Prostate cancer overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Historical Perspective
Prostate cancer was first described in 1536 by Niccolò Massa. In 1983, radical retropubic prostatectomy was first developed by Patrick Walsh to treat prostate cancer. In 1941, the first use of estrogen was developed by Charles B. Huggins to oppose testosterone production in men with metastatic prostate cancer. In the early 20th, radiation therapy was first developed to treat prostate cancer. In the 1970s, systemic chemotherapy was first studied to treat prostate cancer.
Pathophysiology
On microscopic histopathological analysis, increased gland density, small circular glands, basal cells lacking, and cytological abnormalities are characteristic findings of prostate cancer.
Causes
There are no established causes for prostate cancer.
Differential Diagnosis
Prostate cancer must be differentiated from benign prostatic hypertrophy, prostatic sarcoma, and direct invasion of the prostate by rectal adenocarcinoma.
Epidemiology and Demographics
In 2012, the prevalence of prostate cancer was estimated to be 2,800 cases per 100,000 men in the United States. The incidence of prostate cancer is approximately 137.9 per 100,000 individuals worldwide. The majority of prostate cancer cases are reported in the United States. It usually affects individuals of the African American race. Asian, Hispanic and White individuals are less likely to develop prostate cancer. The incidence of Prostate cancer increases with age; the median age at diagnosis is 66 years.
Risk Factors
Common risk factors in the development of prostate cancer are family history, African American men, dietary factors, obesity, elevated blood levels of testosterone, Agent Orange exposure, and sexual factors.
Screening
According to the U.S. Preventive Services Task Force (USPSTF), there is insufficient evidence to recommend routine screening for prostate cancer. According to the American Cancer Society (ACS) guidelines, screening for prostate cancer by PSA and DRE is recommended every year among individuals age 50 years, age 45 years for African-American men and men with a family history of prostate cancer, and age 40 years for men with a very strong family history of prostate cancer. According to the American Urological Association (AUA) guidlines, screening for prostate cancer by PSA is recommended every 2 years among individuals age 55 to 69 years, or younger than 55 years for individuals with high risk.
Prognosis
Prognosis of prostate cancer is generally good, and the 5-year survival rate is approximately 98.9%. The prognosis varies with the stage of tumor; Localized and regional tumors have the most favorable prognosis.
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