Prostate Cancer: Etiology, Clinical Presentation, and Diagnosis
Prostate Cancer: Introduction
Prostate cancer is the second most common cancer among men, after lung cancer. It is a malignancy that develops in the prostate gland, a small organ located below the bladder that produces seminal fluid.
Etiology
The exact cause of prostate cancer is unknown, but several risk factors have been identified, including:
- Age: The risk of prostate cancer increases with age.
- Race: African American men have a higher risk of prostate cancer than men of other races.
- Family history: Men who have a father or brother with prostate cancer are at an increased risk of developing the disease.
- Diet: A diet high in saturated fat and red meat may increase the risk of prostate cancer.
- Obesity: Obese men have a higher risk of prostate cancer than men who are not obese.
Clinical Presentation
The symptoms of prostate cancer can vary depending on the stage of the disease. In the early stages, there may be no symptoms at all. As the cancer progresses, symptoms may include:
- Difficulty urinating
- Frequent urination
- Painful urination
- Blood in the urine
- Erectile dysfunction
- Pain in the lower back, pelvis, or thighs
Diagnosis
Prostate cancer is diagnosed through a combination of tests, including:
- Digital rectal exam (DRE): A DRE is a physical exam in which the doctor inserts a finger into the rectum to feel the prostate gland for any abnormalities.
- Prostate-specific antigen (PSA) test: A PSA test measures the level of PSA in the blood. PSA is a protein that is produced by the prostate gland. Elevated PSA levels can be a sign of prostate cancer.
- Transrectal ultrasound (TRUS): A TRUS is an ultrasound exam that uses a probe inserted into the rectum to create images of the prostate gland.
- Prostate biopsy: A prostate biopsy is a procedure in which a small sample of tissue is removed from the prostate gland and examined under a microscope for cancer cells.
The Gleason score is a grading system that is used to assess the aggressiveness of prostate cancer. The Gleason score is based on the appearance of the cancer cells under a microscope. A higher Gleason score indicates a more aggressive cancer.
The stage of prostate cancer is determined by the size and location of the tumor, as well as whether it has spread to other parts of the body. The stage of prostate cancer is important for determining the best course of treatment.