Prostrate Cancer, Causes, Signs and Symptoms, DIagnosis and Treatment.

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07/07/23

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Chapters

0:00 Introduction
1:01 Causes of prostate cancers
2:00 Symptoms of prostate cancers
2:24 Screening of prostate cancers
3:06 Diagnosis of prostate cancers
3:28 Treatment of prostate cancers

Prostate cancer is cancer of the prostate. The prostate is a gland in the male reproductive system that surrounds the urethra just below the bladder.[6] Most prostate cancers are slow growing.[1][3] Cancerous cells may spread to other areas of the body, particularly the bones and lymph nodes.[7] It may initially cause no symptoms.[1] In later stages, symptoms include pain or difficulty urinating, blood in the urine, or pain in the pelvis or back.[2] Benign prostatic hyperplasia may produce similar symptoms.[1] Other late symptoms include fatigue, due to low levels of red blood cells.[1]

Factors that increase the risk of prostate cancer include older age, family history and race.[3] About 99% of cases occur after age 50.[3] A first-degree relative with the disease increases the risk two- to three-fold.[3] Other factors include a diet high in processed meat and red meat,[3] while the risk from a high intake of milk products is inconclusive.[8] An association with gonorrhea has been found, although no reason for this relationship has been identified.[9] An increased risk is associated with the BRCA mutations.[10] Diagnosis is by biopsy.[2] Medical imaging may be done to assess whether metastasis is present.[2]

Prostate cancer screening, including prostate-specific antigen (PSA) testing, increases cancer detection but whether it improves outcomes is controversial.[3][11][12][13] Informed decision making is recommended for those 55 to 69 years old.[14][15] Testing, if carried out, is more appropriate for those with a longer life expectancy.[16] Although 5α-reductase inhibitors appear to decrease low-grade cancer risk, they do not affect high-grade cancer risk, and are not recommended for prevention.[3] Vitamin or mineral supplementation does not appear to affect risk.[3][17]

Many cases are managed with active surveillance or watchful waiting.[2] Other treatments may include a combination of surgery, radiation therapy, hormone therapy, or chemotherapy.[2] Tumors limited to the prostate may be curable.[1] Pain medications, bisphosphonates, and targeted therapy,[18] among others, may be useful.[2] Outcomes depend on age, health status and how aggressive and extensive the cancer is.[2] Most men with prostate cancer do not die from it.[2] The United States five-year survival rate is 98%.[4]