Etiology

Etiology of prostate cancer development is not completely known. Factors that can influence the creation and development of this type of cancer include:

genetic factors – increase in risk of falling ill among men with a positive family history regarding the prostate cancer. Mutations of suppressor genes are also taken into consideration (p53)

dietetic factors – food rich in saturated fatty acids probably increases the risk of falling ill whereas the consumption of soya and rice may have a beneficial protective effect racial and geographical factors – Afro-Americans are 100% more likely to fall ill, whereas the lowest death rate is reported in Japan and in China

occupational factors – cancerogenous influence of heavy metals and toxins infectious factors – viral infection may lead to/ be the cause of anaplasia of adenocyte cells of prostate

Histopathologically, 95% prostate cancer cases occur in the form of adenocarcinoma. Other types (primary intracellular cancer, squamous carcinoma, anaplastic carcinoma, and sarcoma) are rarely met. Adenocarcinoma usually develops in the peripheral area of the prostate (85%), in the transition area (25% ) and in the central area (5%).

Symptoms

In symptomatology of the prostate cancer, 4 clinical forms are distinguished:

1) visible form with distinct pathological symptoms 2) latent form (carcinoma latens) with no distinct pathological symptoms found 3) hidden form (ca occultum) which is detected in the case of distinct ailments caused by the existence of remote metastases, however changes in prostate are not found in the course of per rectum examination 4) accidentally detected form - based on histopathological test of the gland that was removed because of prostate overgrowth, or based on biochemical tests (PSA) During the development of prostate cancer, an induction phase that lasts about 30 years which is clinically invisible can be distinguished. During the next stage - in situ phase (5-10 years) and invasive phase (1 year), ailments connected with the local growth of tumour start to appear. During this period, symptoms connected with sub bladder obstacle appear including mainly: - pallakiuria - nycturia - weak urine stream - painful vesical tenesmus - impression of incompletion of bladder emptying The above-mentioned symptoms are typical of cancer and in some cases they may suggest mild overgrowth of prostate, or neurogenic or athermatous bladder disorders. During the dissemination phase (about 5 years), prostate cancer develops continuously infiltrating surrounding organs, such as: urinary bladder, rectum, ureters, pelvic walls and leading to urinary retention in kidneys and to secondary failure of function. Ailments typical for this period include: - haematuria - dysuria - urinary incontinence - erection disorders - aches of perineum, lumbar area and anus - haematospermia Metastases spread through the lymphatic vessels and the vascular system. Symptoms caused by the existence of remote metastases are as follows: - osteodynia and pathological fractures - pressure symptoms and spinal paralysis - lymphadema of limbs - clotting disorders - cachexy - coma

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