Prostate cancer is a malignant tumor that originates in the tissues of the prostate gland and is one of the most common cancers among men in Western countries. Globally, it is the second most commonly diagnosed cancer and the fourth leading cause of cancer death among men. In 2020, an estimated 1.4 million new cases of prostate cancer were diagnosed worldwide. Although many men diagnosed with prostate cancer do not die from it, and the five-year survival rate is over 90% if it is detected early and has not spread beyond the prostate, more aggressive forms can quickly spread to nearby organs, lymph nodes, and bones.
Risk Factors
Several factors contribute to an increased risk of prostate cancer. These factors are divided into non-modifiable and modifiable.
Risk Factors
Several factors contribute to an increased risk of prostate cancer. These factors are divided into non-modifiable and modifiable.
Non-modifiable factors:
Advancing age: The risk of prostate cancer increases with age.
Race: Men of African descent have a higher risk of developing prostate cancer than other ethnic groups.
Genetic factors: Inherited genes and mutations play a role, such as mutations in the BRCA1, BRCA2, and HOXB13 genes.
Non-modifiable factors:
Advancing age: The risk of prostate cancer increases with age.
Race: Men of African descent have a higher risk of developing prostate cancer than other ethnic groups.
Genetic factors: Inherited genes and mutations play a role, such as mutations in the BRCA1, BRCA2, and HOXB13 genes.
Family history: Having first-degree relatives (such as a father or brother) with prostate cancer increases the risk.
Modifiable factors:
Lifestyle and diet: Obesity, physical inactivity, and increased consumption of saturated animal fats and red meat are all associated with an increased risk.
Environmental exposure: Exposure to occupational and environmental carcinogens.
Modifiable factors:
Lifestyle and diet: Obesity, physical inactivity, and increased consumption of saturated animal fats and red meat are all associated with an increased risk.
Environmental exposure: Exposure to occupational and environmental carcinogens.
Diagnosis
Diagnosis of prostate cancer relies on a combination of methods, including clinical examination, laboratory tests, and imaging.
Prostate-specific antigen (PSA) blood test:
Diagnosis
Diagnosis of prostate cancer relies on a combination of methods, including clinical examination, laboratory tests, and imaging.
Prostate-specific antigen (PSA) blood test:
A PSA blood test is an initial screening tool, with a PSA level above 4.0 ng/ml being a potential sign of prostate cancer. However, an elevated PSA does not necessarily indicate cancer, as it can be the result of other benign conditions.
Digital rectal examination (DRE): This exam involves the doctor feeling the prostate gland for any abnormalities.
Multiparametric magnetic resonance imaging (mpMRI): MRI is used to provide detailed images of the prostate and is evaluated using the Prostate Imaging Reporting and Data System (PI-RADS). A PI-RADS score of greater than 3 indicates a high probability of cancer, necessitating a biopsy.
MPMRI has demonstrated a 93% sensitivity in detecting clinically significant cancer.
Prostate Biopsy: A biopsy is necessary to confirm the presence of cancer cells. It involves taking small tissue samples from the prostate for microscopic examination. The biopsy can be guided by transrectal ultrasound (TRUS).
Gleason Score: The Gleason Score is the standard method for grading prostate cancer and helps determine disease severity and appropriate treatment.
Liquid Biopsy: Liquid biopsy, which uses blood or urine samples, represents a less invasive alternative for diagnosis and monitoring disease progression. It offers the ability to detect molecular biomarkers and avoids the problem of tumor heterogeneity.
Treatment
Treatment options for prostate cancer depend on the stage and severity of the disease.
Active surveillance: This option for low-risk patients involves close monitoring for cancer without immediate treatment.
Surgery: Radical prostatectomy is a surgical procedure to remove the prostate gland.
Radiation therapy: This includes external beam radiation therapy (EBRT) and brachytherapy, in which radioactive sources are placed directly into the prostate gland.
Androgen deprivation therapy (ADT): This treatment aims to reduce the levels of androgens (male hormones) that fuel the growth of prostate cancer
cells.
Androgen receptor antagonists (ARPIs): Such as apalutamide, enzalutamide, and darolutamide, which block the action of androgens on cancer cells.
Androgen synthesis inhibitors: such as abiraterone, which inhibits the CYP17 enzyme responsible for producing androgens.
Chemotherapy: Docetaxel and cabazitaxel are used in certain cases, particularly in metastatic prostate cancer.
PARP inhibitors: such as olaparib and rucaparib, are used in cases of metastatic castration-resistant prostate cancer with DNA repair defects (HRR).
Immunotherapies: such as Sipuleucel-T and radium-223, which targets bone metastases.
Lutetium PSMA therapy: A promising new treatment for localized, high-risk prostate cancer, it directly targets cancer cells and stimulates an immune response.
Research efforts aim to achieve earlier and accurate diagnosis and provide more effective and personalized treatments for various types of prostate cancer.
At the I.D. Stem Cells and Genome Institute, we keep up with the latest developments in stem cell and gene therapy and regenerative medicine. If you are interested in learning more about the potential benefits of these treatments and the latest research findings, please feel free to contact us.
Treatment
Treatment options for prostate cancer depend on the stage and severity of the disease.
Active surveillance: This option for low-risk patients involves close monitoring for cancer without immediate treatment.
Surgery: Radical prostatectomy is a surgical procedure to remove the prostate gland.
Radiation therapy: This includes external beam radiation therapy (EBRT) and brachytherapy, in which radioactive sources are placed directly into the prostate gland.
Androgen deprivation therapy (ADT): This treatment aims to reduce the levels of androgens (male hormones) that fuel the growth of prostate cancer
cells.
Androgen receptor antagonists (ARPIs): Such as apalutamide, enzalutamide, and darolutamide, which block the action of androgens on cancer cells.
Androgen synthesis inhibitors: such as abiraterone, which inhibits the CYP17 enzyme responsible for producing androgens.
Chemotherapy: Docetaxel and cabazitaxel are used in certain cases, particularly in metastatic prostate cancer.
PARP inhibitors: such as olaparib and rucaparib, are used in cases of metastatic castration-resistant prostate cancer with DNA repair defects (HRR).
Immunotherapies: such as Sipuleucel-T and radium-223, which targets bone metastases.
Lutetium PSMA therapy: A promising new treatment for localized, high-risk prostate cancer, it directly targets cancer cells and stimulates an immune response.
Research efforts aim to achieve earlier and accurate diagnosis and provide more effective and personalized treatments for various types of prostate cancer.
At the I.D. Stem Cells and Genome Institute, we keep up with the latest developments in stem cell and gene therapy and regenerative medicine. If you are interested in learning more about the potential benefits of these treatments and the latest research findings, please feel free to contact us.
