How Well Do You Understand Prostate Cancer?


September brings with it back to school, pumpkin spice and Prostate Cancer Awareness Month. While the odds are good that you know someone who has been affected by prostate cancer, you may not know the facts. Learn the hereditary factors, treatment methods and some possible preventative measures.

What is prostate cancer? The prostate gland is found only in men. It is located below the bladder and in front of the rectum. The urethra, a tube that carries urine, goes through the middle of the prostate. The function of the prostate is to produce semen which provides nutrition and protection to sperm.

What are the types of prostate cancer? Most prostate cancers (90%) are acinar adenocarcinoma, when the cancer is in the prostate gland cells. There are also other types of adenocarcinoma such as atrophic, foamy, colloid and signet ring carcinoma. The other 10% of prostate cancers include ductal adenocarcinoma, transitional cell (or urothelial) cancer, squamous cell cancer, carcinoid, small cell cancer, and sarcomas and sarcomatoid cancers.

How prevalent is prostate cancer? Who is affected? Prostate cancer is the second most common cancer in men, behind skin cancer. It is also the second leading cause of cancer death, behind lung cancer. The American Cancer Society’s estimates for prostate cancer in 2015 in the United States are approximately 220,800 new cases and 27,540 deaths from prostate cancer. One in 7 men are diagnosed with prostate cancer and 1 in 38 men will die of prostate cancer. The risk for prostate cancer increases with age. Under 40 years old, 1 in 10,000 will be diagnosed. This number spikes to 1 in 38 for ages between 40 and 59, and dramatically increase to 1 in 14 for ages 60 to 69. Over 2 million US men are prostate cancer survivors.

What causes prostate cancer? The exact cause of prostate cancer is unknown. What we do know is that changes in the DNA can cause mutations in prostate tissue, and these mutations can cause prostate cancer. Most of these mutations are somatic, meaning that they are found only in the tumor tissue, and not the other cells of the body. Other mutations, called germline mutations, are hereditary and are often inherited from parents. The mutations involved in prostate cancer include RNASEL (formerly HPC1), BRCA1, BRCA2, and DNA mismatch repair genes (such as MSH2 and MLH1).

Can patients prevent prostate cancer? Because the cause of prostate cancer is unknown, many cases of prostate cancer cannot be prevented. However there are a few preventative measures men can exercise to possibly lower their risk. These include: maintaining a healthy weight, exercising and eating at least 2½ cups of a wide variety of vegetables and fruits daily. Some studies support taking minerals and vitamins for risk reduction, or medications like 5-alpha reductase inhibitors such as Finasteride (Proscar®) and Dutasteride (Avodart®), aspirin and or drugs.

How do patients get diagnosed? Screening with a prostate-specific antigen (PSA) blood test and or a digital rectal exam (DRE) is how most men’s prostate cancers are found. Detection can also occur through transrectal ultrasound (TRUS), needle biopsy of a lump or hardening in the prostate, MRIs, and trans perineal template biopsy or targeted biopsy.

What is the treatment for prostate cancer? Treatment options include expectant management (watchful waiting) or active surveillance, surgery, radiation therapy, cryosurgery (cryotherapy), hormone therapy, chemotherapy, vaccine treatment and bone-directed treatment. Factors considered when choosing a treatment plan include: age and expected lifespan, other health conditions, stage and grade of cancer, side effects of the treatment and predictive outcome of treatment.

More resources: American Cancer Society Cancer Research UK Prostate Cancer Foundation

Photo by Antony Stanley, via Flick