What causes prostate cancer?

Prostate cancer refers to an epithelial cell malignant tumor that occurs in the male prostate. In 2004, WHO's "Pathology and Genetics of Tumors of the Urinary System and Male Reproductive Organs" classified prostate cancer pathologically into adenocarcinoma (acinar adenocarcinoma), tubular adenocarcinoma, urothelial carcinoma, squamous carcinoma, and adenosquamous carcinoma. Among them, male prostate adenocarcinoma accounts for more than 95%.

Therefore, the prostate cancer we usually refer to is male prostate adenocarcinoma. In 2012, the prevalence of prostate cancer in the tumor-registered areas of my country was 9.92/100,000, ranking sixth among the prevalence of malignant tumors in men. The age of onset is relatively low before the age of 55, and gradually increases after the age of 55. The prevalence increases with age, and the peak age is 70-80 years old. Patients with familial hereditary prostate cancer develop at an earlier age, and patients aged ≤55 years account for 43%.

Causes

The occurrence of prostate cancer is related to genetic factors. If the relative risk of a family member without prostate cancer is 1, the definite risk is 8; then the relative risk of prostate cancer in a family member with hereditary prostate cancer is 5, and the definite risk is 35-45. In addition, the incidence of prostate cancer is related to sexual activity and diet. More sexual activity increases the risk of prostate cancer. A high-fat diet is also related to the incidence. In addition, the incidence of prostate cancer may be related to race, region, ethnicity and religion.

Prostate cancer often has no symptoms in the early stages. As the tumor develops, the symptoms caused by prostate cancer can be classified into two categories:

1. Oppression syndrome

The gradually enlarged male prostate gland duct compresses the urethral opening, which can cause idiopathic urinary incontinence, mainly manifested as thin urine flow, short effective range, slow urine stream, interrupted urine stream, dribbling after urination, continuous urination, and labored urination. In addition, there are frequent and urgent urination, inability to hold urine, frequent urination, and even urinary incontinence. The tumor compresses the duodenum, which can cause difficulty in defecation or intestinal obstruction. It can also compress the ejaculatory duct, causing male ejaculation deficiency. Nerve damage causes perineal pain, and the compression nerves can radiate to the lumbar spine.

2. Metastatic disease

Prostate cancer can invade the bladder, seminal vesicles, and vascular nerve bundles, causing hematuria, ejaculation bleeding, and impotence. Pelvic cancer metastasis can cause edema of both lower limbs. Prostate cancer is more likely to cause bone metastasis, causing bone pain or pathological fractures and paralysis. Prostate cancer can also invade the bone marrow, causing anemia or a decrease in the whole blood count.