Sunday, September 25, 2022

Why Is Prostate Cancer So Common

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Understanding The Rise In Cancer Rates To Help You Understand Your Own Risk

Why is Prostate Cancer So Common? | Dr. Darshil Shah

Cancer is a complex disease that can grow out of a variety of risk factors, which makes it as difficult to manage as it is to explain. However, advances in research and therapies have clarified how cancer starts, and why it seems like so many more people are suffering from cancer than ever before.

The vast majority of cancers can be traced to genetic mutations that are, to a certain extent, totally natural. As your cells grow, develop, die, and repeat the process, random genetic mutations will take place that make some cells resistant to damage or other healthy cells more prone to dying off.

Once these mutations overpower the surrounding healthy cells, the mutated cells can grow together to form a cancerous tumor and effectively takeover that region.

So what could account for the rise in cancer cases? While human genes havent changed drastically over recent years, the conditions in and around them have shifted.

Lifestyle factors, like diet and bad habits, certainly play a role in your cellular health, as will your life expectancy, and even the job you do. The rates of many chronic diseases have fallen in the past few decades, but cancer is not behaving in the same fashion, for a few reasons.

What Are The Stages Of Prostate Cancer

Your healthcare provider uses the Gleason score and Grade Groups to stage prostate cancer based on its projected aggressiveness. To get this information, the pathologist:

  • Assigns a grade to each type of cell in your sample. Cells are graded on a scale of three to five . Samples that test in the one to two range are considered normal tissue.
  • Adds together the two most common grades to get your Gleason score .
  • Uses the Gleason score to place you into a Grade Group ranging from one to five. A Gleason score of six puts you in Grade Group 1 . A score of nine or higher puts you in Grade Group five . Samples with a higher portion of more aggressive cells receive a higher Grade Group.

Why Is Breast Cancer So Relatively Common

After ovulation, the terminal duct epithelium proliferates and the number of terminal ducts within a lobule increases and the basal epithelial cells become vacuolated. The intralobular stroma becomes edematous and loose. These changes result in progressive fullness, heaviness and tenderness of the breast. As the levels of estrogen and progesterone fall with the onset of menstruation, there is an increase in apoptosis in the TDLU. Lymphocytes infiltrate the intralobular stroma, which becomes dense. The TDLU finally regresses to its resting appearance

The simplified version of the excellent post by /u/MeltedBanana is that there is a cycle of cells proliferating and then dying back in the breast alongside the menstrual cycle. This repetition of tissue growth and reduction together with certain mutations increases cancer risk in that particular part of the body.

Can I assume the cancer risk from the cell cycle in the breast is somewhat similar to the risk in the uterus, as in extensive mitosis every month ? Making genetics the distinguishing factor beteween the two structures ?

Well I don’t know that I would agree that breast cancer is much more common than other types of cancer.

According to the statistics at cancer.gov the new case incidence of difference types of cancer cancers are :

  • Prostate with 238,590 new cases per year

  • Breast 232,340 “

  • Lung 228,190 “

  • Colo-rectal 142,820 “

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    Family History And Genes

    Your risk of prostate cancer is higher if you have a close relative, such as a brother or father, who has had prostate cancer.

    Some inherited genes can increase your risk of prostate cancer. These inherited genes are rare and account for only a small number of prostate cancers.

    The risk increases by up to 5 times in men with the gene BRCA2. And the risk might increase with the BRCA1 gene. These genes also cause breast and ovarian cancers.

    Men with a rare syndrome called Lynch syndrome have a higher chance of developing prostate cancer and some other cancers. A change in one of the genes that fixes mistakes in DNA causes this syndrome eg. MSH2 and MLH1 genes.

    Researchers are looking into other genes that might also increase the risk of prostate cancer.

    Should I Make Any Lifestyle Changes Including In My Diet Or Physical Activity

    Why do some men avoid prostate cancer screening? Local ...

    Achieving and maintaining a healthy weight by eating a balanced diet with plenty of fruits, vegetables, and whole grains, and staying physically active, can help your overall health. These lifestyle changes can also have a positive effect for men with bone metastases, Tagawa says. Both diet and exercise, he says, are things that are under a mans direct control.

    A healthy lifestyle can help you better manage side effects from treatment as well. Try setting small but realistic goals for yourself when it comes to eating a healthy diet and getting plenty of exercise.

    While no single food is likely to have a benefit for prostate cancer, smart food choices may help you feel better day to day. Start by cutting out foods high in sugar, saturated fat, and added flavorings and preservatives.

    If youre not sure which healthy foods to choose, ask your doctor for a referral to a dietitian. This specialist can help you develop a meal plan that includes foods that offer the best chance of slowing the cancers growth and keeping you as healthy as possible.

    As an oncologist, Tagawa says he concentrates on treating the cancer itself, but hes aware that many of the men he sees with advanced prostate cancer are older and more likely than younger men to have health problems that can benefit from diet and exercise.

    And if youre on hormone therapy, talk to your doctor about investing in some weights or elastic resistance bands to support your bone strength too.

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    Rectal Exams And Blood Test

    Prostate specific antigen, or PSA, is a blood test that looks for a protein made by the prostate and prostate cancer cells. When this test is used to screen healthy men between the ages of 5569 years old, it can decrease prostate cancer death by about 20%. Your doctor will draw blood and pair it with a digital rectal exam for initial screening.

    How Do You Decide Whether To Get A Psa Scan

    As you can see, theres a lot of debate. To help cut through, the RACGP has published a decision-making tool.

    Take 2000 men aged between 55 and 69, and give 1000 of them an annual PSA test every year for 11 years. What happens?

    Five men will die from prostate cancer in the untested group and four in the tested group. Overall, one life will be saved. Some would argue this is an excellent thing mortality cut by about 20 per cent.

    However, the tested group bear significant side effects. Some 87 men will learn their test was a false positive after having a surgical biopsy. Some 25 men will choose to be treated because they are fearful of their cancers as a result of the treatment, seven to 10 men will experience impotence or incontinence. Theres a mental dimension as well men diagnosed with low-risk prostate cancer are more likely to develop anxiety and depression.

    Importantly, because of the amount of time it takes for prostate cancer to kill, men with life expectancies of fewer than 10 to 15 years are unlikely to get much benefit from screening.

    For Will McDonald, over-diagnosis wasnt a problem. The cancer had spread he needed treatment immediately. He went through chemotherapy, radiotherapy and hormone deprivation therapy, stripping nearly all the testosterone from his body.

    I feel very fortunate to be able to say this, but it barely touched the sides. I had so little side effects, I was so lucky, he says.

    Recommended Reading: How To Treat Prostate Cancer That Has Spread To Bones

    Risk Factors You Cant Control

    Age: The risk of developing prostate cancer increases with age. One in 10,000 men younger than 40 will be diagnosed with prostate cancer, but one in 15 men in their 60s will be diagnosed with the disease.

    Family history: Being born with a gene mutation is one of the unavoidable risks of prostate cancer. Two of them include the BRCA1 and BRCA2 gene mutations. BRCA and other inherited mutations, including HOXB13 and DNA mismatch repair genes, may explain why prostate cancer runs in families. Having a father or brother with prostate cancer may double a mans risk, especially if that relative was diagnosed before age 55.

    Hormones: The level of male sex hormones, called androgens, may be higher in some men than others. Higher levels of androgensmainly testosteronehave been linked to a higher risk of prostate cancer. Men who use testosterone therapy are at a higher risk of developing prostate cancer, as an increase in testosterone stimulates the growth of the prostate gland.

    Prostatic intraepithelial neoplasia : This condition may be associated with increased risk of prostate cancer. PIN is a condition in which prostate gland cells look abnormal when examined with a microscope. Its not necessarily linked with any symptoms. Nearly half of men will be diagnosed with PIN before age 50.

    Race: Studies show that African-American men are about 70 percent more likely to develop prostate cancer in their lifetime than Caucasian or Hispanic men.

    Cancer Survival Is Increasing Too

    Men’s Health Month – Prostate Cancer

    As we said at the beginning, its important to emphasise that there hasnt been a sudden jump in lifetime cancer risk overnight. The new method shows that the rise has been gradual, and follows the same trend of increasing life expectancy.

    Importantly, cancer survival is showing the same pattern. Forty years ago, 1 in 4 people survived the disease for at least 10 years. Today that figure is 2 in 4, and its our ambition to accelerate progress so that 3 in 4 people survive cancer within the next 20 years.

    At Cancer Research UK, we know that far too many lives are still lost to cancer. Thats why were committed to this challenge.

    But tackling this growing issue has to be a collective effort.

    Research has shown us the impact that a healthy lifestyle can have as well as the role chance plays in our risk of getting cancer. As individuals, we can stack the odds in our favour by not smoking, maintaining a healthy weight, being more active and drinking less alcohol. We can also get to know our bodies and whats normal for us so we can spot any unusual or persistent changes early on.

    But its not just about individuals. Politicians have an important role to play in supporting NHS cancer services, making sure patients have access to the best treatments, and supporting public health measures to keep smoking rates in decline, and tackle obesity.

    Greg

    Reference

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    Five Things Every Man Should Know About Prostate Cancer

    Its only about the size of a walnut, but the prostate takes on an oversized place in mens health as they age. In support of National Prostate Cancer Awareness Month, we talked to MultiCare Urologist Douglas Sutherland, MD, to learn the five things every man should know about prostate cancer and why an annual physical is so important for mens health.

  • Its common.
  • Prostate cancer is the second most common cancer in American men, behind skin cancer, according to the American Cancer Society. In fact, one in eight men will be diagnosed with prostate cancer in his lifetime. Its also the second-leading cause of cancer death in American men .

    But the statistics arent all grim. If caught and treated early, prostate cancer is very survivable. Localized prostate cancer is nearly 100 percent curable. But its also not likely to cause any symptoms. A simple blood test to measure prostate-specific antigens has been shown to reduce the death rate of prostate cancer.

  • Your risk factors.
  • Older men and non-Hispanic Black men are at higher risk for prostate cancer. Family history also plays a part. If your father or brother had prostate cancer, your risk of developing the disease is double what it would be otherwise.

    In a twist, obesity seems to reduce the risk of developing prostate cancer overall. But thats not a license to ignore the scale because when an obese man does develop prostate cancer, its usually more aggressive.

  • Prevention and detection.
  • Signs and symptoms.
  • Family History And Genetics

    Your family history is information about any health problems that have affected your family. Families have many common factors, such as their genes, environment and lifestyle. Together, these factors can help suggest if you are more likely to get some health conditions.

    Inside every cell in our body is a set of instructions called genes. These are passed down from our parents. Genes control how the body grows, works and what it looks like. If something goes wrong with one or more genes , it can sometimes cause cancer.

    Is prostate cancer hereditary?

    If people in your family have prostate cancer or breast cancer, it might increase your own risk of getting prostate cancer. This is because you may have inherited the same faulty genes.

    My father had prostate cancer. What are my risks?

    • You are two and a half times more likely to get prostate cancer if your father or brother has had it, compared to a man who has no relatives with prostate cancer.
    • Your chance of getting prostate cancer may be even greater if your father or brother was under 60 when he was diagnosed, or if you have more than one close relative with prostate cancer.
    • Your risk of getting prostate cancer may also be higher if your mother or sister has had breast cancer.

    Do you have a family history of prostate cancer?

    If you’re over 45 and your father or brother has had prostate cancer, you may want to talk to your GP. Our Specialist Nurses can also help you understand your hereditary risk of prostate cancer.

    Recommended Reading: Does An Enlarged Prostate Affect A Man Sexually

    What Is The Prognosis For People Who Have Prostate Cancer

    Because prostate cancer tends to grow slowly, most men die from something other than the disease. Early detection is key to better outcomes. Almost all men 97% to 98% diagnosed with localized cancer that hasnt spread outside of the prostate live at least five years after diagnosis. When metastatic cancer has spread outside of the gland, one-third of men continue to survive after five years.

    ‘moving Men Forward’ Brings Survivors Together

    Prostate Exam: Should All Men Get a Prostate Cancer ...
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    ‘Moving Men Forward’ brings survivors together

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    ‘Moving Men Forward’ brings survivors together

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    MILWAUKEE

    Prostate cancer is one of the most common diagnoses among men, but African Americans are impacted at higher rates.

    Researchers aren’t sure why that disparity exists, so Froedtert and the Medical College of Wisconsin are bringing survivors together in search of answers.

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    For Many Men Diagnosed With Prostate Cancer The Treatment May Be Worse Than The Disease

    To screen or not to screen? For prostate cancerthe second leading cause of cancer deaths in men, after lung cancerthat is the bedeviling question.

    The dilemma springs the wide variation in the potential of prostate cancers to spread to the rest of the body. The vast majority of these malignancies, especially those discovered with the extensively used prostate-specific antigen, or PSA, test, are slow-growing tumors that are unlikely to cause a man any harm during his lifetime. Yet in 10 to 15 percent of cases, the cancer is aggressive and advances beyond the prostate, sometimes turning lethal.

    Genomic Variant And Aggressive Disease

    Using genetic, genomic, molecular, and bioinformatic tools, Prof. Wei and his colleagues analyzed data from 2,738 cases of prostate cancer. The analysis confirmed the link between the rs11672691 variant and aggressive disease.

    On further investigation, they found that a certain aggressive prostate cancer version of rs11672691 called the guanine allele was linked to higher expression of two particular genes.

    The two genes called PCAT19 and CEACAM21 have previously been tied to growth of cells and progression of tumors in prostate cancer.

    The team also found that the guanine allele of rs11672691 influences a third gene called HOXA2. This gene contains the instructions for producing a protein that controls the decoding of PCAT19 and CEACAM21.

    Using CRISPR/Cas9 gene editing tools, the researchers then showed that they could manipulate the effect of rs11672691 on PCAT19 and CEACAM21 gene expression and the aggressiveness of prostate cancer cells.

    They conclude that their findings reveal a plausible mechanism for rs11672691 in aggressive prostate cancer and thus lay the groundwork for translating this finding to the clinic.

    Prof. Wei suggests that further research is now needed to investigate how this gene regulatory circuit accounts for pathogenesis and progression of prostate cancer.

    We think the findings may be repurposed to stratify prostate cancer patients for personalized treatment and care.

    Prof. Gong-Hong Wei

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    How Is Prostate Cancer Treated

    Your treatment will depend on what kind of cancer cells you have, how far they have spread, your age and general health, and your preferences. At HealthPartners and Park Nicollet, we approach cancer treatment by understanding the impact it has both physically and mentally. So, you and your doctor may decide to manage your cancer with active surveillance or to treat it with surgery or radiation.

    If youre over age 80 or have other serious health problems, like heart disease, you may choose not to have treatments to cure your cancer. Instead, you can just have treatments to manage your symptoms. This is called watchful waiting.

    If youve already been diagnosed with prostate cancer, choosing treatment for prostate cancer can be confusing. Both urologists and oncologists have the specialty training and expertise to treat prostate cancer. They can work with you develop a treatment plan thats right for you.

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