Prostate Cancer

Most prostate cancers are adenocarcinomas arising from glandular epithelial cells, often in the peripheral zone. Because the peripheral zone is away from the urethra, a tumour can grow substantially without causing early urinary obstruction. Lower urinary tract symptoms therefore do not automatically mean prostate cancer; benign prostatic hyperplasia (BPH) is a more common explanation for gradual hesitancy, weak stream, and nocturia. Prostate cancer cells commonly depend on androgen-receptor signalling. Testosterone and related androgens stimulate tumour growth, which explains why androgen-deprivation therapy (ADT) can slow advanced disease. The same reduction in androgen activity produces predictable effects such as hot flashes, reduced libido, fatigue, metabolic changes, loss of bone mineral density, and sexual dysfunction. Two reports describe different dimensions of the disease: - Grade describes how abnormal and aggressive the cells appear under the microscope. Gleason patterns are combined into a Grade Group; higher groups indicate more aggressive biology. - Stage describes where the cancer is located: confined to the prostate, locally extending beyond it, involving regional nodes, or metastasized to distant organs. Prostate cancer characteristically forms osteoblastic or sclerotic bone metastases....