Prostate cancer is among the most common types of cancer. It is the second-leading cause of cancer death in men, exceeded only by lung cancer, and affects men of all backgrounds. Successful treatment depends in large measure on early detection, so understanding the signs and symptoms of prostate cancer is essential. So is beginning screening for prostate cancer at an age appropriate for your risk level.
Regional Cancer Care Associates (RCCA), one of the nation’s largest networks of oncology specialists, provides personalized care for all types of cancer and blood disorders, including prostate cancer. We have more than 20 community-based care centers in New Jersey, Connecticut, Massachusetts, Maryland, and the Washington, D.C., area. Learn more about the types of prostate cancer we treat.
Prostate cancer is a type of cancer that begins in the prostate, a gland located below the bladder in men. Like other cancers, it begins when cells begin to grow rapidly. Healthy cells reproduce at a consistent rate to replace cells that die. Cancerous cells, however, have undergone a genetic mutation that causes out-of-control reproduction. This creates a mass of abnormal cells that can keep spreading.
Researchers do not fully understand what causes cells to become cancerous. However, there are several known risk factors for prostate cancer that increase a person’s likelihood of developing the condition. These include:
A man’s risk of developing prostate cancer increases significantly as he gets older. Very few cases occur before age 40. The incidence rate rises after age 50, and most cases are diagnosed after age 65. The median age of diagnosis for prostate cancer is 67.
People of all racial backgrounds can develop prostate cancer. However, it is more common in people of African-American ancestry and Caribbean people of African ancestry. These individuals also tend to develop prostate cancer at a younger age than men of other racial and ethnic backgrounds. The reasons for this difference are still being investigated.
Some cases of prostate cancer may be tied to family history. A person’s chances of developing prostate cancer are much higher if one or more close relatives, such as a father or brother, have also been diagnosed. The risk is especially high if a relative was diagnosed with prostate cancer at a younger age than usual.
The familial connection is partly, though not entirely, due to inherited genetic mutations. Men with Lynch syndrome, a non-symptomatic condition affecting how DNA repairs itself, are at higher risk of developing prostate cancer. The same is true for men with mutations in their BRCA1 or BRCA2 genes, which are also associated with increased risks of breast cancer in women.
Several lifestyle factors may contribute to prostate cancer risk, though the reasons for this connection are still not fully understood. These include:
To understand the different types of prostate cancer, it is important to be familiar with the location, structure and function of the prostate gland. The prostate is a small organ found in the male reproductive system. Though it remains chestnut-sized through a person’s early life, it often grows larger after age 40, increasing up to the size of a lemon. It is located below the bladder, in front of the rectum, and surrounds the urethra. It is primarily made up of connective and glandular tissue and consists of five lobes:
Though not essential for life, the prostate plays a significant role in reproduction and sexual activity. Its primary function is to produce seminal fluid that nourishes and transports sperm. The prostate also contains muscles that forcefully push semen into the urethra, enabling ejaculation. These functions are often impacted by prostate cancer, especially in middle to advanced stages of the disease.
RCCA provides treatment for several different types of prostate cancer. They are categorized based on where the cancer originates in the prostate. Determining which type a patient has developed is key to planning the most effective treatment. The types of prostate cancer include:
Prostatic acinar adenocarcinoma refers to an adenocarcinoma, or cancer of the glandular tissue, that develops in the periphery (back) of the prostate. It typically does not spread any further than the prostate gland. This cancer accounts for nearly all prostatic adenocarcinomas.
Prostatic ductal adenocarcinoma initially develops in the tubes, or ducts, of the prostate gland. It often develops at the same time as acinar adenocarcinoma. Ductal adenocarcinoma is more aggressive and spreads more quickly than other adenocarcinoma types.
Small cell neuroendocrine prostate cancer develops in the hormone-producing cells of the prostate. It is a very rare form of prostate cancer that occurs in less than two percent of cases. It grows extremely aggressively, with a high chance of metastasizing — or spreading — to other parts of the body. As a result, most cases of small cell neuroendocrine carcinoma are diagnosed in advanced stages.
Sarcomatoid prostate cancer is a prostate cancer variant that develops in both glandular cells and in spindle cells, which are found in connective tissues and smooth muscle. This combination of cell types presents a unique challenge for treatment. Though rare, sarcomatoid carcinomas are extremely aggressive, with a tendency to spread throughout the body.
Transitional cell carcinoma of the prostate, also called urothelial carcinoma of the prostate, typically originates in the bladder. It develops in the urethra, the tube that transports urine outside the body. This form of prostate cancer makes up two to four percent of cases.
Prostate sarcoma is also sometimes called soft-tissue prostate cancer. This variant is unusual because it does not originate in glandular tissue. Instead, it develops from mesenchymal cells, or soft tissue cells, found in and around the prostate glands. It is also very aggressive.
There are also a handful of other, rare cancers that can develop in the prostate. These include:
There are multiple approaches to treating prostate cancer, and the optimal approach for a particular patient depends upon the nature and stage of his prostate cancer, his overall health, and his preferences and priorities. In many cases, an initial intervention – such as surgery or radiation therapy – will be followed by one or more medical treatments, such as hormonal therapy or – in advanced cases – chemotherapy. The wide range of effective treatment options has helped to significantly improve the outlook for the great majority of patients with prostate cancer. Management options include:
Active surveillance is also known as “watchful waiting.” Many cases of prostate cancer involve slow-growing acinar adenocarcinomas. Treatment may not be urgent if the cancer is diagnosed in its early stages. Instead, a urologist or oncologist may simply monitor the cancer with regular diagnostic testing. This course is often recommended for older patients and those with other serious health concerns.
Surgery is a common treatment for prostate cancer that has not spread outside the prostate gland. The standard procedure is a radical prostatectomy, which involves removing the entire prostate gland and some of the surrounding tissue. These surgeries are often performed using robotic technologies for increased precision during the procedure. The patient may experience some side effects afterward, including urinary incontinence or erectile dysfunction.
There are two main types of radiation therapy. External beam radiation therapy (EBRT) directs a precise beam of radiation at the tumor, killing cancer cells while sparing healthy tissue. Brachytherapy involves implanting a small pellet or “seed” of radioactive material directly into the tumor. Either type may be an option r for low-grade cancers that are still limited to the prostate gland or for cancer that returns after treatment.
Chemotherapy utilizes strong drugs to kill cancer cells. The drugs attack cells that divide quickly, including cancer cells. However, they may also attack other fast-growing cells, causing hair loss and other side effects. For this reason, and due to the availability of other effective medical therapies, the use of chemotherapy typically is reserved for advanced forms of prostate cancer marked by metastasis, or spread, to other areas of the body.
Targeted therapy is a newer treatment method that utilizes drugs designed to work specifically against proteins or other substances that are found only in cancer cells or that support the growth and spread of cancer cells. Some targeted therapies work by inhibiting the processes that allow cell growth, while others deliver radiation or chemotherapy directly to cancer cells. Not all cancer types are susceptible to targeted therapy. If the cancer is susceptible, however, this approach is effective in destroying cancer cells with minimal side effects. Two targeted therapies currently are approved by the Food and Drug Administration to deliver radiation to cancer cells in men with metastatic prostate cancer.
Hormone therapy plays a central role in the ongoing management of prostate cancer. Two main forms of hormone therapy are used to treat the disease. The first form, called androgen deprivation therapy (ADT), lowers levels of androgens, the male sex hormones that fuel the growth and spread of prostate cancer. In later stages of prostate cancer, the second type of hormonal therapies, called androgen receptor pathway inhibitors, or ARPIs, may be prescribed. These medications inhibit – or interfere with – the ability of androgens to bind with receptors on other cells. They also limit the ability of those receptors to move to a cell’s nucleus, where they can influence the cell’s reproduction. This inhibition can slow the growth of prostate cancer tumors.
Immunotherapy harnesses the power of the body’s immune system to identify and attack cancer cells. In some forms of immunotherapy, physicians remove immune cells from the patient’s body by means of an intravenous lines, modify those to enhance their ability to attack cancer cells, and then re-infuse the cells into the body.
Prostate cancer can present in a variety of forms. The medical oncologists of Regional Cancer Care Associates have the expertise, experience, and cutting-edge therapies need to treat those different types of prostate cancer. Our compassionate team of medical oncologists and hematologists delivers cutting-edge treatments for several types of cancer and blood disorders. With more than 20 locations near you throughout New Jersey, Connecticut, Massachusetts, Maryland, and the Washington, D.C., area, patients can receive treatment close to home. Contact us today to schedule a consultation.
What are the symptoms of prostate cancer?
Many cases of prostate cancer are not marked by symptoms, particularly in their early stages. Later-stage prostate cancer can cause urinary and sexual symptoms, including:
Stage IV metastatic prostate cancer may cause symptoms elsewhere in the body, such as bone pain, neurological symptoms, fatigue, or weight loss.
It is important to note that symptoms such as frequent urination or slow urination can be indicative of a number of conditions and do not necessarily mean that a man has prostate cancer. While they are not cause to panic, they are reason to seek prompt medical evaluation.
How is prostate cancer diagnosed?
Indications of possible prostate cancer are identified by a variety of methods, including PSA (prostate-specific antigen) blood tests, medical imaging, or digital rectal examination (DRE). Diagnoses are confirmed with a biopsy.
What types of prostate cancer are treated at RCCA?
RCCA treats all types of prostate cancer, including:
What treatments are available for prostate cancer?
RCCA provides a wide range of medical therapies to treat prostate cancer, with the recommended regimen for a particular patient based on the type of prostate cancer, its stage, and the patient’s overall health condition. Some of the approaches available at RCCA include:
What other types of cancer are treated at RCCA?
RCCA has expertise in handling all cancer types, including prostate, breast, lung, and colon cancer, in addition to a variety of blood disorders.
No matter which type of prostate cancer you or a loved one has been diagnosed with, Regional Cancer Care Associates is there to fight the battle with you. Our team of experts will determine the best combination of the most advanced treatments and methods, which can include chemotherapy, radiation, hormone therapy or surgery, to help you achieve the best possible outcome. For more information or to find an RCCA location near you, contact us today at 844-346-7222.
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