Prostate cancer

It is the second most frequent cancer among men, with approximately 899.000 new cases per year in the world.

The prostate is the sexual gland of man responsible for producing semen. It is the size of a walnut and is located under the bladder of urine, surrounding the urethra. Unlike another type of cancer, prostate cancer is characterized by very slow evolution. Prostate cancer is extremely common, even though its exact cause is unknown. When the prostate tissue is examined under the microscope after surgery or at an autopsy, cancer is found in 50 percent of men over 70 years of age and practically all of those over 90, although most of them are not aware of the disease in the absence of recognizable symptoms.

Symptoms of the disease can take a long time, even years, to manifest. In the early stages, when the tumor is limited to the prostate, it may be asymptomatic or accompanied by mild obstructive symptoms easily attributable to benign hyperplasia, such as urinary incontinence, decreased caliber or disruption of the urine stream, the frequency of urination, especially during the night, difficulties in urinating and the stinging sensation during urination.

When tumors are locally advanced they are accompanied by clear obstructive symptoms, hematuria (blood in the urine) or signs of infection (the latter two are rare). It can also lead to frequent pain in the lower back and difficulties in intercourse.

When it comes to advanced tumors, edema or swelling of the legs (due to the growth of regional lymph nodes), bone pain (by tumoral extension to the bone) and even weakness or loss of leg strength (compression of the spinal cord or Nerve roots). It can also cause kidney failure, loss of appetite and weight or anemia.

The exact cause of prostate cancer is unknown but 4 main hypotheses have been established:

Genetic Factors

Although there are indications that genetic factors are involved in the cause of prostate cancer, it is difficult to separate these factors from environmental factors. Genetic studies have shown that there is a chromosome 1 gene or HPC-1 gene that increases the likelihood of getting prostate cancer..

Hormonal factors

Several studies have suggested that hormonal factors may play a role in the development of prostate cancer. These include:

  • The dependence of androgenic (male) hormones on most prostate cancers.
  • The fact that prostate cancer does not appear in eunuchs.
  • The fact that prostate cancer can be induced in rats by chronic administration of estrogens and androgens (female and male hormones).
  • The frequent association of prostate cancer with areas of sclerotic prostatic atrophy.

Environmental factors

Those who migrate from regions of low incidence to regions of high incidence maintain a low incidence of prostate cancer for a generation and then adopt an intermediate incidence. Several environmental factors that could be prostate cancer promoters have also been identified. These include:

  • Diet high in animal fats.
  • Exposure to smoke from the tailpipe of cars.
  • Pollution of air, cadmium, fertilizers and chemicals in the rubber, printing, painting and naval industries.

Infectious agents

It has been considered that sexually transmitted infectious agents could cause prostate cancer, however, epidemiological, virological and immunological studies have yielded conflicting results. Epidemiological studies have suggested an increase in the risk of prostate cancer associated with a greater number of sexual partners, a previous history of sexually transmitted disease, frequency of sexual intercourse, relationship with prostitutes, and early age of onset of sexual activity.

In contrast, other studies have suggested that there is an increased risk of prostate cancer associated with suppression of sexual activity, such as a later onset, earlier spike and premature cessation of sexual activity. On the other hand, some studies have shown a higher risk among patients who were never married and an even greater risk among those who had children, but other studies have not shown a significant correlation with marital status or number of children. Similarly, studies of potential infectious agents have not yielded conclusive results, nor do they provide concrete evidence for an infectious cause of prostate cancer.

The probability of survival after prostate cancer is very high, close to 100 percent in the five years following the time of diagnosis. The survival rate for the next 10 years is 99 percent, while for the subsequent 15 years it is 94 percent.

The only cases in which the survival rate is low is when the cancer spreads, and spreads to other bones and organs. In these cases, the survival rate is 28 percent.

Despite the difficulty in accurately predicting the side effects of prostate cancer treatment, some constant effects may be known according to the type of treatment used.

Surgery

Surgical treatment can cause discomfort the first few days after the operation. Another common symptom in these types of interventions is the feeling of tiredness and weakness. Impotence and urinary incontinence are undoubtedly the most annoying side effects for the patient.

Radiotherapy

The patient may have a feeling of deep tiredness. Other common symptoms of this type of intervention are hair loss, diarrhea and / or pain when urinating. External radiation therapy can also cause redness, dryness and sagging of the part of the treated skin. Some men undergoing this type of treatment suffer impotence.

Hormonal therapy

Loss of sexual appetite, impotence or sudden increases in temperature are common symptoms of this treatment. Some methods of this therapy can cause higher physical alterations.

Biological therapy

Some of its side effects are fever, muscle pain, body weakness, loss of appetite, nausea, vomiting or diarrhea.

Benign prostatic hyperplasia

It is a condition characterized by enlargement of the prostate. It has no relation to prostate cancer.

Increased size of the prostate is a process stimulated by the presence of the hormone testosterone. This hormone is present throughout life in the male sex. The older a person, their prostate has had more time to grow. This means that, with age, virtually all men will have a large prostate. By age 40, 10% of men already have an enlarged prostate; At 50 years, that number jumps up to 50%; After 80 years, more than 80% of the male population has benign prostatic hyperplasia.
Increasing the prostate itself is not a problem. The problem is in the fact that the prostate is found anatomically located next to some structures of the urinary tract, mainly the urethra.
Among the main symptoms are: Pain or difficulty urinating. Weak urine stream. Need to urinate small volumes with great frequency. Inability to empty the bladder. Urinary infection. Bladder calculus. Renal insufficiency in cases of severe obstruction and hydronephrosis
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