Understanding Prostate Cancer
1 in 7 men will be diagnosed with prostate cancer at some point in their lifetime. This is a sobering and frightening statistic; however, despite its prevalence, many men still don’t fully understand what their cancer means.
There are many aspects to understanding your prostate cancer.
Knowing what you’re dealing with and the terminology that your doctor will use to discuss your cancer can ease your stress and anxiety, help you ask the right questions and allow you to proactively participate in your health.
What is the Prostate?
Located between the bladder and the penis is the prostate gland. More specifically, the prostate is located below the bladder and above the pelvic floor, and surrounds the urethra. In healthy males, the prostate gland weighs about an ounce, and is roughly the size of a walnut.
This gland is found only in men and, when combined with sperm cells from the testicles, produces the fluid that makes up semen. Prostatic secretion is an important part of nourishing sperm cells, ensuring that they function properly.
The muscles of the prostate are also responsible for pressing semen into the urethra, which is then expelled outward in the process of ejaculation.
The prostate gland is comprised of three zones:
- The transition zone, which is the smallest part of the gland and the closest to the urethra;
- The central zone, which surrounds the transition zone and comprises a quarter of the prostate’s mass;
- The peripheral zone, which is the main part – about 75% – of the prostate.
Cancer is mostly found in the peripheral zone.
How does Prostate Cancer Form?
In healthy, noncancerous cells, division, growth and cell death are normal aspects of a cell’s life cycle. Healthy human cells are almost always in one of two phases: interphase or mitosis.
Interphase occurs when cells grow and replicate their DNA. Cells spend most of their time in this phase, and undergo a series of bodily checkpoints to ensure that they are functioning properly. If the cells are not functioning properly, they undergo a process of self-destruction called apoptosis, which prevents them from growing and taking nutrients from healthy cells.
When cells are not in interphase, they are undergoing mitosis, or dividing to make new cells. The frequency of mitosis depends on the cell type. For example, hair follicles undergo mitosis more frequently than, say, brain cells.
When cancer forms, however, the normal chain of events becomes warped. Somehow, abnormal cells bypass the body’s checkpoints and – instead of growing, dividing, and dying due to apoptosis – cancerous cells grow and divide unchecked. Because these cells are busy constantly dividing, they cannot function properly.
In the prostate, cell growth is attributed to a hormone called androgen. Testosterone is an androgen hormone. The prostate grows during puberty (when testosterone increases) and again in old age as the body seeks to even out falling testosterone levels.
This prostate growth is not always cancerous, but when it is, these abnormal cells form what is known as a malignant tumor, and can attach themselves to other tissues in the body or spread to the blood vessels.
Cancer cells also have the ability to secrete their own growth hormones, and can use blood cells to supply them with nutrients. This deprives healthy cells of the nutrients necessary to function and making it easier for the abnormal cells to grow and spread.
Prostate Cancer Terminology – A Brief Overview
During your diagnosis and treatment, you will be overwhelmed with information.. One of the keys to understanding your cancer is to understand the terminology your oncologist and doctor will use to discuss your prognosis.
- PSA Test: the prostate specific antigen test is a blood test designed to measure how much protein is emitted by the prostate gland. Typically, the higher the PSA levels your test reveals, the more likely the presence of cancer; however, this is not always the case, as PSA levels rise with age and other prostatic issues.
- Gleason Score: the Gleason score is a system of grading prostate cancer. It is comprised of two numbers: a primary score, given after assessing the areas where the cancer is the most prominent; and a secondary score, which is used to see how far the cancer has advanced. These two scores are then added up to determine the stage of your cancer and the best course of treatment.
- DRE: A DRE, or digital rectal exam, is a screening process that allows physicians to examine internal organs and the lower rectum. Because the rectum is right behind the prostate, this is the easiest way for doctors to check the prostate gland for abnormalities, such as increased size or tumor-like masses.
- Biopsy: a biopsy is a procedure in which tissue is removed in order to examine it for cancer or disease. If your PSA readings are high and your doctor finds an abnormality during your digital rectal exam, he or she may remove a sample of prostate tissue to examine it for cancer.
- Prostate: the prostate is a small, walnut-sized gland between the bladder and the penis.
- TNM Staging: Staging is the process of determining how far a cancer has progressed. TNM stagings typically refers to the reach and size of the primary cancerous tumor (T), and if it has spread to the lymph nodes (N) or metastasized (M).
- Localized tumor: localized refers to cancerous tumor that is contained within the prostate gland and has not spread. If this cancer is low grade and slow-growing, you and your doctor may decide that active surveillance is your best course of treatment.
- Locally Advanced: locally advanced prostate cancer is cancer that has begun to spread outside the covering of the prostate gland. Locally advanced prostate cancer has not yet progressed to other body parts, but is the stage before metastasis.
- Metastasized: Metastasized is the term used to refer to cancer that has spread to other parts of the body, such as the lymph nodes, organs, or bones.
We Are Here to Help
Understanding your prostate cancer is the key to regaining control over a disease that can often leave you feeling helpless.
We aim to provide resources that bridge the gap between the medical community and ours, and to help men understand the causes, treatment options, and preventative measure that can help them live full and healthy lives.