The prostate is a gland, about the size of an average walnut, located below the bladder and just in front of the rectum. It is also located around part of the urethra, which is the tube that helps carry urine and semen through the man's body. While many men have healthy prostates, sometimes the cells can become cancerous. In fact, prostate cancer is one of the most common types of cancer affecting men worldwide, and many older men have this condition without even knowing it. This is precisely why regular prostate exams are recommended once men reach fifty years old, or earlier if they have a family history of cancer. While prostate cancer often grows slowly, certain types can be aggressive. Additionally, treatments will often vary based on the type and grade of prostate cancer.
Acinar And Ductal Adenocarcinoma
Acinar adenocarcinoma, the most common type of prostate cancer, affects roughly ninety percent of all prostate cancer patients. This type of prostate cancer forms in the cells of the prostate gland. Many individuals with acinar adenocarcinoma are not expected to see the disease spread, though some cancers may grow quicker than others. Symptoms of acinar adenocarcinoma include an urgency to urinate, difficulty passing urine, pain while urinating, and blood in the urine or semen. This kind of cancer does make use of traditional options, including chemotherapy.
Ductal adenocarcinoma cancer forms in cells that line the tubes of the prostate gland. This type of cancer grows and spreads quickly. Because of this, some men with ductal adenocarcinoma may find their condition is in an advanced stage when first diagnosed. Surgery is the most common treatment for ductal adenocarcinoma as it does not respond well to hormone therapy.
Transitional Cell (Urothelial) Cancer
Urothelial cancer begins in the urethra, which are the tubes responsible for carrying urine. Urine moves through the male body by passing through the urethra from the bladder and finally out of the body. Typically, urothelial cancer begins in the bladder and from there will spread into the prostate, though in rare cases, it can begin in the prostate and spread to the bladder and nearby tissue. Symptoms will vary based on the individual as well as the extent of their cancer, but common signs include pelvic pain, painful urination, and blood in the urine. Most of the time, surgery is used to remove this cancer, though chemotherapy (intravesical or systemic), radiation, and immunotherapy may also be employed. Patients may also require reconstruction to form a new way for urine to exit their body.
Small Cell Prostate Cancer
Small cell prostate cancer is quite a rare form of prostate cancer, accounting for less than two percent of prostate cancer cases. This form of cancer occurs as a result of a type of neuroendocrine tumor that consists of small round cells. Typically, most men with this condition have a mix of both small cells and other cells. This type of cancer is difficult to determine by a prostate-specific antigen test, and because of this, small cell cancer is more difficult to detect. It also grows and spreads faster than other forms of prostate cancer like acinar adenocarcinoma. Symptoms of small cell prostate cancer are quite similar to other forms of prostate cancer, and they include painful urination, frequent urination, difficulties passing urine, and rarely, blood in the urine. The most common treatment used for small cell prostate cancer is chemotherapy, though treatment can vary based on the spread. It is worth noting, however, hormone therapy does not typically work.
Squamous Cell Cancer Of The Prostate
Squamous cell cancer of the prostate, which begins in the flat cells (squamous cells) covering the prostate gland, is a rarer form of prostate cancer, affecting only up to one percent of all prostate cancers. It is, however, quite the aggressive form of prostate cancer, and cancerous squamous cells grow and spread quickly, so most men see advanced types of this cancer when first being diagnosed. Symptoms of this form of cancer can vary, but often include blood in the urine, urinary tract infections, and pain secondary to bony metastases. Treatment varies a fair amount, but often includes radiation therapy, chemotherapy, and surgery. Reports indicate a multimodal approach is the most successful on average.
Another rare type of prostate cancer is called prostate sarcoma. This type, unlike common forms of prostate cancer, develops in the smooth muscle cells of the prostate, which are known as mesenchymal cells. As an aggressive cancer, the cancerous cells in prostate sarcoma grow quickly. Leiomyosarcoma is the most common type of prostate sarcoma found in adults, and symptoms include difficulty urinating and blood in the urine, due to a narrowing of the urethra. Men between thirty-five and sixty years old are most at risk for this type of prostate cancer. Surgery is often used to treat prostate sarcoma, though other options include hormone therapy, radiation, and chemotherapy, based on the extent of the cancer.