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Prostate cancer: the male nightmare


Can you imagine if it were called that, but it developed in the bones? Well, it can happen, but then it’s metastasis. Prostate cancer always arises initially in the prostate.

It follows the usual “cancer protocol”: prostate cells mutate, decide to go solo, and begin to multiply uncontrollably.

95% of the time, it is thought that the cancer comes from the luminal secretory cells. This is the most numerous cell type in the epithelium, they are well differentiated and secrete prostate-specific antigen (PSA) and acid phosphatase into the glandular lumen. The other percentage is mostly the neuroendocrine cell origin. Is their origin important? For cancer, yes. Luminal epithelial cells have a high expression of androgen receptors and require androgens for their survival. The other cell populations are indifferent to these hormones.

Because of this, one way of detection is through blood tests to check PSA levels. This protein is specific to the prostate, in fact, it is in its name, and is found in very low levels in the blood. This cancer often causes an increase in protein values due to the greater number of prostate cells.

The other usual method is physical examination of the prostate through a rectal examination (it is located just in front of the rectum). If there is unconfirmed suspicion, a biopsy of the gland tissue is performed to check.

Biopsies are often performed with the help of transrectal prostate ultrasound. An ultrasound probe is inserted into the patient’s rectum to place it close to the prostate. High-frequency sound waves generate images that guide the needle in the process of tissue extraction.

Some professionals recommend annual testing from the age of 50. In people with a high risk, even from the age of 45.

Prostate cancer: the male nightmare

The risks of the prostate becoming evil

The biggest risk factor is being a male over 50. Already, a high percentage of the population cannot escape that risk. Excluding skin cancers, it is the most common cancer in men and the second most deadly after lung cancer.

It does not have a high mortality rate, its deaths are due to its high frequency. It is estimated that 80% of men will have had this cancer by the time they reach 80 years of age, and that 1 in 41 men will die from this disease. However, in the United States, only 13% of men will be diagnosed. 60% of cases are detected in advanced stages.

The 5-year survival rate is practically 100%, EXCEPT when it has been found to have spread to other tissues. Then that 100% becomes a sad 30%.

Another risk factor is the presence of prostate intraepithelial neoplasia (PIN). This is a non-cancerous growth of cells that line the internal and external surfaces of the prostate gland. It involves morphological changes in the cells and can occur as early as age 20. The more radical and Lovecraftian the changes, the higher the risk. The loss of cellular cilia is correlated with a high level of danger.

On the list of risks are also genes (and a family history of cases), obesity, and diet. And on the list of curiosities, a relationship has been found between dairy consumption and prostate cancer. Men with a higher consumption of dairy products had a higher probability of contracting the disease and with greater aggression. Personally, it is a risk that I am willing to take in the face of the terrible option of not eating cheese.

It is a slow-growing and highly persistent cancer with little symptomatology. If you reach old age and your sex chromosomes are XY, there is a high likelihood that when the Reaper comes to collect you, you will have been living with this cancer for years without being aware of it.

Many of the symptoms are related to urination. Problems and pain when urinating, combined with frequent urges to do so. A stressful and unpleasant duo. Blood in the urine may also be present, and, because the world is a cruel place, there may be sexual problems such as difficulty in achieving an erection.

Once the presence of the pathology has been confirmed, the next step is to verify its state in order to select the appropriate treatment.

In addition to the previously mentioned detection methods, biopsies and magnetic resonance imaging are also used to check the disease’s state.

Sometimes it is even recommended not to take action if the cancer is small, asymptomatic, and barely growing, in very elderly patients and/or with other serious illnesses. However, the disease is still monitored for any changes.

Get out of my prostate, demon!

Among the treatments, we have surgery. Prostatectomy is the total or partial removal of the prostate, and it is mainly carried out in patients who present the pathology in the early stages and do not exceed 70 years of age. A variant is cryosurgery, where tumor cells are destroyed by extreme cold. Healing through elimination.

Radiation therapy can be used in combination with surgery or when the patient cannot undergo surgical operation. A variant is brachytherapy, which involves placing radioactive capsules in the prostate.

Chemotherapy is also used, but only when there is metastasis. Unfortunately, it is a method incapable of eliminating all cancer cells, but it can decrease their population and growth.

Do you remember the sound waves used for detection? Turn them up to high intensity, center them on cancer cells, and destroy them with heat.

And do you remember that cancer cells used to have high levels of androgen receptors? Well, we use androgen hormone blockers. However, these cells use hormones to grow, but they do not need them to exist. Hormone blockers slow their expansion, but do not cure the disease.

In the worst scenario, where we have metastasis due to the regulation and functioning of this cancer, the preferred tissues are lymph nodes and bones. Bones are particularly problematic due to the difficulty of performing biological extractions in quantities high enough to perform reliable analysis.

The prostate and genetic inheritance are closely related

There are more than 250 genetic variants involved in the risk of having this cancer. Biology, in its eagerness to complicate things, has made these variants independent of cancer aggressiveness, so they cannot be used to make prognoses on their own. Some of the genes involved are AR (an androgen receptor), MYC, or PTEN. MYC and PTEN mutations together frequently occur in aggressive versions of the cancer.

RB1, a tumor suppressor, is often failing when there is metastasis.

Two of them are particularly popular for being among the genes most related to breast cancer, the female nightmare, BRCA1, and BRCA2. Carriers of mutations in these two genes have a higher risk of developing this pathology, regardless of other cancers, of course. Of the two genes, it appears that carriers of alterations in BRCA2 have a higher risk of developing cancer with a worse prognosis.

TP53, the guardian of the genome, is another gene frequently affected by mutations in this disease.

A twin study has estimated that 58% of the risk of prostate cancer can be explained by hereditary factors. The first gene linked to hereditary prostate cancer was RNASEL, an endoribonuclease. With so much genetic predisposition in this pathology, why not use an DNA Advanced kit to complement PSA and rectal screening?