Types of Prostate Cancer

Prostate cancer is an abnormal, uncontrolled growth of cells that results in the formation of a tumor in the prostate gland. Prostate, the walnut sized gland, is a part of the reproductive system which lies deep in the pelvis. It is located in front of the rectum and underneath the urinary bladder and surrounds the urethra, (the urine tube running from the bladder, through the prostate and the penis). It contains gland cells that produce some of the seminal fluid, which protects and nourishes sperm cells in semen and supports the ejaculatory ducts, or sperm tubes. The prostate continues to grow till a man reaches adulthood and is maintained after it reaches normal size as long as male hormones are produced.

Prostate cancer begins most often in the outer part of the prostate. It is the most common cancer in men older than age 50. In most men, the cancer grows very slowly. In fact, many men with the disease will never know they have the condition. Early prostate cancer is confined to the prostate gland itself, and the majority of patients with this type of cancer can live for years with no problems. In some cases, it may spread from the prostate to nearby lymph nodes, bones or other organs. This spread is called metastasis. Most Prostate cancers originate in the posterior prostate gland, the rest originate near the urethra.

Types of Prostate Cancer

There are many types of prostate cancer and the condition is often present in many different parts of the prostate. The precursor to prostate cancer is known as prostatic intraepithelial neoplasia, this is also found in many different locations within the prostate.

Although there are many different kinds of prostate cancer the vast majority (around 95%) are of the type known as adenocarcinoma. As this is the most wide spread from it has become synonymous with the term prostrate cancer.

Adenocarcinoma

The most common site of origin of prostate cancer is in the peripheral zone (the main glandular zone of the prostate). The term adenocarcinoma can be split up to derive its meaning. Adeno means ‘pertaining to a gland’, whilst Carcinoma relates to a cancer that develops in epithelial cells. The term epithelial simply relates to cells that surround body organs or glands. aldara and basal cell carcinoma

Small cell carcinoma

This kind of cancer is made up of small round cells, and typically forms at nerve cells. Small cell carcinoma is very aggressive in nature and as it does not lead to an increase in prostate specific antigens it can be somewhat harder to detect than adenocarcinoma; this usually means that it has reached an advanced form upon detection.

Squamous cell carcinoma

This is a non glandular cancer, like small cell carcinoma there is no increase in prostate specific antigens when this is present. Squamous cell carcinoma is very aggressive in nature.

There are other, more rare, forms of prostate cancer these include sarcomas and transitional cell carcinoma; the latter rarely develops in the prostate but derives from primary tumours present in the bladder or urethra.

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Risks and Causes of Prostate Cancer

The cause of this cancer is not established but hormonal, genetic, environmental and dietary factors are involved in some cases. The male sex hormone testosterone aids the growth of prostrate cancer cells. Risk increases with age more rapidly than any other cancer. Men who have a history of prostate cancer in their family, especially a close relative such as father, brother etc are at an increased risk. Racial predisposition is another factor, incidence of prostrate cancer is highest in Blacks and lowest in Asians.

Inhalation or ingestion of chemicals such as cadmium, a mineral found naturally in certain foods and cigarette smoke, plastics, paints, nickel cadmium batteries etc increases the risk for developing prostate and lung cancer.

People involved in battery manufacture, welding, soldering, manufacture of paint, plastic, cadmium alloy, textile etc are at high risk. A diet high in animal fat also has been implicated in the development/increased risk of prostate cancer.

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Signs and Symptoms of Prostate Cancer

Often the disease has no symptoms until the disease is well advanced. However, as the tumor grows, it may spread from the prostate to surrounding areas like lymph nodes, bones or other organs. This may result in back pain. Men with prostate cancer may experience any of the following symptoms.

A need to urinate frequently, especially at night;

Difficulty starting urination or holding back urine;

Weak or interrupted flow of urine;

Painful or burning urination or bowel movement;

Difficulty in having an erection;

Painful ejaculation;

Blood in urine or semen; or

Frequent pain or stiffness in the lower back, hips, or upper thighs.

It is advised to consult a doctor immediately if you have experienced any of the above symptoms. Men aged 50 and above have the chances of developing prostate cancer. Those who have a family history of prostate cancer should consider screening at age 45.

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Diagnosis of Prostate Cancer

Doctors may feel the prostate gland via the rectum (Digital rectal examination) in order to detect any abnormality. A small, hard nodule may reveal the presence of cancer.

Further tests by measuring Prostate-specific antigen (PSA) levels in your bloodstream followed by an Ultra sound scan, can help to detect the disease. Preferably men older than age 40 should have an yearly Digital Rectal Examination and men older than 50 should check their PSA levels yearly.

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Stages of Prostate Cancer

If you are diagnosed with prostate cancer, it is important to know how far the cancer has spread. The physician stages the tumor based on its size, the character of its cells, and the extent of metastasis.

Prostate cancer can be staged as 'A,B,C,D'. Stage A and B cancers are curable. Stages C and D are treatable, but their prognoses are discouraging.

Stage A - This is the very early stage without any symptoms, in this stage cancer cells are confined to the prostate. It can be identified with PSA tests and Biopsy. This type of cancer is usually curable.

Stage B - In this stage, it is known that cancer is in several places within the prostate. It is detectable by Digital rectal examinationand by elevated PSA.

Stage C - In this stage, cancer cells can be found throughout the prostate as well as near by tissue or the bladder. This stage is determined by Digital Rectal Exam, or CT/ MRI scans, and/or Sonography. Some Stage C cancers are curable.

Stage D : At this stage, cancer has spread beyond the prostate and nearby lymph nodes, distant bones, organs such as liver, lungs and also to other tissues. This is usually determined by bone scan, Prostascint scan or other studies. Stage D cancer is not curable but treatable.

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Treatments of Prostate Cancer

Treatment depends on individual circumstances such as the man's age and general health, extent of the cancer etc. Elderly patients with minor symptoms, early stage cancer, or coexisting illness may be treated conservatively.

There are many different ways to treat prostate cancer. It is advisable to get advise from two or more doctors before making a final decision about the treatment. Treatment includes Prostatectomy and Hormone Therapy or anti-antrogen drugs, Chemotherapty and Radio Therapy.

Hormone Therapy : Hormone therapy, is used either alone or in combination with surgery or radiation. It is based on the fact that prostate cancer cells frequently use the male hormone , testosterone as a fertilizer and the absence of this hormone may lead to the death or weakening of prostate cancer cells. So It is used to stop the production of testosterone hormone and hence a person with Stage C and D cancer can have their life extended and improved by the use of hormonal therapy.

There are side effects associated with Hormone therapy. They include hot flashes, weight gain, erectile dysfunction, decrease in muscle mass and strength, personality changes, decreased mentation and osteoporosis.

Prostatectomy : Patients in good health and under age 70 is usually offered surgery as a treatment option. Various types of surgical procedures are done depending on the stage of prostate cancer and patient's over all health.

Prostatectomy is the most common treatment option for localised prostate cancer. It involves surgical removal of prostate gland and some other near by tissues and reattaching the urethra and bladder. It will prevent further spread of the cancer. If the prostate cancer is in the early stages, prostatectomy can treat the cancer completely. This is done either through a surgical incision in the lower abdomen or the space between the scrotum and rectum.

This procedure also produce side effects like impotency, Urinary incontinence, narrowing of the urethra and difficulty in urination.

Radio Therapy : It is a form of treatment which uses high levels of radiation to kill cancer cells or keep them from growing and dividing thus reducing damage to healthy cells. It is more effective for early stage prostate cancer.

Good nutrition is an important part of recovering from the side effects of radiation therapy.

Slight skin changes will be visible after radiation. Skin may become red, swollen, warm and sensitive, as if in a sunburn but it is temporary. The long term effects include, slight darkening of the skin, enlarged pores, increased or decreased sensitivity of the skin and a thickening of tissue or skin.

Chemotherapy : It is a combination of drugs which is effective to kill or slow the growth of rapidly multiplying cells. Chemotherapy is usually prescribed to men with advanced prostate cancer. Chemotherapy drugs are carefully controlled in both dosage and frequency so that cancer cells are destroyed while minimizing the risk to healthy cells. As the drugs circulate throughout the whole body, they can effect the healthy cells also.

The side effects of chemotherapy include hair loss, nausea, vomiting, diarrhea, lowered blood counts, reduced ability of the blood to clot, and an increased risk of infection.

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Types of Mesothelioma Cancer

Mesothelioma is a rare form of cancer in which malignant cells are found in the mesothelium. When it occurs, the cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also spread to other parts of the body.

Mesothelium is a membrane that covers and protects most of the internal organs of the body. A layer of specialized cells called mesothelial cells lines the chest cavity, abdominal cavity, and the cavity around the heart. These cells also cover the outer surface of most internal organs. The tissue formed by these cells is called mesothelium. The mesothelium of chest is called pleura, of the abdomen is peritoneum and of the pericardial cavity, i.e the sac-like space around the heart, is called pericardium.

Most cases of mesothelioma begin in the pleura or peritoneum. The fibrous sheets, pleura helps to protect the lungs. There are 2 pleura and they can be called pleural membranes. Pleural space is the gap between them and they produce a lubricating fluid that fills the gap. This helps the lungs to move smoothly in the chest when they are inflating and deflating as we breathe. Peritoneal or Peritoneum is a smooth membrane, which lines the cavity of the abdomen (stomach). It helps to protect the contents of the abdomen. It also produces a lubricating fluid which helps the organs to move smoothly inside the abdomen as we move around.

Types of Mesothelioma Cancer

The three types of mesothelioma are

Pleural mesothelioma or cancer of the lung lining is the most common form.

Peritoneal mesothelioma or cancer of the abdomen lining

Pericardial mesothelioma

The structural appearance of cells under the microscope determine the cell or sub-type of mesothelioma. They are

Epithelioid - which is the least aggressive, most common, and considered the most amenable to treatment

Sarcomatous - the most aggressive form


Biphasic or mixed - a combination of both of the other cell types.

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