of the abnormal cells.

Mutations in DNA mismatch repair genes (such as MSH2, MSH6, MLH1, and PMS2): There is increased risk of developing prostate cancer if men have any of these genes inherently mutated.

Risk Factors

Age

It is the most common risk factor and the incidence rates are higher in older men above 50 years of age.

Family history

The risk increases if your father or brother had been diagnosed with prostate cancer before 60 years of age. The risk is even higher for men if there are several relatives affected by cancer at a very young age.

Race or Ethnicity

The chances of developing prostate cancer are higher in African- American and African-Caribbean men. Whereas, it is less common in Asian-American men.

Obesity

Some research studies suggest that obese men may be more prone to develop prostate cancer.

Signs & symptoms

Frequent urination, especially during the night

Interruption or weak flow of urine

Difficulty in initiating the flow of urine

Difficulty in completely emptying the bladder

Blood in semen or urine

Irritating sensation or pain while urinating

Diagnosis

Digital rectal exam (DRE)

The doctor inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall for lumps.

Prostate-specific antigen (PSA) test

A test that measures the level of PSA in the blood. PSA is a substance made by the prostate that may be found in higher than normal amounts in the blood of men who have prostate cancer.

Trans-rectal Ultrasound guided biopsy

In this procedure, with the guidance of an ultrasound probe inserted into the rectum prostate biopsy is performed.

Trans-rectal magnetic resonance imaging (MRI)

A transrectal MRI is done to find out if cancer has spread outside the prostate into nearby tissues. A biopsy may be performed under guidance of transrectal MRI.

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