What is prostate cancer?
Prostate cancer occurs when cells in the prostate begin to grow out of control. The prostate is a gland that only men have. This gland produces part of the fluid that makes up semen.
The prostate is a part of the male reproductive system, which is made up of:
- Penis
- The prostate
- Seminal vesicles
- Testicles
The prostate is located just below the bladder and in front of the rectum. It is about the size of a walnut and wraps around the urethra (the tube through which urine empties from the bladder). The function of the prostate is to produce the fluid that is part of the semen.
As men age, the prostate tends to enlarge. This can cause the urethra to narrow and decrease the flow of urine.
Some of the symptoms of prostate cancer are:
- Difficulty starting to urinate.
- Weak or interrupted urine flow.
- Frequent urination, especially at night.
- Difficulty emptying the bladder completely.
- Pain or burning when urinating.
- Blood in the urine or semen.
- Persistent pain in the back, hips, or pelvis.
- Pain when ejaculating.
Types of prostate cancer
The vast majority of prostate cancers are adenocarcinomas.
These cancers develop from glandular cells (the cells that make the prostatic fluid that is added to semen).
Other types of cancer that can originate in the prostate are:
– Small cell carcinomas
– Neuroendocrine tumors (other than small cell carcinomas)
– Transitional cell carcinomas
– Sarcomas
Some prostate cancers grow and spread quickly, but most grow slowly. In fact, rigorous autopsy studies have shown that many older men (and even some younger men) who die of other causes
also suffer from prostate cancer, but it has never affected them in their lives. In many cases, they don’t know, not even their doctor, that they have prostate cancer.
That is why it is important to pay attention to the following symptoms:
- Urination problems, including a slow or weak urinary stream or the need to urinate more often, especially at night.
- Blood in the urine or semen.
- Difficulty getting an erection (erectile dysfunction).
- Pain in the hips, back (spine), chest (ribs), or other areas due to cancer that has spread to the bones.
- Weakness or numbness in the legs or feet, or even loss of bladder or bowel control because the cancer compresses the spinal cord.
- Prostate cancer in Mexico.
Prostate cancer is a disease that commonly appears after the age of 50 and its peak is after the age of 65. According to GLOBOCAN estimates.
Researchers from the Population Health Research Center (CISP) of the National Institute of Public Health (INSP) carried out a study on mortality from prostate
cancer in Mexico, the main objective was to identify important changes in cancer mortality trends of the prostate during the last three decades and to
look at the population level for possible explanations for these changes.
The CISP researchers found that during the study period, 114,616 men, with an average age of 76.5 years, died from this malignant tumor and the risk of death
was 16 deaths for every 10,000 men over 40. years. Likewise, it was observed that during the last 13 years, mortality from PC registered a sustained annual
growth of 2.3%. However, this behavior in mortality was different according to the degree of state marginalization.
Sonora, Baja California Sur, and Sinaloa were the states with the highest five-year mortality rates over the three decades. However, the states that suffered
the main changes in mortality throughout the period were those classified as very high and highly marginalized. At the beginning of the period, the states of
Chiapas, Guerrero and Oaxaca (of very high marginalization); as well as in Campeche, Hidalgo, Michoacán, Puebla, San Luis Potosí, Tabasco, Veracruz and
Yucatán (with high marginalization) had the lowest mortality rates or presented a significant reduction.
- Prostate cancer in Latin America.
With more than 412,000 new cases and more than 85,000 deaths, prostate cancer is the first cancer in the Americas in terms of new cases and the second in terms of cancer deaths in men.
If current trends continue, the number of new cases and deaths from prostate cancer in Latin America and the Caribbean will almost double by 2030.
Incidence and mortality rates for prostate cancer vary between countries.
The highest rates of mortality and incidence from prostate cancer occur in the Caribbean, with Barbados, Trinidad and Tobago and Guyana standing out.
It is important to mention that in Latin America there are more than 20 countries that, together, have approximately 516 million
inhabitants. In addition, the population in Latin America is heterogeneous in relation to race, life expectancy, diet, socioeconomic and cultural levels, causes of mortality, and other factors that could influence the incidence of prostate cancer.
The quality of health care, the sources for obtaining adequate information, the proportion of young people and the distribution between the urban and rural population are also different, all of which could also influence the statistics.
In countries like Argentina, Uruguay and Chile there is a large proportion of white race due to their European migrants. However, in Mexico, Ecuador, Bolivia, Colombia and Venezuela, among others, the mestizo race predominates and, in some regions, the indigenous race.
In Peru, Colombia and Brazil, in addition, there are geographical areas in which the black race predominates.
Finally, the causes of mortality vary from country to country. The main causes in Latin America, in general terms, are circulatory diseases, communicable diseases and neoplasias. Compared with other countries where external causes (traffic accidents, murders and homicides) are considered an important cause of mortality.
- Prostate cancer worldwide.
Worldwide, PC is the second leading cause of cancer and the fifth leading cause of cancer death in men.
In the world, incidence and mortality rates vary from country to country. In 2002 there were 679,000 new cases of prostate cancer in the world, and it is the fifth most frequent cancer in the world and the second most frequent in men (11.7% of new cancer cases; 19% in developed countries and 5.3% in developing countries).
The GLOBCAN study reported that in northern European countries (Denmark, Norway and Sweden) the diagnosis of prostate cancer has increased by 8.2% per year; however, there is a decreasing mortality since 2000 of 3.1% per year (6). Similar data have been found in the USA and Canada, with a stable incidence of 4.3% and a decrease in mortality of 3.1%; however, in developing countries mortality has been increasing (6,7). Regarding the national epidemiology, Colombia has one of the lowest incidences of CAP in Latin America and a ratio of 28% between incidence and mortality, a value very close to the world average of 28.6% and lower than that of countries like Ecuador (40.41% ), Cuba (46.65%) and Peru (37.74%) (6); in the same way
There are different types of treatment for prostate cancer:
Watchful waiting: If your doctor thinks your prostate cancer is unlikely to grow quickly, he or she may recommend that you not get treatment right away. Instead, you can choose to wait, to see if you develop symptoms, in one of two ways:
Active Surveillance: Watching closely for the patient’s prostate cancer through regular PSA testing; Treatment is only given if the cancer is producing symptoms or showing signs that it is growing.
Watchful Watch: No tests are done. Your doctor treats symptoms when they occur. This is generally recommended for men who are expected to live at most 10 more years.
Surgery: Prostatectomy is an operation where doctors remove the prostate. Radical prostatectomy removes the prostate and the tissue around it.
Radiation therapy: The use of high-energy x-rays (radiation) to destroy cancer.
There are two types of radiation therapy:
– External radiation therapy: Radiation is applied to cancer cells by a machine outside the body.
– Internal radiation therapy (brachytherapy): During surgery, radioactive seeds or pellets are inserted into or near the cancerous tumor to destroy the malignant cells.
Other therapies for the treatment of prostate cancer that are still being studied are:
Cryotherapy: A special probe is placed into or near the tumor in the prostate to freeze and destroy the cancer cells.
Chemotherapy: Special drugs are given to shrink or kill the cancerous tumor. These drugs can be pills that you take or drugs that are given through an IV, and sometimes a combination of both.
Biological therapy: This helps the immune system fight cancer or control the side effects of other cancer treatments. Side effects are the reaction the body can have to medicines or other treatments.
High-intensity focused ultrasound: This treatment directs high-frequency radio waves (ultrasound) at the cancerous tumor to kill the malignant cells.
Hormonal therapy: Prevents cancer cells from getting the hormones they need to multiply.