Prostate cancer is cancer that occurs in the prostate gland. The prostate gland is a small, walnut-shaped gland in men. It produces the seminal fluid that helps in the transportation and nourishment of the sperm, which helps in conceiving and pregnancy.
Types: The different types of prostate cancers depending on the type of cells affected, include-
1. Adenocarcinomas: Almost all types of prostate cancers are adenocarcinomas. They are generally cancerous (malignant) in nature and start in the cells of the glands that make secretions.
2. Small cell carcinomas: It is a rare kind of malignancy that may be life-threatening.
3. Neuroendocrine tumors: It is an aggressive type of cancer, which may be seen rarely.
4. Transitional cell carcinomas: It is a type of prostate cancer that is of urothelial origin (starting in the urethra, from where urine exits the body) and involves the prostate tissue.
5. Sarcomas: It is a rare type of malignant tumor.
Causes: The exact cause of prostate cancer is not known. Prostate cancer occurs when the cells in the prostate gland develop mutations (changes) in their DNA. These changes cause the growth and multiplication of the abnormal cells. The accumulating abnormal cells lead to the formation of a tumor. The tumor can grow and invade the nearby tissue. These abnormal cells may metastasize (spread) to the other parts of the body.
Risks factors: The following factors may increase the risk of developing prostate cancer:
In the early stages of prostate cancer, no symptoms are normally seen.
In advanced cases of prostate cancer, the following symptoms may be seen:
Prostate screening is the most effective way of diagnosing prostate cancer. The first prostate screening is usually done at the age of 55. The screening is generally stopped after the age of 70 but may have to be continued in some circumstances.
The various screening tests for prostate cancer are:
1. Digital rectal exam: The doctor inserts a lubricated, gloved finger into the rectum to feel the prostate gland, which is in front of the rectum. The presence of hard areas or bumps could indicate cancer.
2. Prostate-specific antigen (PSA) blood test: A protein called PSA is made by the prostate gland. An increase in the levels of PSA could indicate cancer.
3. Biopsy: The doctor removes a sample of the tissue and sends it to the laboratory to check for the presence of cancer cells.
4. Transrectal ultrasound: A small probe is inserted into the rectum. Sound waves are used to create a clear image of the prostate gland.
5. Magnetic resonance imaging (MRI) scan: The doctor may sometimes advise an MRI-guided biopsy. The MRI helps the doctor to get a more detailed image of the prostate gland to help in the removal of the samples of the prostate tissue.
The type of treatment done for prostate cancer depends on the stage of cancer, how fast it is growing, whether it has spread to the other parts of the body, and the overall health of the patient.
1. Active surveillance: The doctor advises scans, screenings, and biopsies every one to three years to monitor the growth of cancer. This is usually done in cases of cancer restricted to the prostate gland, not causing any symptoms, and is growing slowly.
2. Watchful waiting: This is done in the case of frail and old patients. The testing is less frequent than active surveillance and focuses on the management of the symptoms.
3. Internal radiation therapy or brachytherapy: Radioactive seeds are placed within the prostate to kill the cancer cells. This helps in the preservation of the surrounding healthy tissue.
4. External beam radiation therapy: A machine delivers high-powered energy beams directly to the tumor and kills the cancer cells.
5. Chemotherapy: A group of drugs is used to kill the cancer cells in this procedure.
6. Targeted therapy: Certain medications target specific weaknesses of the cancer cells, and help in destroying the cancer cells in this therapy.
7. Androgen deprivation hormone therapy: A therapy to decrease the androgen (male sex hormone) levels that are made in the testis.
8. Focal therapy: This type of treatment includes the treatment of only that area of the prostate which is affected by cancer. It is performed when cancer has not spread to the other parts of the body. The different types of treatments under focal therapy include:
9. Cryotherapy: Use of extreme cold for freezing the cancer cells.
10. Laser ablation: A laser beam is used to kill the cancer cells.
11. Photodynamic therapy: A light-sensitive medicine and a light source are used for killing the cancer cells.
12. High-intensity focused ultrasound (HIFU): Ultrasonic waves are used to heat and remove tissue growth.
13. Prostatectomy: It is a surgical procedure done for the removal of the diseased prostate gland by making small abdominal (stomach) incisions. The different types include:
14. Laparoscopic prostatectomy: Surgical tools are inserted for the removal of the prostate gland by using a laparoscope, which is a lighted instrument with a camera on one end.
15. Robotic radical prostatectomy: The surgeon controls a robotic system of surgical tools from outside the body.
16. Open radical prostatectomy: a larger abdominal incision is made to remove cancer.
The risks of prostate cancer treatment include:
In most cases, prevention of prostate cancer is not possible. However, one can reduce the risk of developing prostate cancer by: