prostate cancer
Meaning of prostate cancer: The hard part is not finding it but judging which ones need treating, since many would never have caused harm.
Definition of prostate cancer
Prostate cancer is a cancer that begins in the glandular tissue of the prostate, the walnut sized gland sitting below the bladder that supplies part of the fluid in semen. Most cases grow slowly and stay confined to the gland for years, while a minority grow and spread quickly, and separating the two is the central problem.
How is its behavior judged?
Three separate measurements are taken, and confusing them is the most common source of misunderstanding about a report.
| Measure | What it describes |
|---|---|
| Grade | How far the cancer's gland structure has departed from normal under the microscope, scored from the two most prominent patterns and then placed in a band |
| Stage | Whether the tumor is confined within the gland, has grown through its outer layer, or has reached lymph nodes or bone |
| Blood marker level | A protein made by prostate tissue, raised by cancer but also by simple enlargement, by inflammation and by recent examination or procedures |
A low grade tumor confined to the gland may never threaten a person's health, which is why active monitoring, with repeat testing and imaging instead of immediate treatment, is an established option for cancers in that group, as at stage I.
How is it usually found?
Early prostate cancer produces no symptoms, because it typically begins in the outer part of the gland rather than beside the tube carrying urine. Urinary symptoms are far more often caused by ordinary age related enlargement of the gland pressing on the bladder outlet. Detection therefore comes from a blood marker, from examination, or as an incidental finding in tissue removed for another reason, with imaging and a needle biopsy following. The difficulty of screening lies here: testing finds many cancers that would never have surfaced in a person's lifetime, alongside the ones that would.
Where does it spread?
Lymph nodes in the pelvis come first, and bone is the characteristic distant site, particularly the spine, pelvis and ribs. Deposits in bone can cause pain, fracture or pressure on the spinal cord. Growth in most prostate cancers depends on male hormones, and treatments that lower or block those hormones are effective for a period even in widespread disease, which is unusual among advanced cancers. Age, a family history of the disease, African ancestry and certain inherited gene variants all raise the likelihood of developing it.
Used in a sentence
An elevated PSA level prompted a biopsy that confirmed prostate cancer.
Good to know
Prostate cancer grade, which reflects how abnormal the cancer cells appear, is distinct from its stage, which describes how far the cancer has spread, and both are considered together when evaluating the disease.
Word origin
Where “prostate cancer” comes from
Formed from prostate, from Greek prostates, meaning one standing before, combined with cancer, from Latin cancer, meaning crab.