3d rendered medically accurate illustration of prostate cancer

Author’s Bio: Dharshini Senthilkumar is an incoming college freshman majoring in biology. She is interested in the medical sciences and hopes to provide awareness on serious medical conditions.

Prostate cancer is a type of cancer that begins in the prostate. The prostate is below the bladder, in front of the rectum, and found only in the male reproductive system. This gland is partly responsible for the production of fluid that is part of the semen.

Most prostate cancers are adenocarcinomas.

Other types of cancers of the prostate include:
  • Small cell carcinomas
  • Neuroendocrine tumors
  • Transitional cell carcinomas
  • Sarcomas

Some prostate cancers develop and spread quickly, but generally, they grow slowly.
There is not an identified cause, but there are a few researched risk factors that are still being learnt about. Prostate cancer occurs due to a change in the DNA of a normal prostate cell. Cancer can be caused by the mutations in DNA that keep oncogenes (genes that help cells grow, divide, and survive) turned on. It can also be caused by the DNA mutation that turns off tumor suppressor genes (genes that keep cell growth under control, repair mistakes, or cause cell death). These types of mutations can lead to out-of-control cell growth.

These gene mutations may be passed from generation to generation in 10% of the time in prostate cancer cases. This type of cancer is called hereditary cancer, and there are a several inherited mutations that have been linked to prostate cancer.

There are also genes that mutate during someone’s lifetime. These changes are called acquired mutations and will only be found in cells that come from the original mutated cell. During cell division, DNA is replicated, but the process is not always perfect. The quicker the prostate cells grow and divide, the more likely mutations will occur.

High levels of androgens might contribute to prostate cancer risk in some men because these hormones promote prostate cell growth. Another risk factor is having high levels of the hormone  insulin growth factor-1 (IGF-1). Inflammation in the prostate may also be linked to prostate cancer. And lastly, exposure to radiation or cancer-causing chemicals can lead to DNA mutations, but research has not shown this to be as important of a cause in mutations in prostate cells.

All men are at risk for prostate cancer. The most common risk factor is age- the older the man is, the higher his risk for developing prostate cancer. Men that are at an increased risk include African-American men or those that have a family history of prostate cancer.

Different people get different symptoms, and some men have no symptoms at all. Some important signs to see your doctor about immediately include:

  • Difficulty urinating
  • Frequent urination
  • Weak or interrupted flow of urine
  • Pain or burning during urination
  • Blood in urine or semen
  • Painful ejaculation
  • Pain in the back, hips, or pelvis

These symptoms may have other conditions causing them, so do not immediately get worried. However, it is just important to be informed.
Screening tests are used to look for possible signs of prostate cancer, but these tests cannot tell you if you have cancer or not. If test results are abnormal, you will have to take a prostate biopsy to know for sure if you have cancer.

One type of screening is called the Prostate-specific Antigen Blood Test. There is a protein made by prostate cells which is found in semen and in small amounts in the blood. This protein is a prostate-specific antigen. The chance of having prostate cancer increases as PSA level increases. Although there is no set cutoff point that can determine whether a man has prostate cancer or not, at a PSA level of 4-10, there is about a 1 in 4 chance of having prostate cancer.

Another screening method is a digital rectal exam (DRE) where a doctor inserts a gloved, lubricated finger into the rectum to feel for bumps or hard sections that could be cancer. This method is less effective in comparison to PSA blood tests but can help detect cancer in men with normal PSA levels.

Getting a biopsy test would be the best option for most men with high PSA levels because when a sample is taken from the body and examined under a microscope, you get a definite answer whether cancer is present or not. This test can also tell how likely the cancer will grow and spread.

There are various treatment plans that your doctor and you will pick between for the best results.

  • Active surveillance- monitoring the prostate cancer through PSA blood tests, DRE tests, and biopsies regularly and further action ill only occur if it grows and causes symptoms.
  • Surgery- prostatectomy is an operation where the prostate is removed (surrounding tissue may also be removed).
  • Radiation therapy- high energy rays like X-rays are used to kill the cancer
    • External radiation therapy- machine on the outside directs the radiation at the cancer cells
    • Internal radiation therapy- radioactive seeds are surgically placed into or near the cancer to destroy those cells.
  • Cryotherapy- a special probe is placed inside or near the prostate to freeze and kill the cancer cells
  • Chemotherapy- special drugs are used to shrink or kill the cancer. These drugs can come in the form of pills or medicines that are administered through the veins
  • Biological therapy- works with immune system to help fight the cancer and helps control side effects from other treatments.
  • High-intensity focused ultrasound- high-energy sound waves are directed at the cancer to kill cancer cells
  • Hormone therapy- blocks cancer cells from getting hormones that may allow them to grow
  • 5-alpha reductase inhibitors- drugs like finasteride and dutasteride block the 5-alpha reductase enzyme from making dihydrotestosterone which is the main hormone that causes prostate to grow. These drugs are used to treat a benign growth on the prostate and have been studied to show that usage helps reduce the risk of developing prostate cancer.

There is no specific way to prevent prostate cancer due to many risk factors being uncontrollable like age; however, there are precautions that can be taken to lower your risk.

  • Get to and stay at a healthy weight
  • Stay physically active
  • Follow an eating pattern that is healthy- include veggies, fruits, and whole grains; avoid or limit red meat, processed foods, and sugary drinks.

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