Prostate cancer is a disease which only affects men. Cancer begins to grow in the prostate - a gland in the male reproductive system.
The word "prostate" comes from Medieval Latin prostate and Medieval French prostate. The ancient Greek word prostatesmeans "one standing in front", from proistanai meaning "set before". The prostate is so called because of its position - it is at the base of the bladder.What is the prostate?The prostate is an exocrine gland of the male reproductive system, and exists directly under the bladder, in front of the rectum. An exocrine gland is one whose secretions end up outside the body e.g. prostate gland and sweat glands. It is approximately the size of a walnut.
The urethra - a tube that goes from the bladder to the end of the penis and carries urine and semen out of the body - goes through the prostate.
There are thousands of tiny glands in the prostate - they all produce a fluid that forms part of the semen. This fluid also protects and nourishes the sperm. When a male has an orgasm the seminal-vesicles secrete a milky liquid in which the semen travels. The liquid is produced in the prostate gland, while the sperm is kept and produced in the testicles. When a male climaxes (has an orgasm) contractions force the prostate to secrete this fluid into the urethra and leave the body through the penis.
As the urethra goes through the prostate: the prostate gland is also involved in urine control (continence) with the use of prostate muscle fibers. These muscle fibers in the prostate contract and release, controlling the flow of urine flowing through the urethra.
owing they had prostate cancer - it is only when an autopsy is done that doctors know it was there. Several studies have indicated that perhaps about 80% of all men in their eighties had prostate cancer when they died, but nobody knew, not even the doctor.
Experts say that prostate cancer starts with tiny alterations in the shape and size of the prostate gland cells - Prostatic intraepithelial neoplasia (PIN). Prostatic intraepithelial neoplasia means "dysplastic changes involving glands and ducts of the prostate that may be a precursor of adenocarcinoma; low grade (PIN 1), mild dysplasia with cell crowding, variation in nuclear size and shape, and irregular cell spacing; high grade (PIN 2 and 3), moderate to severe dysplasia with cell crowding, nucleomegaly and nucleolomegaly, and irregular cell spacing."
Doctors say that nearly 50% of all 50-year-old men have PIN. The cells are still in place - they do not seem to have moved elsewhere - but the changes can be seen under a microscope. Cancer cells would have moved into other parts of the prostate. Doctors describe these prostate gland cell changes as low-grade or high-grade; high grade is abnormal while low-grade is more-or-less normal.
Any patient who was found to have high-grade PIN after a prostate biopsy is at a significantly greater risk of having cancer cells in his prostate. Because of this, doctors will monitor him carefully and possibly carry out another biopsy later on.
What are the symptoms of prostate cancer?During the early stages of prostate cancer there are usually no symptoms. Most men at this stage find out they have prostate cancer after a routine check up or blood test. When symptoms do exist, they are usually one or more of the following:
- The patient urinates more often
- The patient gets up at night more often to urinate
- He may find it hard to start urinating
- He may find it hard to keep urinating once he has started
- There may be blood in the urine
- Urination might be painful
- Ejaculation may be painful (less common)
- Achieving or maintaining an erection may be difficult (less common)
- Bone pain, often in the spine (vertebrae), pelvis, or ribs
- The proximal part of the femur can be painful
- Leg weakness (if cancer has spread to the spine and compressed the spinal cord)
- Urinary incontinence (if cancer has spread to the spine and compressed the spinal cord)
- Fecal incontinence (if cancer has spread to the spine and compressed the spinal cord)
Age is considered as the primary risk factor. The older a man is, the higher is his risk. Prostate cancer is rare among men under the age of 45, but much more common after the age of 50.
Statistics indicate that genetics is definitely a factor in prostate cancer risk. It is more common among certain racial groups - in the USA prostate cancer is significantly more common and also more deadly among Afro-Americans than White-Americans. A man has a much higher risk of developing cancer if his identical twin has it. A man whose brother or father had/had prostate cancer runs twice the risk of developing it, compared to other men.
Studies indicate that the two faulty genes - BRCA 1 and BRCA 2 - which are important risk factors for breast cancer and ovarian cancer, have also been implicated in prostate cancer risk.
In a study scientists found seven new sites in the human genome that are linked to men's risk of developing prostate cancer.
Faulty BRCA2 gene linked to aggressive form of prostate cancer - researchers at the The Institute of Cancer Research, UK, reported in the Journal of Clinical Oncology (April 2013 issue) that men who have inherited the faulty BRCA2 gene are more likely to have the faster-spreading type of prostate cancer. The scientists say these men should receive treatment immediately after diagnosis with surgery or radiation therapy, rather than receive the "watchful waiting" approach.
Senior author Ros Eeles wrote that experts have already known that those with the faulty BRCA2 gene have a higher risk of developing prostate cancer. This is the first large study to demonstrate that the faulty gene is also linked to a faster spread of the disease and poorer survival.
This new discovery will make some health authorities around the world rethink their policies and procedures. In the United Kingdom, the National Health Service offers the same prostate cancer treatment for both carriers and non-carriers of the faulty BRCA2 gene.
Prof. Eeles said "It must make sense to start offering affected men immediate surgery or radiotherapy, even for early-stage cases that would otherwise be classified as low-risk. We won't be able to tell for certain that earlier treatment can benefit men with inherited cancer genes until we've tested it in a clinical trial, but the hope is that our study will ultimately save lives by directing treatment at those who most need it."
A review of diets indicated that the Mediterranean diet may reduce a person's chances of developing prostate cancer. A diet high in vegetable consumption was found to be beneficial.
A US pilot study on men with low risk prostate cancer found that following an intensive healthy diet and lifestyle regime focusing on low meat and high vegetable and fruit intake, regular exercise, yoga stretching, meditation and support group participation, can alter the way that genes behave and change the progress of cancer, for instance by switching on tumor killers and turning down tumor promoters.
Other studies have indicated that lack of vitamin D, a diet high in red meat may raise a person's chances of developing prostate cancer.
Some studies say there might be a link between the daily use of anti-inflammatory medicines and prostate cancer risk. A study found that statins, which are used to lower cholesterol levels, may lower a person's risk of developing prostate cancer.
A study found a clear link between obesity and raised prostate cancer risk, as well as a higher risk of metastasis and death among obese people who develop prostate cancer.
- Sexually transmitted diseases (STDs)
Men who have had gonorrhea have a higher chance of developing prostate cancer, according to research from the University of Michigan Health System.
- Agent Orange
Veterans exposed to Agent Orange have a 48% higher risk of prostate cancer recurrence following surgery than their unexposed peers, and when the disease comes back, it seems more aggressive, researchers say. Another study found that Vietnam War veterans who had been exposed to Agent Orange have significantly increased risks of prostate cancer and even greater risks of getting the most aggressive form of the disease as compared to those who were not exposed.
- Enzyme PRSS3 linked to aggressive prostate cancer
Scientists from the Mayo Clinic, Florida, reported in Molecular Cancer Research that PRSS3, an enzyme, changes the environment of prostate cancer cells, making the cancer much more likely to metastasize.
Senior researcher, Evette Radisky, Ph.D., said "This molecule is a protease, which means it digests other molecules. Our data suggests PRSS3 activity changes the environment around prostate cancer cells - perhaps by freeing them from surrounding tissue - to promote malignancy and invasiveness. I don't think PRSS3 is the only factor involved in driving aggressive prostate cancer, but it may be significant for a certain subset of this cancer - the kind that is potentially lethal."
Scientists tested turmeric, also known as curcumin, along with phenethyl isothiocyanate (PEITC), a naturally occurring substance in certain vegetables such as watercress, cabbage, winter cress, broccoli, brussels sprouts, kale, cauliflower, kohlrabi and turnips.
They say that in experiments in laboratory mice, PEITC and curcumin, alone or in combination, showed significant cancer-preventive qualities.
The combination of the two could be effective in treating established prostate cancers.
It is estimated that Prostate cancer is the second leading cause of cancer death in men in the United States, with a half-million new cases appearing each year.
The incidence and mortality of prostate cancer has not decreased in the last decade despite tremendous efforts and resources devoted to treatment because advanced prostate cancer cells are unresponsive to even high concentrations of chemotherapy or radiotherapy.
In contrast to the high incidence of prostate cancer in the United States, the incidence of the disease is very low in India.
This has been attributed to the high consumption of plant-based foods rich in phytochemicals which have protective or disease-preventive properties.