PROSTATE CANCER

The prostate gland is a small organ found below the bladder of the male
reproductive system. It surrounds a part of the urethra called prostrate urethra.
About the size of a walnut, it is accessory glandular or which secretes the whitish
prostatic fluid which is one of the components of human semen.

Cancer of the prostate gland is one of the most common cancers in the middle aged
men. It normally affects men above 65years. The cancer cells may grow slowly
initially or even rapidly depending on the type. Cancers of the prostate are normally
Adenocarcinomas (cancers of glandular epithelial cells; cells that the surfaces of
glands).

WHAT IS PROSTATE CANCER?

This happens when cells in the prostate grow abnormally and spread to other organs.
This abnormal growth of cells normally begins in the peripheral zone of the prostate
gland. This zone is at the posterior up of large amount of glandular tissues.

TYPES OF PROSTATE CANCER

For effect management of prostate cancer it is important to know the types. These
types may be first growing (aggressive) or slow growing (non-aggressive). The type of
cancer is mostly based on the original cell the cancer begins from.

1. Acinar Adenocarcinoma: The malignant glandular epithelial cells of the

prostate grow into sac like structure called acinus. The epithelial cells in the
cancer are either cuboidal or columnar in shape. This is the most common
type of prostate cancers known.
2. Ductal Adenocarcinoma: The cancer cells originate from the cells lining the
ducts of the gland. The growth rate and metastasis is higher than acinus
adenocarcinoma.
3. Transitional Cell Carcinoma: The cancerous cells in this type arise from the
transitional epithelial cells. The cancer mostly begins from the bladder and
invades the prostates. Although rate, the cancer may begin from the prostate
and spread to the urethra and bladder.
4. Squamous Cell Carcinoma of Prostate: The cancer cells originate from
squamous epithelial cells covering the prostate gland. These cells grow
 quicker and spread faster. They are more aggressive than the
adenocarcinomas.
5. Small Cell Carcinoma of the Prostate: The cells in this type of cancer are
undifferentiated cells (have not taken final form) and are highly malignant.
The cells are small and have little to no cytoplasm. The cells contain small
secretory granules which produce hormone.
This type of cancer is also known as neuroendocrine cancer. This means that
the cells in this cancer have influence from the nervous system, which
stimulates them to produce hormones. This cancer type is not very common.

CAUSES OF PROSTATE CANCER

Although the exact cause of prostatic malignancy is not clear, it is known that
mutations on genes that regulate cell growth in the prostate cause this disease.
These mutations may be:

 Spontaneous Mutations: Inherited genetic mutations or acquired in

intrauterine (in the uterus) life. These mutations are congenital (present at
birth).
 Induced Mutations: Acquired mutations which occur after birth, as result of
environmental factors.

PATHOPHYSIOLOGY

The mutations of genes found in the prostate gland cells, lead to the abnormal
growth of the cells. Most of the abnormal cells are epithelial in organ and they form
precancerous lesions. This is called carcinoma in situ. These cells are localised and
stay in their place of origin.

The precancerous lesions continue to grow bigger and invade neighbouring tissues
and organs. The abnormal cells grow and begin to speed through lymphatic vessels
and blood to distant organs. The ability of the cells to invade or spread is what makes
them cancerous.
 RISK FACTORS

 Old age
 Family history of prostate cancer: If there are males diagnosed of prostate
cancer in your family.
 Obesity: There is a link between unhealthy life-styles, being overweight and
prostate cancer.
 Known Genetic Changes: Mutations in tumour suppressor gene
BRCA1/BRCA2.
 Neglect of personal hygiene.

SIGNS AND SYMTOMS

Prostate cancer in its early stages may not show any clear clinical manifestations, if
they do however, the early signs are urine related symptoms.

 Difficult urination
 Reduced force in the stream of urine
 Blood in urine
 Blood in semen
 Erectile dysfunction
 Pain in the pelvic region and back
 Numbness in the pelvic region and back

PROGNOSIS

The outcome of the prostate cancer is not always death. Early detection by prostate
biopsy can help reduce the death of prostate cancer patients. Prostate cancers which
non-metastatic at the time of diagnosis have 5 year patient survival rate of 100%.
Metastatic cancer have 5 year survival rate of 29%.

There are clear makers of outcome of patients under therapy.

 Stage of cancer
 Levels of Prostate Specific Antigen (PSA) before therapy began
 Gleason sore
Decrease levels of PSA to normal range after hormonal therapy depict great
prognosis. Similarly, the prognosis is very bad for patients with a higher grade or
stage of cancer.

DIAGNOSIS

 Screening test
 Digital Rectal Exam (DRE)
 Test for Prostate Specific Antigens (PSA)
 Trans rectal Ultrasonography (TRUS)
 Prostate Biopsy

PREVENTION AND MANAGEMENT

 Regular check-ups in every six(6) months or yearly.

 Dietary management: Eating fruit and vegetables will help reduce the risk of
prostate cancer
 Regular Exercise: Working out reduces cancer risk by reducing body weight.
 Medication for high risk men to prevent prostate cancer: These drugs are 5-
Alpha Reductase Inhibitors and work by preventing conversion of testosterone
to dihydrotestosterone (DHT), by inhabiting the enzyme 5-Alpha reductase.
The absence of DHT prevents prostate enlargement.
 Personal hygiene and early treatment of Urinary Tract Infection (UTI).

TREATMENT

 Patients with asymptomatic low grade cancers undergo regular check-ups,

examination and monitoring without any active treatment therapies. This is
called Active Surveillance.
 Radiation therapy: High energy electromagnetic waves are used to kill
cancerous cells.
 Hormone therapy: Drugs are given to prevent production of testosterone
from reaching cancerous cells. This starves cancerous cells, reducing their
growth rate and resulting in their death. Some of the drugs include:
 Testosterone production inhibitors example Histrelin and Triptorelin
 Androgen Receptors blockers example Flutamide, Nilutamide
 Surgery
 Removal of the prostate gland. (prostatectomy)
 Removal of both testes to prevent the production of testosterone
(bilateral orchiectomy)
 Freezing of cancer cells to kill them (cryosurgery)
 Immunotherapy: Boosting the body’s immune system to help it kill cancer
cells. It is also called biological therapy.
 Chemotherapy: Use of drugs to kill cancer cells.

THANK YOU

BRO BISMARK [0543678262]