Introduction
Prostate cancer is the most prevalent non-skin cancer that affects men. As the name suggests, the condition attacks the prostate, which is a gland found in the male reproductive system. The majority of prostate cancers take time to develop. Nonetheless, others grow rapidly. The cancer cells may affect other parts of the body including lymph nodes and bones (James et al., 2017). The symptoms of prostate cancer are hard to detect, and the condition may show no signs in the early stages.
Doctors use prostate-specific antigens (PSA) to diagnose the disease (James et al., 2017). The use of this diagnostic procedure has contributed to an increase in the number of people found to be suffering from the condition. Nonetheless, the process remains contentious because of contradicting outcomes from the latest randomized control experiments. The disease is age-related and affects mainly men aged above 50 (James et al., 2017). It does not imply that prostate cancer cannot affect young men.
The fact that prostate cancer does not exhibit apparent symptoms at an early stage makes it difficult to diagnose. This article is important as it will enable people to understand the various risk factors that subject men to the danger of contracting the disease. Worldwide, prostate cancer is the second most prevalent form of cancer and one of the principal causes of fatality in men. Currently, the disease affects over 1.1 million men and kills at least 300,000 males annually (James et al., 2017). The reason for choosing this ailment is to identify its risk factors and create public awareness. It will go a long way towards enhancing people’s health.
It will change the misperception that prostate cancer is a disease of the elderly. Understanding the pathophysiology of the disease will enable people to institute precautionary measures. The study will enable the country and society at large to cut down on the cost attributed to treating and caring for prostate cancer patients. People will avoid risk factors that expose them to the danger of contracting the disease.
Background
The first case of prostate cancer was reported in 1853 at the London Hospital by J. Adams. The surgeon detected the ailment via histological assessment (Mustafa et al., 2016). He noted that the condition was a “rather strange disease”. Decades later, the disease has become an important health issue among men. In the United States, prostate cancer is the most prevalent cancer type among men.
The country reports over 180,000 new cases of the disease and at least 31,000 deaths annually (Mustafa et al., 2016). Three factors are attributed to the high number of prostate cancer patients in the United States. First, it is hard to make a distinction between the condition and other forms of urinary obstructions. Second, age contributes to the increase in the rate of prostate cancer. It does not influence other types of cancers. Third, the ‘western’ lifestyle exposes men to the risk of contracting the disease (Mustafa et al., 2016). The condition is not common among Asian populations.
Prostate cancer obstructs the urinary system. It begins by affecting the prostate, which is an organ that is responsible for the production of seminal fluid used to preserve and transport sperm. At the onset, the condition does not affect the urinary system because the cancerous cells are concentrated in the prostate. However, when the cells start to spread to other parts of the body, they affect the ureters.
A person develops urinary incontinence and is unable to regulate urine stream. Failure of the prostate to function normally may also impact the reproductive system, leading to the inability of the patient to generate sufficient seminal fluid to store and transport sperm.
Pathophysiology
Prostate cancer is regarded as epithelial cancer or adenocarcinoma, which occurs due to the mutation of semen-producing gland cells. The condition affects the peripheral areas of the prostate gland. In the beginning, tiny clusters of cancer cells remain enclosed in the otherwise strong prostate gland (Mustafa et al., 2016). Such a condition is referred to as prostatic intraepithelial neoplasia (PIN) (Mustafa et al., 2016).
Despite the lack of evidence of PIN as a cancer sign, it is strongly connected to the ailment. The cancer cells multiply gradually and spread to the prostate tissue, developing into a tumor. With time, the size of the tumor may grow, affecting other adjacent organs like the rectum and seminal vesicles. The spread of the growth of other organs is referred to as metastasis. Prostate cancer mainly spreads to lymph nodes and bones.
The prostate amasses zinc and uses it to generate citrate. Mustafa et al. (2016) argue that protein ZIP 1 helps to carry zinc to the prostate cells. The Zinc facilitates the transformation of the metabolism of the cells to generate citrate, which is a crucial constituent of semen. The process of zinc amassment, alteration of metabolism, and citrate generation lack sufficient energy. Therefore, prostate cells forfeit a lot of energy to facilitate this process. According to Mustafa et al. (2016), prostate cancer cells do not have zinc. Hence, they store adequate power, which they use to replicate and spread. The lack of zinc is said to be a result of inhibition of the gene that produces protein ZIP 1.
Discussion
Link Between Age and Prostate Cancer
Aging in males is associated with fatigue, lack of energy, depression, reduced sexual performance, and gradual loss of libido among other symptoms. Age-related reduction in bioavailable and free testosterone impacts different bodily compositions of men (Vaidyanathan et al., 2016). As one grows old, the bone mineral density declines. Moreover, the muscle and fat masses decrease and increase respectively. Vaidyanathan et al. (2016) argue, “Testosterone is the primary androgen receptor-activating hormone and is also responsible for the development of the principal sexual characteristics” (p. 11).
Age contributes to the reduction of the overall amount of biochemical testosterone. Various androgens, among them testosterone are responsible for the development of the prostate gland. Nonetheless, researchers are yet to understand the specific contribution of testosterone levels to the progression of prostate cancer. Currently, the majority of the studies reveal that an increased amount of circulating testosterone cushions an individual from the danger of prostate cancer.
Researchers argue that adaptive immunity decreases as one gets old. Numerous age-related factors are attributed to this decline. They include “reduced production of naïve T-cells, limited diversity of antigen-recognition repertoire, and alterations in signal transduction in T-cells with changes in the cytokine induction patterns” (Vaidyanathan et al., 2016, p. 15). Aging results in a reduction in an immune reaction and activates the inflammatory channels causing the growth of prostate cancer.
The decline in the level of naïve T-cells contributes to the increased production of pro-inflammatory cytokines, which trigger instability in the pro- and anti-inflammatory systems. Inflammation has numerous impacts on cancer, which range from growth and progression to tumors, to a reaction to treatments.
Clinical Problem
Studies show that one out of six men born in the United States is at risk of contracting prostate cancer (Mustafa et al., 2016). These grim and confounding statistics reveal the enormous clinical problem that the condition poses to society. One cannot disregard the considerable cost attributed to diagnosing and treating the disease. In the United States, the rise in the rate of prostate cancer is hurting an already overstrained health care system.
Currently, no universal therapy has proved to be useful in the treatment of the condition, especially after it metastasizes. Mustafa et al. (2016) contend, “The biology of prostate cancer is heterogeneous and unpredictable, which contributes to the paucity of effective therapies for the aggressive disease” (p. 7). The inability to detect prostate cancer at an early stage makes the condition a significant clinical problem, therefore the call for the formulation of modern therapeutic approaches to contain the disease.
Symptoms
Prostate cancer shows no apparent symptoms at the onset. At times, it results in signs akin to those of benign prostatic hyperplasia. The symptoms include frequent urination at night, challenges in starting and maintaining a constant flow of urine, pain when urinating, and traces of blood in the urine. Prostate cancer causes urinary dysfunction because the affected gland is adjacent to the prostatic urethra. Adjustments in the organ, such as the growth of cancerous cells interfere with the normal urinary function. Mustafa et al. (2016) maintain, “The vas deferens deposits fluid into the prostatic urethra and secretions from the prostate gland are included in semen content” (p. 7).
Hence, prostate cancer may also lead to complications like erectile dysfunction and painful ejaculation. The ailment may exhibit other signs after spreading to other parts of the body. For instance, individuals suffering from the condition may complain of bone pain, particularly the ribs, pelvis, or vertebrae.
Prognosis
The prevalence of prostate cancer is high in the developed states compared to the developing countries. The majority of the risk factors associated with the condition are common in developed nations. Consumption of red meat, longer life expectancy, and failure to eat vegetables and fruits are some of the factors that contribute to the high rate of prostate cancer in the developed countries (Mustafa et al., 2016).
Additionally, the availability of screening programs adds to the high number of cases reported in the states. In the United States, individuals diagnosed with prostate cancer have a 5-year survival rate. In Japan, patients have a higher survival rate than those in Europe and the United States. Gleason score, pretreatment prostate-specific antigen level, and stage of the disease are the most significant clinical prognostic indicators of the condition (Epstein et al., 2016). The prognosis becomes weaker with changes in the phase of the disease. Oncologists may use nomograms to estimate the danger of a patient who has prostate cancer.
Treatment
Doctors use local therapies to manage prostate cancer. They entail the removal of a tumor from a particular, small region of the body (Horwich, Parker, De Reijke, & Kataja, 2013). The therapies include radiation therapy and surgery. Local treatments may help to cure early-stage prostate cancer. Nevertheless, if the disease has metastasized, the doctors require using systematic treatments to deal with the condition.
Surgery
It entails the removal of the growth together with some adjacent healthy tissue. The operation helps to get rid of the tumor before it metastasizes. The stage of prostate cancer determines the form of surgery to be performed (Horwich et al., 2013). The two common types of operations are radical prostatectomy and laparoscopic prostatectomy. Radical prostatectomy refers to the amputation of the seminal vesicles and the whole prostate.
It may also include the removal of lymph nodes located close to the pelvic region. The operation may result in sexual complications (Horwich et al., 2013). Laparoscopic prostatectomy is not invasive and heals fast. The surgery entails the use of robotic instruments to remove the prostate gland together with some adjacent healthy tissues. Even though the operation results in insignificant pain and bleeding, it may cause urinary and sexual complications.
Radiation Therapy
The treatment method involves the use of high-energy rays to kill cancer cells. The various forms of radiation therapy include external-beam radiation therapy, proton therapy, and intensity-modulated radiation therapy (IMRT). External-beam radiation therapy is the most regular treatment procedure used to treat prostate cancer patients. A radiation oncologist “uses a machine located outside the body to focus a beam of x-rays on the area with cancer” (Horwich et al., 2013, p. 113). Some cancer centers have advanced machines that use computers to identify the area affected by cancer.
Conclusion
Prostate cancer is an age-related condition that is prevalent among men. The disease affects the urinary system. If not treated, it spreads to other parts of the body and affects the reproductive system as a whole. Lack of noticeable symptoms at an early stage makes it hard for doctors to diagnose the disease. Surgeries and radiation therapy are the primary modes of treatment used to cure prostate cancer.
The emergence of new ways of diagnosing the condition has resulted in many people being concerned about overdiagnosis. They are afraid that overdiagnosis of prostate cancer may lead to additional needless investigations like radiation therapy and prostatectomy. According to my view, overdiagnosis will remain a major problem in dealing with prostate cancer. Therefore, there is a need for the establishment of comprehensive and accurate diagnostic approaches to guarantee that patients are not subjected to unnecessary invasive procedures that might affect their reproductive health.
References
Epstein, J., Zelefsky, M., Sjoberg, D., Nelson, J., Egevad, L., Magi-Galluzzi, C., … Klein, E. (2016). A contemporary prostate cancer grading system: A validated alternative to the Gleason score. European Urology, 69(3), 428-435.
Horwich, A., Parker, C., De Reijke, T., & Kataja, V. (2013). Prostate cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 24(6), 106-114.
James, L., Wong, G., Craig, J., Hanson, C., Ju, A., Howard, K., … Tong, A. (2017). Men’s perspectives of prostate cancer screening: Systematic review of qualitative studies. PLoS ONE, 12(11), 1-23.
Mustafa, M., Salih, A., Illzam, E., Sharifa, A., Suleiman, M., & Hussain, S. (2016). Prostate cancer: Pathophysiology, diagnosis, and prognosis. Journal of Dental and Medical Sciences (IOSR-JDMS), 15(6), 4-11.
Vaidyanathan, V., Karunasinghe, N., Jabed, A., Pallati, R., Kao, C., Wang, A., … Ferguson, L. (2016). Prostate cancer: Is it a battle lost to age? Geriatrics, 1(4), 1- 27.