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Types of Prostate Cancer

There are a few different types of cells in the prostate, but the overwhelming majority of prostate cancers begin in the gland cells of the prostate. Over 99% of all prostate cancers start in the gland cells. These cells are responsible for making the prostate fluid present in semen. This type of prostate cancer is referred to as adenocarcinoma.  As the other types of prostate cancer are very rare, is it almost guaranteed that a diagnosis of prostate

cancer leads to a diagnosis of the adenocarcinoma type. Listed below are some of the different types of prostate cancer
Adenocarcinoma The most common type of prostate cancer, adenocarcinoma begins in the main glandular zone of the prostate, affecting gland cells.  When these gland cells mutate into cancer cells, adenocarcinoma is present.  This type of cancer develops on the surface of the prostate (hence carcinoma, or cancer affecting the epithelial layer of cells).  This type of cancer is also the second most common cancer in men over 65 years of age, behind only melanoma. Prostatic Intraepithelial Neoplasia Although prostatic intraepithelial neoplasia is not typically cancerous, it can sometimes lead to more serious prostate tumors.  Prostatic intraepithelial neoplasia is the abnormal growth of cells found in a biopsy of the prostate. Leiomyosarcoma Leiomyosarcoma is a rare type of prostate cancer that is an abnormal growth of smooth muscle.  Since these smooth muscle cells are found in most parts of the body, this type of cancer can actually appear anywhere in the body.  Rhabdomyosarcoma This rare type of cancer is a cancer of connective tissues where cancerous cells grow from skeletal muscle progenitors.  As this type of cancer can appear in almost any anatomic location in the body, they sometimes, albeit rarely, appear in the prostate.  It generally affects children more than adults, most commonly found in children between the ages of 1 and 5. Since the overwhelming majority of prostate cancer cases are classified as adenocarcinoma, most information available, including treatment options, diagnostic tests, or screening procedures are focused on adenocarcinoma of the prostate.  When diagnosing cancer, the doctor will let the patient know the type of prostate cancer they have.
Prostate Cancer Diagnosis: If an individual shows abnormalities in their prostate cancer screening tests, doctors will continue by diagnosing the patient.  Since prostate cancer often does not show symptoms in its early stages, prostate cancer diagnosis relies on a number of different tests to obtain a proper diagnosis.  Using imaging tests and biopsy procedures, doctors can determine whether or not cancerous cells are present in the prostate, and determine the type of prostate cancer that is present.  Most cases can proceed directly to a treatment procedure and diagnosis and staging.
Transrectal Ultrasound: An ultrasound may sound more familiar for pregnancy tests, but a form of ultrasounds can be used to determine whether or not the cancerous cells have spread past the prostate. The ultrasound can not only depict the presence of cancer, but it also may reveal has spread to any nearby tissue.
Computerized Tomography (CT) Scan: The purpose of a CT scan is to create a cross sectional image of the body. This medical procedure can identify any abnormality to the organs, such as enlarged lymph nodes. Unfortunately, this medical test can not determine whether or not the abnormalities are due to cancer. Therefore, doctors will administer CT scans along with other medical tests, to properly gauge an individual's health.
Bone Scan: This medical procedure snaps a photograph of an individual's skeleton. This medical test determines whether or not the cancerous cells have spread to the bone. Prostate cancer is unique, in that it can spread to any bone in the body.
Magnetic Resonance Imaging: This medical procedure produces the same purpose of a CT scan, but with magnets and radio waves. However, the MRI can detect the possibility of a spread of cancer in the bones or lymph nodes.
Prostate Biopsy
: A prostate biopsy is essential in reaching a diagnosis.  In this procedure, a doctor removes a sample of the suspected region.  This sample, taken from the tumor, is then sent to the laboratory where it is studied by a specialist under a microscope.  If cancerous cells are found, the doctor may order additional tests to determine the stage, grade, and Gleason score of the tumor.
Lymph Node Biopsy: Once a CT scan or an MRI scan discovers an enlarged lymph node, a doctor will administer this test. A doctor performs this medical procedure by removing several of the nodes by the prostate for a closer examination. Once the doctor has removed said nodes, a pathologist will examine them through a microscope to determine the damage by prostate cancer.
Gleason Score: The Gleason score grading system is used in prostate cancer staging to assist in determining the prognosis for prostate cancer patients.  It is used in conjunction with other diagnostic tests such as transrectal ultrasounds and prostate specific antigen tests in prostate cancer staging.  By classifying each case into a detailed staging system, doctors are able to better choose treatment options and determine the prognosis of a patient.  A Gleason score is determined by the microscopic appearance of the prostate tissue.  This biopsy of the prostate tissue is taken through the rectum using hollow needles.  The sample is then brought to a laboratory where a pathologist studies the slides and assigns a grade according to the tumor pattern.  Two grades are taken, based on the two most common patterns in the tissue.  After these grades are taken, they are added together to obtain a Gleason score.  Since there are 5 patterns, the worst possible Gleason grade is 5.  A Gleason score, then, varies between 2 and 10, with 10 being the worst prognosis.  Patterns:
  • Pattern 1 - The cancerous tissue closely resembles healthy prostate tissue.  Prostate glands are closely packed and well-shaped.

  • Pattern 2 - The cancerous tissue still possesses well-shaped glands, but the glands are enlarged and spaced out.

  • Pattern 3 - The cells are darker, but glands are still recognizable.  Some of the cells have invaded surrounding tissue as well

  • Pattern 4 - Glands are becoming unrecognizable, with many cells invading healthy tissue.

  • Pattern 5 - The tissue has no recognizable glands.  Sheets of cells are found throughout the surrounding healthy tissue.

Using the primary grade and the secondary grade, the pathologist can then give a Gleason score to the patient.  The Gleason score system is also used in prostate cancer staging.
Over the past decade prostate cancer has become one of the most commonly diagnosed cancers in the United States. This past year alone, over 180,000 individuals were diagnosed with prostate cancer, and an estimated 28,000 people died from the disease. It is the leading cancer for all men for all races, in the United States to develop. Prostate Cancer Statistics (Race & Ethnicity)
Although prostate cancer is the leading cancer in men; the statistics differ from ethnic populations. Out of all men, African American males have the highest propensity for developing prostate cancer. Caucasian males ranked second. The rest of the list was comprised in this order: Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native males. Since 1975, the death rate among males has varied depending on the ethnic background of the individual. This past year, African American males had the highest death rate, followed closely by Caucasian males. The list continued, in the following order: American Indian/Alaska Native, Hispanic, and Asian/Pacific Islander
Prostate Cancer Statistics (By Age):  The rate of a male developing prostate cancer, will increase with age. Percentage of U.S. Men Who Develop Prostate Cancer over 10-,20-, and 30-Year Intervals According to Their Current Age (2004-2006)

Current Age

10 Years

20 Years

30 Years

30

0.01

0.30

2.41

40

0.29

2.44

8.07

50

2.23

8.08

14.06

60

6.45

13.06

15.81

Prostate Cancer Statistics by Incidence:

  • Since to 2001, the incidence of prostate cancer has significantly decreased (4.4%) for Caucasian males.

  • Since to 2001, the incidence of prostate cancer has decreased by 1.6% for African American males.

Prostate Cancer Statistics by Death Trends:
  • Since 1994, each ethnic race's death rate from prostate cancer significantly decreased in the United States, but American Indian/Alaska Native males.

4.1%

Caucasian Males

4.0%

African American Males

4.1%

Asian/Pacific Islander Males

3.5%

Hispanic Males

 
 
 
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