Benign prostatic hyperplasia BPH , also called prostate enlargement , is a noncancerous increase in size of the prostate gland. The cause is unclear. Treatment options including lifestyle changes, medications, a number of procedures, and surgery. About million men are affected globally. BPH is the most common cause of lower urinary tract symptoms LUTS , which are divided into storage, voiding , and symptoms which occur after urination.
Prostate cancer that is only present in the prostate is often treated with either surgical removal of the prostate or with radiotherapy or by the insertion of small radioactive particles brachytherapy  Cancer that has spread to other parts of the body is usually treated with hormone therapy, to deprive a tumour of sex hormones androgens that stimulate proliferation. Thyroid cancer Thyroglobulin Medullary thyroid cancer Calcitonin Carcinoembryonic antigen. The American Naturalist. Nature Reviews Urology. The Volume section of that page only Prostate wiki refers to declining volume of semen during subsequent ejaculations. Archived Prostate wiki the original on 6 October These include frequent urination, nocturia increased urination at nightdifficulty starting and maintaining a steady stream of urine, hematuria blood in the urineand dysuria painful urination. We also recognised that there will need Prostate wiki be a prolonged period of consultation as part of the process of acceptance of guidelines by the NHMRC and this will add to the time between the end of the review and the final publication of the guidelines.
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Unsourced material may be Prostaet and removed. Namespaces Page Talk. Views Read Edit View history. Any surgical procedure has risks associated with it. A review found little comparative effectiveness research wi,i on person-centered outcomes for prostate cancer treatments. Hidden categories: All articles with dead external links Articles with dead external links from December Webarchive template wayback links Prostate wiki with dead external links from November CS1 errors: missing periodical CS1 maint: uses editors parameter CS1 maint: BOT: original-url status unknown Use dmy dates from July Articles containing potentially dated statements from All articles containing potentially dated statements All accuracy disputes Articles with disputed statements from February All articles with unsourced statements Articles with unsourced statements from February Articles with unsourced statements from July Articles needing additional references from July All articles needing additional references. Retrieved 4 March Vasectomy Vasectomy reversal Vasovasostomy Vasoepididymostomy. This zone is usually devoid of glandular components and composed only, as its name suggests, of muscle and fibrous tissue. Inflammation of the prostate can cause painful urination or ejaculation, groin pain, difficulty passing urine, or constitutional symptoms. European Radiology. Fraction of Prostate wiki gland Payne lesson model. However, prostate wikk can also be present in the complete absence of Prostate wiki elevated PSA level, in which case siki test result would be a false negative. Archived from the original on September 13, Transscrotal ultrasound.
PSA is a member of the kallikrein -related peptidase family and is secreted by the epithelial cells of the prostate gland.
- PSA is a member of the kallikrein -related peptidase family and is secreted by the epithelial cells of the prostate gland.
- Benign prostatic hyperplasia, better known as prostate enlargement or BPH, is an incredibly common medical problem in which the prostate grows in size.
- This operation is done for benign conditions that cause urinary retention, as well as for prostate cancer and for other cancers of the pelvis.
- The prostate is an exocrine gland of the male reproductive system in most mammals.
- The prostate is a gland of the male body that adds part of the fluid to semen.
- Prostate cancer is the development of cancer in the prostate , a gland in the male reproductive system.
Prostate cancer screening is the screening process used to detect undiagnosed prostate cancer in men without signs or symptoms.
Screening precedes a diagnosis and subsequent treatment. The digital rectal examination DRE is one screening tool, during which the prostate is manually assessed through the wall of the rectum. The second screening tool is the measurement of prostate-specific antigen PSA in the blood. The evidence remains insufficient to determine whether screening with PSA or DRE reduces mortality from prostate cancer.
The American studies were determined to have a high bias. European studies included in this review were of low bias and one reported "a significant reduction in prostate cancer-specific mortality.
DRE was not assessed separately. Guidelines generally recommend that the decision whether or not to screen should be based on shared decision-making ,  so that men are informed of the risks and benefits of screening. In general, they conclude that based on recent research, "it is uncertain whether the benefits associated with PSA testing for prostate cancer screening are worth the harms associated with screening and subsequent unnecessary treatment.
Prostate biopsies are used to diagnose prostate cancer but are not done on asymptomatic men and therefore are not used for screening. Prostate-specific antigen PSA is secreted by the epithelial cells of the prostate gland and can be detected in a sample of blood. Screening with PSA has been associated with a number of harms including over-diagnosis , increased prostate biopsy with associated harms, increased anxiety, and unneeded treatment.
Low-risk prostate cancer does not always require immediate treatment, but may be amenable to active surveillance. During a digital rectal examination DRE , a healthcare provider slides a gloved finger into the rectum and presses on the prostate, to check its size and to detect any lumps on the accessible side. If the examination suggests anomalies, a PSA test is performed. If an elevated PSA level is found, a follow-up test is then performed. A review recommended against primary care screening for prostate cancer with DRE due to the lack of evidence of the effectiveness of the practice.
The American Urological Association in stated that for men aged 55 to 69, they could find no evidence to support the continued use of DRE as a first-line screening test; however, in men referred for an elevated PSA, DRE may be a useful secondary test. Prostate biopsies are considered the gold standard in detecting prostate cancer.
Transrectal ultrasonography TRUS has the advantage of being fast and minimally invasive, and better than MRI for the evaluation of superficial tumor. MRI imaging is used when screening suggests a malignancy. A number of biomarkers for prostate cancer exist. These include: . From population screening to early diagnosis there is a lack of understanding. Publications authored by governmental, non-governmental and medical organizations continue the debate and publish recommendations for screening.
Death rates from prostate cancer have declined at a steady rate since Screening for prostate cancer varies by state and indicates differences in the use of screening for prostate cancer as well as variations between locales. African American men are less likely to receive standard therapy for prostate cancer. This discrepancy may indicate that if they were to receive higher quality cancer treatment their survival rates would be similar to whites.
Prostate cancer is also extremely heterogeneous: many, perhaps most, prostate cancers are indolent and would never progress to a clinically meaningful stage if left undiagnosed and untreated during a man's lifetime. On the other hand, a subset are potentially lethal, and screening can identify some of these within a window of opportunity for cure.
Screening for prostate cancer is controversial because of cost and uncertain long-term benefits to patients. Private medical institutes, such as the Mayo Clinic , likewise acknowledge that "organizations vary in their recommendations about who should — and who shouldn't — get a PSA screening test.
They conclude: "Ultimately, whether you should have a PSA test is something you'll have to decide after discussing it with your doctor, considering your risk factors and weighing your personal preferences. A study in Europe resulted in only a small decline in death rates and concluded that 48 men would need to be treated to save one life. But of the 47 men who were treated, most would be unable to ever again function sexually and would require more frequent trips to the bathroom.
Screening of PSA began in the s. A study published in the European Journal of Cancer October documented that prostate cancer screening reduced prostate cancer mortality by 37 percent. By utilizing a control group of men from Northern Ireland, where PSA screening is infrequent, the research showed this substantial reduction in prostate cancer deaths when compared to men who were PSA tested as part of the ERSPC study.
A study published in the New England Journal of Medicine in found that over a 7 to year period, "screening did not reduce the death rate in men 55 and over.
In February , the American Cancer Society urged "more caution in using the test. From Wikipedia, the free encyclopedia.
Prostate cancer screening Medical diagnostics Purpose Detect prostate cancer when no symptoms are present Prostate cancer screening is the screening process used to detect undiagnosed prostate cancer in men without signs or symptoms. This article incorporates text from this source, which is in the public domain. National Cancer Institute. Retrieved Retrieved 18 February The Journal of Urology. Journal of Clinical Oncology. European Urology. Epidemiology and Infection.
Canadian Medical Association Journal. Is There a Preferred Technique? American Society of Andrology Handbook. San Francisco: American Society of Andrology. International Journal of Molecular Sciences. The Medical Clinics of North America. Seth; Mangione, Carol M. Clinicians should not screen men who do not express a preference for screening.
Seminars in Oncology. September NHS Choices. The Annals of Family Medicine. Epstein JI. Pathology of prostatic neoplasia. Biomedical Engineering and Computational Biology. Radiologic Clinics of North America. Translational Andrology and Urology. This article incorporates text by Nat P. Lenzo, Danielle Meyrick, and J. Current Opinion in Oncology. Canadian Urological Association Journal. Retrieved 2 March Nature Reviews Urology. Reviews in Urology. Analogies to the early lung cancer screening debate".
Retrieved 18 August Biomarkers in Medicine. The New England Journal of Medicine. European Journal of Cancer. University of Bristol Dept. Archived from the original on Transurethral incision of the prostate Prostate biopsy Transrectal biopsy Transurethral biopsy Prostatectomy Transurethral resection of the prostate Radical retropubic prostatectomy Transurethral microwave thermotherapy Transurethral needle ablation of the prostate Brachytherapy Prostate brachytherapy Prostate massage.
Vasectomy Vasectomy reversal Vasovasostomy Vasoepididymostomy. Orchiectomy Castration Orchiopexy. Circumcision Penectomy Penile prosthesis Preputioplasty. Penile plethysmograph Postage stamp test Frenuloplasty of prepuce of penis. Semen analysis. Transscrotal ultrasound. Categories : Male genital surgery Prostatic procedures Cancer screening Prostate cancer Men's health.
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Penis Circumcision Penectomy Penile prosthesis Preputioplasty.
The 5-lipoxygenase 5-LOX pathway is implicated in the development and progression of human cancers. April Sertoli-Leydig cell tumour Sertoli cell tumour Leydig cell tumour. Therefore, many will experience the side effects of treatment, such as for every men screened, 29 will experience erectile dysfunction, 18 will suffer urinary incontinence, 2 will have serious cardiovascular events, one will suffer pulmonary embolus or deep venous thrombosis, and one perioperative death. Chromosome 7 mouse . Unsourced material may be challenged and removed. People with low-grade disease Gleason 2—4 were unlikely to die of prostate cancer within 15 years of diagnosis.
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The prostate can be massaged by using a finger or during anal sex. Some males are able to orgasm with prostate stimulation alone. From Wikipedia, the free encyclopedia. Human reproductive system. Ejaculation — Estrogen — Orgasm — Ovum. This short article about biology can be made longer.
You can help Wikipedia by adding to it. Categories : Anatomy of the male reproductive system Glands. Hidden category: Biology stubs. Namespaces Page Talk. In adult men, a typical prostate is about 3 centimeters long and weighs about 20 grams. The prostate surrounds part of the urethra , the tube that carries urine from the bladder during urination and semen during ejaculation.
In prostate cancer, the cells of these prostate glands mutate into cancer cells. The prostate glands require male hormones , known as androgens , to work properly. Androgens include testosterone , which is made in the testes ; dehydroepiandrosterone , made in the adrenal glands ; and dihydrotestosterone , which is converted from testosterone within the prostate itself.
Androgens are also responsible for secondary sex characteristics such as facial hair and increased muscle mass. Most prostate cancers are classified as adenocarcinomas , or glandular cancers, that begin when normal semen-secreting prostate gland cells mutate into cancer cells.
The region of prostate gland where the adenocarcinoma is most common is the peripheral zone. Initially, small clumps of cancer cells remain confined to otherwise normal prostate glands, a condition known as carcinoma in situ or prostatic intraepithelial neoplasia PIN.
Although there is no proof that PIN is a cancer precursor, it is closely associated with cancer. Over time, these cancer cells begin to multiply and spread to the surrounding prostate tissue the stroma forming a tumor.
Eventually, the tumor may grow large enough to invade nearby organs such as the seminal vesicles or the rectum , or the tumor cells may develop the ability to travel in the bloodstream and lymphatic system. Prostate cancer is considered a malignant tumor because it is a mass of cells that can invade other areas of the body. This invasion of other organs is called metastasis. Prostate cancer most commonly metastasizes to the bones , lymph nodes , and may invade rectum, bladder and lower ureters after local progression.
The route of metastasis to bone is thought to be venous as the prostatic venous plexus draining the prostate connects with the vertebral veins.
The prostate is a zinc -accumulating, citrate -producing organ. The protein ZIP1 is responsible for the active transport of zinc into prostate cells.
One of the zinc's important roles is to change the metabolism of the cell in order to produce citrate, an important component of semen. The process of zinc accumulation, alteration of metabolism, and citrate production is energy inefficient, and prostate cells sacrifice enormous amounts of energy ATP in order to accomplish this task.
Prostate cancer cells are generally devoid of zinc. This allows prostate cancer cells to save energy not making citrate, and utilize the new abundance of energy to grow and spread. The absence of zinc is thought to occur via a silencing of the gene that produces the transporter protein ZIP1.
The cause of the epigenetic silencing is unknown. Strategies which transport zinc into transformed prostate cells effectively eliminate these cells in animals. Unfortunately, oral ingestion of zinc is ineffective since high concentrations of zinc into prostate cells is not possible without the active transporter, ZIP1. Loss of cancer suppressor genes, early in the prostatic carcinogenesis, have been localized to chromosomes 8p , 10q , 13q , and 16q.
P53 mutations in the primary prostate cancer are relatively low and are more frequently seen in metastatic settings, hence, p53 mutations are a late event in the pathology of prostate cancer. RUNX2 is a transcription factor that prevents cancer cells from undergoing apoptosis thereby contributing to the development of prostate cancer. The androgen receptor helps prostate cancer cells to survive and is a target for many anti cancer research studies; so far, inhibiting the androgen receptor has only proven to be effective in mouse studies.
The American Cancer Society 's position regarding early detection by PSA testing is "Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. Starting at age 50, 45 if African American or brother or father suffered from condition before age 65 talk to your doctor about the pros and cons of testing so you can decide if testing is the right choice for you.
There are also several other tests that can be used to gather more information about the prostate and the urinary tract. Digital rectal examination DRE may allow a doctor to detect prostate abnormalities.
Cystoscopy shows the urinary tract from inside the bladder, using a thin, flexible camera tube inserted down the urethra. Transrectal ultrasonography creates a picture of the prostate using sound waves from a probe in the rectum.
But the only test that can fully confirm the diagnosis of prostate cancer is a biopsy , the removal of small pieces of the prostate for microscopic examination. Ultrasound US and magnetic resonance imaging MRI are the two main imaging methods used for prostate cancer detection. Urologists use transrectal ultrasound during prostate biopsy and can sometimes see a hypoechoic area tissues or structures that reflect relatively less of the ultrasound waves directed at them.
As ultrasound has poor tissue resolution, it is generally not used clinically. Prostate MRI has better soft tissue resolution than ultrasound. MRI in those who are at low risk might help people choose active surveillance; in those who are at intermediate risk it may help with determining the stage of disease, while in those who are at high risk it might help find bone disease.
Prostate MRI is also used for surgical planning for men undergoing robotic prostatectomy. It has also shown to help surgeons decide whether to resect or spare the neurovascular bundle, determine return to urinary continence, and help assess surgical difficulty.
If cancer is suspected, a biopsy is offered expediently. During a biopsy a urologist or radiologist obtains tissue samples from the prostate via the rectum. A biopsy gun inserts and removes special hollow-core needles usually three to six on each side of the prostate in less than a second.
Prostate biopsies are routinely done on an outpatient basis and rarely require hospitalization. Antibiotics should be used to prevent complications like fever , urinary tract infections , and sepsis  even if the most appropriate course or dose of the antibiotic is still undefined. The tissue samples are then examined under a microscope to determine whether cancer cells are present, and to evaluate the microscopic features or Gleason score of any cancer found.
Prostate specific membrane antigen is a transmembrane carboxypeptidase and exhibits folate hydrolase activity. Tissue samples can be stained for the presence of PSA and other tumor markers in order to determine the origin of malignant cells that have metastasized. The oncoprotein BCL-2 is associated with the development of androgen-independent prostate cancer, due to its high levels of expression in androgen-independent tumours in advanced stages of the pathology.
The upregulation of BCL-2 after androgen ablation in prostate carcinoma cell lines and in a castrated-male rat model further established a connection between BCL-2 expression and prostate cancer progression. The expression of Ki by immunohistochemistry may be a significant predictor of patient outcome for men with prostate cancer. An important part of evaluating prostate cancer is determining the stage , or how far the cancer has spread. Knowing the stage helps define prognosis and is useful when selecting therapies.
Its components include the size of the tumor, the number of involved lymph nodes , and the presence of any other metastases. The most important distinction made by any staging system is whether or not the cancer is still confined to the prostate. Several tests can be used to look for evidence of spread.
Medical specialty professional organizations recommend against the use of PET scans , CT scans , or bone scans when a physician stages early prostate cancer with low risk for metastasis. Bone scans should reveal osteoblastic appearance due to increased bone density in the areas of bone metastasis —opposite to what is found in many other cancers that metastasize. After a prostate biopsy, a pathologist looks at the samples under a microscope.
If cancer is present, the pathologist reports the grade of the tumor. The grade tells how much the tumor tissue differs from normal prostate tissue and suggests how fast the tumor is likely to grow.
The Gleason system is used to grade prostate tumors from 2 to 10, where a Gleason score of 10 indicates the most abnormalities. The pathologist assigns a number from 1 to 5 for the most common pattern observed under the microscope, then does the same for the second-most-common pattern.
The sum of these two numbers is the Gleason score. The Whitmore-Jewett stage is another method sometimes used. The data on the relationship between diet and prostate cancer are poor. Consuming fish may lower prostate-cancer deaths but does not appear to affect its occurrence.
Men who get regular exercise may have a slightly lower risk, especially vigorous activity and the risk of advanced prostate cancer. In those who are being regularly screened, 5-alpha-reductase inhibitors finasteride and dutasteride reduce the overall risk of being diagnosed with prostate cancer, but there are insufficient data to determine if they have an effect on the risk of death and they may increase the chance of more serious cases.
Prostate cancer screening is an effort to find unsuspected cancers in those without symptoms. American Urological Association AUA guidelines call for weighing the benefits of preventing prostate cancer mortality in 1 man for every 1, men screened over a ten-year period against the known harms associated with diagnostic tests and treatment.
The AUA recommends offering screening to those 55 to 69 be based on shared decision making, and that if screening is performed it should occur no more often than every two years. The first decision to be made in managing prostate cancer is whether treatment is needed. Prostate cancer, especially low-grade forms found in elderly men, often grows so slowly that no treatment is required. Alternative approaches that delay active treatment and instead involve surveillance of diagnosed prostate cancers are termed expectant management.
Which option is best depends on the stage of the disease, the Gleason score, and the PSA level. Other important factors are age, general health, and a person's views about potential treatments and their possible side effects.
Because most treatments can have significant side effects , such as erectile dysfunction and urinary incontinence , treatment discussions often focus on balancing the goals of therapy with the risks of lifestyle alterations.
A review found little comparative effectiveness research focused on person-centered outcomes for prostate cancer treatments. Guidelines for treatment for specific clinical situations requires a good estimation of a person's long-term life expectancy. Most of those who are newly diagnosed and made a treatment choice can not correctly answer over half of the questions.
If radiation therapy is done first, and fails, then radical prostatectomy may be an option though it becomes a very technically challenging surgery, is associated with decreased quality of life and may not be feasible. In localized disease, it is unknown if radical prostatectomy is better or worse than watchful waiting. A meta-analysis on the effects of voiding position during urination in males with prostate enlargement showed that sitting was superior to standing.
Bladder emptying was significantly improved, while there was a trend towards a higher urinary flow and shorter voiding time. Many men diagnosed with low-risk prostate cancer are eligible for active surveillance. This means that careful observation of the tumor is conducted over time, with the intention of initiating treatment if there are signs of cancer progression. Active surveillance is not synonymous with watchful waiting , an older term which implies no treatment or specific program of monitoring, with the assumption that palliative , not curative, treatment would be used if advanced, symptomatic disease develops.
Active surveillance involves monitoring the tumor for signs of growth or the appearance of symptoms. The goal of surveillance is to avoid overtreatment and the sometimes serious, permanent side effects of treatment for a slow-growing or self-limited tumor that in most people, would be unlikely to cause problems.
This approach is not used for aggressive cancers, but it may cause anxiety for people who wrongly believe that all cancer is deadly or themselves to have life-threatening cancer. Treatment of metastatic prostate cancer can be difficult. As the average life expectancy increases due to advances in the treatment of cardiovascular, pulmonary and other chronic diseases, it is likely that more elderly patients will be living long enough to suffer the consequences of their prostate cancer.
Therefore, there is currently much interest in the role of aggressive prostate cancer treatment modalities such as with surgery or radiation in the elderly population who have localized disease. If the cancer has spread beyond the prostate, treatment options significantly change, so most doctors that treat prostate cancer use a variety of nomograms to predict the probability of spread.
Hormonal therapy and chemotherapy are often reserved for disease that has spread beyond the prostate. There are exceptions: local or metastasis-directed therapy by radiation treatment may be used for advanced tumors with a limited amount of metastases,  and hormonal therapy is used for some early stage tumors. Cryotherapy the process of freezing the tumor , hormonal therapy , and chemotherapy may also be offered if initial treatment fails and the cancer progresses.
Sipuleucel-T , a cancer vaccine has been found to result in a benefit a four-month increase in survival for men with metastatic prostate cancer. Prostate cancer that persists even when the levels of testosterone in the body are lowered substantially by hormonal therapy is called castrate-resistant prostate cancer CRPC. Previously considered "hormone-refractory prostate cancer" or "androgen-independent prostate cancer", the term CRPC has replaced "hormone refractory" because these cancers still show reliance upon hormones, particularly testosterone, for androgen receptor activation.
The cancer chemotherapic docetaxel has been used as treatment for CRPC with a median survival benefit of 2 to 3 months. Both abiraterone and enzalutamide are currently being tested in clinical trials in those with CRPC who have not previously received chemotherapy. Only a subset of people respond to androgen signaling blocking drugs and certain cells with characteristics resembling stem cells remain unaffected.
It is possible that for further advances, a combination of androgen signaling blocking agent with stem-like cell directed differentiation therapy drug would prove ideal.
Prostate cancer rates are higher in developed countries than in the rest of the world. Many of the risk factors for prostate cancer are more common in developed countries, including longer life expectancy and diets higher in red meat. Also, where there is greater access to screening programs, there is a higher detection rate.
In patients who undergo treatment, the most important clinical prognostic indicators of disease outcome are the stage, pretherapy PSA level, and Gleason score. In general, the higher the grade and the stage, the poorer the prognosis. Nomograms can be used to calculate the estimated risk of the individual patient. The predictions are based on the experience of large groups of patients suffering from cancers at various stages. In , Charles Huggins reported that androgen ablation therapy causes regression of primary and metastatic androgen-dependent prostate cancer.
After remission, an androgen-independent phenotype typically emerges, wherein the median overall survival is 23—37 months from the time of initiation of androgen ablation therapy. Many prostate cancers are not destined to be lethal, and most men will ultimately not die as a result of the disease.
Several tools are available to help predict outcomes, such as pathologic stage and recurrence after surgery or radiation therapy. Life expectancy projections are averages for an entire male population, and many medical and lifestyle factors modify these numbers.
For example, studies have shown that a year-old man will lose 3. If he is both overweight and a smoker, he will lose 6. At this time, there is no evidence that either surgery or beam radiation has an advantage over the other in this regard, the lower death rates reported with surgery appear to occur because surgery is more likely to be offered to younger men with less serious forms of cancer.
Insufficient information is available to determine whether seed radiation extends life more readily than the other treatments, but data so far do not suggest that it does. People with low-grade disease Gleason 2—4 were unlikely to die of prostate cancer within 15 years of diagnosis.
Men with high-grade disease Gleason 8—10 experienced high prostate cancer mortality within 15 years of diagnosis, regardless of their age at diagnosis, underscoring the very aggressive nature of poorly differentiated prostate cancer. The average annual incidence rate of prostate cancer between and among Chinese men in the United States was 15 times higher than that of their counterparts living in Shanghai and Tianjin,    but these high rates may be affected by increasing rates of detection.
In such men, diagnosing prostate cancer is overdiagnosis —the needless identification of a technically aberrant condition that will never harm the patient—and treatment in such men exposes them to all of its adverse effects, with no possibility of extending their lives. It is estimated that in , approximately , new cases and 29, prostate cancer—related deaths will occur in the United States.
Prostate cancer is now the second leading cause of cancer death in men, exceeded by lung cancer and colorectal cancer. Age-adjusted incidence rates increased steadily from through , with particularly dramatic increases associated with the inception of widespread use of prostate-specific antigen PSA screening in the late s and early s, followed by a fall in incidence.
Between and , mortality rates appear to have stabilized. It has been suggested that declines in mortality rates in certain jurisdictions reflect the benefit of PSA screening, but others have noted that these observations may be explained by independent phenomena such as improved treatments.
The estimated lifetime risk of a prostate cancer diagnosis is about Prostate cancer is the third leading type of cancer in Canadian men. In , around 4, died and 21, men were diagnosed with prostate cancer. In Europe in it was the 3rd most diagnosed cancer after breast and colorectal at , cases. In the United Kingdom it is also the second most common cause of cancer death after lung cancer, where around 35, cases are diagnosed every year and of which around 10, die of it.
The first treatments of prostate cancer were surgeries to relieve urinary obstruction. Young at Johns Hopkins Hospital. Surgical removal of the testes orchiectomy to treat prostate cancer was first performed in the s, but with limited success. Transurethral resection of the prostate TURP replaced radical prostatectomy for symptomatic relief of obstruction in the middle of the 20th century because it could better preserve penile erectile function.
Radical retropubic prostatectomy was developed in by Patrick Walsh. In , Charles B. Huggins published studies in which he used estrogen to oppose testosterone production in men with metastatic prostate cancer. GnRH receptor agonists, such as leuprorelin and goserelin , were subsequently developed and used to treat prostate cancer. Radiation therapy for prostate cancer was first developed in the early 20th century and initially consisted of intraprostatic radium implants.
External beam radiotherapy became more popular as stronger [X-ray] radiation sources became available in the middle of the 20th century. Brachytherapy with implanted seeds for prostate cancer was first described in Systemic chemotherapy for prostate cancer was first studied in the s. The initial regimen of cyclophosphamide and 5-fluorouracil was quickly joined by multiple regimens using a host of other systemic chemotherapy drugs.
People with prostate cancer generally encounter significant disparities in awareness, funding, media coverage, and research—and therefore, inferior treatment and poorer outcomes—compared to other cancers of equal prevalence. It also discovered that the waiting time between referral and diagnosis was two weeks for breast cancer but three months for prostate cancer. The Times also noted an "anti-male bias in cancer funding" with a four-to-one discrepancy in the United Kingdom by both the government and by cancer charities such as Cancer Research UK.
Disparities also extend into areas such as detection, with governments failing to fund or mandate prostate cancer screening while fully supporting breast cancer programs. For example, a report found 49 U. Prostate Cancer Awareness Month takes place in September in a number of countries. A light blue ribbon is used to promote the cause.
Alpharadin completed a phase 3 trial for CRPC patients with bone metastasis. A pre-planned interim analysis showed improved survival and quality of life. The study was stopped for ethical reasons to give the placebo group the same treatment. Alpharadin uses bone targeted Radium isotopes to kill cancer cells by alpha radiation. Over the last decade molecules that could successfully target these alternative domains have emerged. Arachidonate 5-lipoxygenase has been identified as playing a significant role in the survival of prostate cancer cells.
Targeting galectin-3 might be effective in slowing prostate cancer progression. Scientists have established a few prostate cancer cell lines to investigate the mechanism involved in the progression of prostate cancer. The LNCaP cancer cell line was established from a human lymph node metastatic lesion of prostatic adenocarcinoma. PC-3 and DU cells were established from human prostatic adenocarcinoma metastatic to bone and to brain, respectively. AR, an androgen-activated transcription factor , belongs to the steroid nuclear receptor family.
Development of the prostate is dependent on androgen signaling mediated through AR, and AR is also important during the development of prostate cancer. Elevation of AR expression is often observed in advanced prostate tumors in patients. These androgen -independent LNCaP cells have elevated AR expression and express prostate specific antigen upon androgen treatment.
The paradox is that androgens inhibit the proliferation of these androgen-independent prostate cancer cells. In , a previously unknown retrovirus, Xenotropic MuLV-related virus XMRV , was associated with human prostate tumors,  but subsequent reports on the virus were contradictory,   and the original finding was instead due to a previously undetected contamination.
At present, an active area of research and non-clinically applied investigations involve non-invasive methods of prostate tumor detection. A molecular test that detects the presence of cell-associated PCA3 mRNA in fluid obtained from the prostate and first-void urine sample has also been under investigation. PCA3 mRNA is expressed almost exclusively by prostate cells and has been shown to be highly over-expressed in prostate cancer cells.
The higher the expression of PCA3 in the sample, the greater the likelihood of a positive biopsy; i. From Wikipedia, the free encyclopedia. Main article: Prostate biopsy. Main article: Gleason score. Main article: Prostate cancer staging. Sclerosis of the bones of the thoracic spine due to prostate cancer metastases CT image. Sclerosis of the bones of the pelvis due to prostate cancer metastases.
Main article: Prostate cancer screening. Main article: Management of prostate cancer. For the journal, see Prostate Cancer journal. National Cancer Institute. Archived from the original on 5 July Retrieved 1 July World Cancer Report.
World Health Organization. Archived from the original on 6 July Retrieved 18 June January Archived from the original on 12 October Retrieved 12 October Cancer biology 4th ed. Oxford: Oxford University Press. Archived from the original on Cancer Epidemiology. Retrieved 1 March Controversy exists regarding the value of screening The Medical Clinics of North America.
Retrieved 5 March Retrieved 30 August May Prostate International. Family Practice. July Frontiers in Bioscience.
Prostate - Simple English Wikipedia, the free encyclopedia
Funding received from. Management of locally advanced and metastatic prostate cancer. Sydney: Cancer Council Australia. Prostate cancer has many uncertainties associated with its management. A major problem for any review at present arises from the difficulty in establishing with certainty that the cancer is confined to the prostate at the time of diagnosis.
Currently, through a combination of PSA measurement and ultra-sound-guided biopsy, it is now possible to establish with greater certainty than before the local extent of the cancer within the gland and its likely aggressiveness by application of the Gleason scoring system.
This information, when incorporated with other measurable factors into nomograms, has enabled clinicians to establish the probability but not the certainty of the cancer being confined to the prostate.
Before the introduction of PSA it was easier to be certain that a person had metastatic disease on the basis of a positive bone scan or computed tomography CT. Unfortunately, while the bone scan has a high level of specificity its sensitivity is too low and in current prostate cancer management, bone scans have little use in determining the presence of metastatic disease.
Consequently, after presumed curative treatment for local disease, a rising PSA is now used as a surrogate marker for metastatic disease. There is urgent need for a more sensitive and specific test to predict the metastatic potential of an individual cancer. This review initially intended to focus on metastatic disease, but for the reasons outlined above the scope was expanded to include locally advanced as well as metastatic cancer. The Australian Institute of Health and Welfare report  based on data predicted that the risk of a male being diagnosed with cancer before age 75 was one in three and before age 85 was one in two.
We know that approximately men die each year from prostate cancer  and while earlier diagnosis and more aggressive local therapy have been available for at least a decade, the death rate has not declined greatly. The age-standardised mortality rate in was 35 deaths per , males and in was It is therefore evident that for the foreseeable future we will continue to need to care for a significant number of older men with metastatic disease.
A cure for metastatic cancer would be the ideal but seems unlikely in the short term. The middle ground is to try to ensure the information currently available is used appropriately to achieve optimal cancer control for these men while preserving the best quality of life.
The development of these guidelines is one step in trying to achieve this goal. As part of the original plan no systematic review of evidence took place after April We recognised that this is a limitation of the guidelines.
We also recognised that there will need to be a prolonged period of consultation as part of the process of acceptance of guidelines by the NHMRC and this will add to the time between the end of the review and the final publication of the guidelines. To try to in part to address this issue, we noted and provided references for high quality randomised controlled trials where the review team believed that this more contemporary information may cause clinicians to reflect on the interpretation and relevance of the recommendations, given that the recommendations were all based on the systematic review of the evidence available as of April Another important consideration is the significant change in the way medicine is practised, with a much greater focus on informed and shared decision making.
The development of these guidelines has provided the evidence base for the production of a consumer guide that will facilitate shared decision making as men and their families confront the health issues associated with the management of advanced and metastatic prostate cancer.
Clinical Guidelines Network. Personal tools Create account Log in. Social links. Page actions View Code History. Information on authorship and revision Funding received from. Cite this page. Introduction to prostate cancer. Australian Cancer Incidence Statistics Update. Canberra: AIHW. Cancer An Overview Cancer series number