1. Introduction
Prostate cancer is a malignant tumor arising from the epithelial cells of the prostate gland. It is one of the most common cancers in men, particularly affecting older age groups. The disease often progresses slowly but may become aggressive in advanced stages.
2. Types of Prostate Cancer
Prostate cancer is classified mainly by histology:
- Adenocarcinoma
- Ductal adenocarcinoma
- Small cell (neuroendocrine) carcinoma
- Transitional cell carcinoma
- Arises from the prostatic urethra (rare)
- Sarcoma
- Very rare, seen in younger patients
3. Pathogenesis
Prostate cancer develops through hormonal and genetic influences:
- Androgen-dependent tumor growth (testosterone, DHT)
- Progression from prostatic intraepithelial neoplasia (PIN)
- Key genetic alterations:
- TMPRSS2–ERG fusion
- PTEN loss
- BRCA1/BRCA2 mutations
- TP53 mutations
- Risk factors:
- Increasing age
- Family history
- High-fat diet
- Obesity
- Smoking
- Chronic inflammation
4. Laboratory Diagnosis
Diagnosis involves clinical, laboratory, and radiological evaluation:
A. Screening Tests
B. Confirmatory Diagnosis
C. Histological Grading
- Gleason score / Grade Group system
D. Imaging and Staging
- MRI prostate (multiparametric MRI)
- CT scan / Bone scan for metastasis
5. Treatment
Treatment depends on stage, grade, and patient factors:
A. Active Surveillance
- For low-risk, localized disease
B. Surgery
C. Radiotherapy
- External beam radiotherapy
- Brachytherapy
D. Hormonal Therapy
- Androgen deprivation therapy (ADT)
- LHRH agonists/antagonists
- Anti-androgens
E. Chemotherapy
- Docetaxel (advanced disease)
F. Targeted & Immunotherapy
- PARP inhibitors (BRCA-mutated tumors)
- Immunotherapy in selected cases
6. Prevention
Preventive measures include:
- Regular PSA screening in high-risk men
- Healthy diet (low fat, high fruits & vegetables)
- Physical activity
- Weight control
- Avoid smoking
- Genetic counseling for familial cases
7. Keynotes
- Prostate cancer is the most common malignancy in elderly men.
- Adenocarcinoma accounts for the majority of cases.
- PSA is the most important screening marker.
- Gleason score determines prognosis.
- Androgen deprivation therapy is the cornerstone of advanced disease treatment.
- Early-stage disease has an excellent prognosis.
Further Readings
- https://int.livhospital.com/latest-prostate_cancer-treatments-7-cutting-edge-options-to-know-in-2025
- https://www.cancerresearchuk.org/about-cancer/prostate_cancer/stages/types
- https://www.cityofhope.org/clinical-program/prostate_cancer/types
- https://www.icr.ac.uk/about-us/icr-news/detail/scientific-achievements-of-2025
- https://www.nature.com/articles/s41572-020-00243-0
- https://int.livhospital.com/7-latest-prostate_cancer-treatments-new-advances-and-practical-options-for-2025
- https://www.mayoclinic.org/diseases-conditions/prostate_cancer/in-depth/prostate_cancer-types/art-20584938
- https://www.mskcc.org/news/top-cancer-treatment-advances-at-msk-in-2025
- https://www.cancer.org/cancer/types/prostate_cancer/about/key-statistics.html
- https://www.renalandurologynews.com/features/more-biomarker-testing-in-prostate_cancer-care-a-priority-in-2025
- https://oncologynewstoday.co.uk/new-super-test-for-prostate_cancer-developed-in-the-uk
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9828197
- https://www.mdpi.com/1420-3049/27/17/5730
- https://www.sciencedirect.com/science/article/abs/pii/S0263931925001425
- https://www.aafp.org/pubs/afp/issues/2024/1100/prostate-cancer-screening.html#:~:text=Prostate%2Dspecific%20antigen%20screening%20should%20be%20performed%20only,expectancy):%20Age%2050:%20Men%20with%20average%20risk
