Prostate Cancer
Introduction
Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part
of the body can become cancer cells and can spread to other areas of the body. In most
developing countries, prostate cancer is the second most leading cause of death in men
[1]. Prostate cancer begins when cells in the prostate gland start to grow uncontrollably
(malignant). The prostate is the walnut-sized gland in men reproductive system, located
just below the bladder and in front of the rectum, surrounding the urethra – the tube that
carries urine out of the bladder. Prostate cancer is the most common type of cancer found
in men in the United State, aside from skin cancer, and often begins without symptoms.
In 2018, the American Cancer Society estimates that 164,690 men will be newly
diagnosed with prostate cancer, 29,430 will die from the disease and 1 in every 9 men
will be diagnosed with prostate cancer during their lifetimes. Prostate cancer can be slow
growing, such that many men die of other diseases before prostate cancer causes
significant problems. However, many prostate cancers are more aggressive and can
spread outside the confines of the prostate gland, which can be deadly, figure 1 illustrates
the normal prostate gland and a prostate with a tumor. The prostate cancer survival rate
is greatly improved with early detection and personalized treatment [2].
Figure 1 Normal and a Tumor Prostate Gland
1
Prostate Cancer Effects
Prostate cancer affects the prostate gland, the gland that produces some of the fluid in
semen and plays a role in urine control and involved in regulating bladder control. If
symptoms appear, they include problems with urination, for example, frequent urges to
urinate especially at nighttime, difficulty in commencing and maintaining urination,
blood in the urine, painful urination and less commonly ejaculation. If prostate cancer
reaches on its advanced stage then it can affect a person in such a way that he will feel
pain in his bones, often in the spine, femur, pelvis, or ribs, and it causes bone fractures.
If cancer spreads to the spine and compresses the spinal cord then there may be a leg
weakness, urinary and fecal incontinence found in the men. As the prostate is directly
involved with sexual reproduction, removing it affects semen production and fertility [3].
Development of Prostate Cancer Cells
Prostate cancer is comprised nearly always of adenocarcinoma cells, cells that arise from
glandular tissue. Cancer cells are named according to the organ in which they originate
no matter where in the body we find such cells. Thus, if prostate cancer cells spread in
the body to the bones, it is not then called bone cancer. It is prostate cancer metastatic to
the bones. Metastasis is the process of cancer spread through the blood or lymphatic
system to other organs/areas throughout the body [4]. Prostate cancer more commonly
metastasizes to lymph nodes in the pelvis and to the bones. The exact causes of prostate
cancer are not known. Several risk factors for developing prostate cancer have been
identified, but which of these risk factors cause a prostate cell to become cancerous is not
fully known. For cancer to develop, changes must occur in the chemicals that make up
the DNA, which makes up the genes in the cell. The genes control how the cell works,
for example, how quickly the cell grows, divides into new cells, and dies, as well as
correcting any mistakes that occur in the DNA of the cell to keep the cell working
normally. Cancer occurs when certain genes that either control the growth or death of the
cell are affected, which results in abnormal cell growth and/or death [5]. Genes are
inherited (passed on from parents to their children) and thus some changes in the genes
(gene mutations) that increase the risk of developing cancer may be inherited. For
prostate cancer, approximately 5%-10% of prostate cancers are due to inherited gene
changes. Gene changes may also be acquired (develop during your life). These changes
are not passed on to children. Such changes may occur when a cell normally undergoes
growth and division. It is thought that at times during normal cell growth, risk factors
may affect the DNA of the cell.
Symptoms of Prostate Cancer in Patients
Unfortunately, there are not any early warning signs of prostate cancer. The growing
tumor does not push against anything to cause pain, so for many years, the disease may
be silent. A person can get only early symptoms if cancer grows near the tube from where
he can urinate through called urethra and presses against it, changing the way of
urination. Patients in prostate cancer will face an unexplained weight loss, fatigue,
swelling in legs and pelvic area [6]. The symptoms of prostate cancer often differ from
patient to patient. The most common first sign of recurrent prostate cancer is a rise in the
prostate-specific antigen (PSA) level in the blood. The prostate gland produces PSA, a
2
protein that at an elevated level may be a sign of prostate cancer. A high PSA reading
also may indicate noncancerous conditions such as inflammation of the prostate
(prostatitis) and enlargement of the prostate (benign prostatic hyperplasia).
Conclusion
Prostate cancer is a unique and controversial disease, the global burden of this disease is
rising. Lifestyle modifications like smoking cessation, exercise and weight control offer
opportunities to decrease the risk of developing prostate cancer [7]. There are several
tests available to diagnose prostate cancer, prostate-specific test, a digital rectal
examination which includes MRI scan, when the PSA test or DRE shows an abnormality,
a biopsy is often the next step [8]. Incidence rates of prostate cancer vary more than 25-
fold between different parts of the world, with the highest rates in Australia, New
Zealand, Northern, and Western Europe and North America.
3
REFERENCES
[1] Rodney, S., Shah, T., Patel, H. and Arya, M. (2014). Key papers in prostate
cancer. Expert Review of Anticancer Therapy, 14(11), pp.1379-1384.
[2] Martínez-Bosch, N., Rodriguez-Vida, A., Juanpere, N., Lloreta, J., Rovira, A.,
Albanell, J., Bellmunt, J. and Navarro, P. (2019). Galectins in prostate and
bladder cancer: tumorigenic roles and clinical opportunities. Nature Reviews
Urology.
[3] Fleming, M., Ravula, S., Tatishchev, S. F., & Wang, H. L. (2012). Colorectal
carcinoma: Pathologic aspects. Journal of gastrointestinal oncology, 3(3), 153–
173. doi:10.3978/j.issn.2078-6891.2012.030
[4] Cooper, G. (2000). The Cell: A Molecular Approach. 2nd ed. Sunderland (MA):
Sinauer Associates.
[5] Kannan, A., Kirkman, M., Ruseckaite, R. and Evans, S. (2019). Prostate care
and prostate cancer from the perspectives of undiagnosed men: a systematic
review of qualitative research. BMJ Open, 9(1), p.e022842.
[6] Mazhar, D. and Waxman, J. (2002). Prostate cancer. Postgraduate Medical
Journal, 78(924), pp.590-595.
[7] Cuzick, J., Thorat, M. A., Andriole, G., Brawley, O. W., Brown, P. H., Culig,
Z., … Wolk, A. (2014). Prevention and early detection of prostate cancer. The
Lancet. Oncology, 15(11), e484–e492. doi:10.1016/S1470-2045(14)70211-6
[8] Castillejos-Molina, R. and Gabilondo-Navarro, F. (2016). Prostate
cancer. Salud Pública de México, 58(2), pp.279-284.
