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History
In 1536, prostate was first described by Venetian anatomist Niccol Massas and it
was illustrated by Flemish anatomist Andreas Vesallius in 1538. But since then, prostate
cancer was not identified until 1853. J. A dams (1853), a surgeon at The London
histological examination and also he noted in his report that it was a very rare disease.
Over the past several decades, surgeries for prostate cancer were executed to relieve
urinary obstruction (B. Lytton, 2001). However, there was no systematic technique for the
removal of the prostate until the pioneering work of Hugh Hampton Young in 1904 who
performed the first radical perineal prostatectomy (H. H. Young, 1905). Later, it became
the standard method for prostatectomy for the next four decades and it was used in an
therapy. In 1890s, orchiectomy (surgical removal of the testes) was first performed to
treat prostate cancer but then it wasnt that successful. After several decades,
prostatectomy for the aid of obstructive prostate cancer because it could better preserve
This approach allows the maintenance of erectile function and sexual potency. Huggins
et al. (1941) was the first to used systemic approach to treat prostate cancer by describing
the effects of treating advanced prostate cancer patients through surgical or medical
1966. Andrzej W. Schally and Roger Guillemin also both won the 1977 Nobel Prize in
Physiology and Medicine for determining the role of the gonadotropin-releasing hormone
(GnRH) in reproduction. GnRH receptor agonists, such as leuprolide and goserelin, were
subsequently developed and used to treat prostate cancer (Schally, Kastin & Arimura,
1971). In the advent of twentieth century, reports on the use of radiation to treat localized
prostate cancer appeared but then, these techniques, however, were difficult to perform
and it is very uncomfortable for the patient. Concerns in brachytherapy did not pop up
until the 1970s when Willet Whitmore described an open implant techniques using the
radioisotope of iodine.
Pathogenesis
androgen signalling pathway and its contact with other pathways influences cellular
process from growth, cell cycle, differentiation to growth arrest and process of
programmed cell death. And through adaptation and alteration, cells become more
capable of forming tumours. Initially, this procedure can be stopped by manipulating the
cells requirement for androgens although in the end it will just fail and cancer cells will
continue to grow. The terms 'androgen independent' and 'hormone refractory' may be
have been evidences that the prostate retains a level of androgen that is high enough to
induce AR transactivation in prostate cancer cell lines despite performing castration (both
activators and possible down regulation of co-repressors further potentiate these effects.
Alternative pathways involving growth factors and receptors and IL-6 have been shown
to interact with the androgen signalling pathway enabling transactivation to occur even in
Prevalence
population and consists of diagnosed cases plus those cases that are present but yet
Prostate cancer is the fourth most common cancer in both sexes combined and the
The number of new cases of prostate cancer was 129.4 per 100,000 men per year.
The number of deaths was 20.7 per 100,000 men per year. These rates are age-adjusted
and based on 2009-2013 cases and deaths. Based on 2011-2013 data, approximately
12.9 percent of men will be diagnosed with prostate cancer at some point during their
lifetime. The prevalence of the prostate cancer in 2013 were an estimated 2, 850, 139
In the past year, it is estimated that there will be 180,890 new cases of prostate
cancer and an estimated 26,120 people will die of this disease. The percentage of all new
In most cases, prostate cancer symptoms are not apparent in the early stages of
the disease. The symptoms of prostate cancer may be different for each man and any
one of these may be caused by varying conditions. Consequently, it is vital for patients to
have routine screenings in the form of digital rectal exams (DRE) and prostate specific
androgen (PSA).
Since prostate gland is neighbouring the bladder and urethra, prostate cancer may
a tumour may press on and contract the urethra, preventing the flow of urine. Some
Prostate cancer may spread to nearby tissues or bones. If the cancer spreads to
the spine, it may press on the spinal nerves. Other prostate cancer symptoms include:
Blood in semen
Painful ejaculation
Swelling in legs or pelvic area
Different factors cause different types of cancer. Researchers continue to look into
what factors cause this type of cancer. Although there is no proven way to completely
prevent this disease, you may be able to lower your risk. Talk with your doctor for more
information about your personal risk of cancer as they have more knowledge about it.
High levels of testosterone, a male sex hormone, may speed up or cause the
development of prostate cancer. For instance, it is very uncommon for a man whose body
no longer makes testosterone to develop prostate cancer. In addition, stopping the bodys
prostate tumour.
dutasteride (Avodart) and finasteride (Proscar), may lower a mans risk of developing
prostate cancer. In clinical trials, both drugs have reduced the risk of prostate cancer.
Some previous studies suggested that 5-ARIs were linked to more aggressive prostate
cancers, but newer studies have shown this claim isnt true. Interestingly, according to
the results of a long-term follow-up study published in 2013, 78% of men taking finasteride
or a placebo were alive 15 years later. These results suggest that taking finasteride does
not decrease in the risk of death for men with prostate cancer. This subject remains
controversial, and the U.S. Food and Drug Administration (FDA) has not approved these
drugs for prostate cancer prevention. However, 5-ARI is FDA approved for the treatment
of lower urinary tract symptoms. Because the decision to take a 5-ARI is different for each
patient, any men considering taking this class of medications should discuss the benefits
There is little information right now to prove the role of diet in preventing the risk of
having prostate cancer. Dietary changes may need to be made many years earlier in a
mans life to reduce the risk of developing prostate cancer. And here is a brief summary
A diet high in fat, especially animal fat, may increase prostate cancer risk.
However, no prospective studies, meaning studies that look at men who follow either
high-fat or low-fat diets and then measure the total number of men in each group
diagnosed with prostate cancer, have yet shown that diets high in animal fat raise the risk
of prostate cancer.
A diet high in vegetables, fruits, and legumes, such as beans and peas, may
decrease the risk of prostate cancer. It is unclear which nutrients are directly responsible.
Although lycopene, the nutrient found in tomatoes and other vegetables, has been linked
to a lower risk of prostate cancer, the data so far have not demonstrated a relationship.
shown in clinical trials to prevent prostate cancer. Some, including vitamin D, vitamin E,
and selenium, may even be harmful for some men. Men should talk with their doctors
and it is possible such changes would need to be made early in life to have an effect.
And lastly, there is no concrete evidence on how to prevent prostate cancer but a
healthy lifestyle may be important. The latest research suggests that being overweight or
balanced diet and regular exercise can help you stay a healthy weight, so these may be
Adams, J. (1853). The case of scirrhous of the prostate gland with corresponding
affliction of the lymphatic glands in the lumbar region and in the pelvis. Lancet. 1,
393.
Lytton, B. (2001). Prostate cancer: a brief history and the discovery of hormonal ablation
Young, H. H. (1905). Four cases of radical prostatectomy. Johns Hopkins Bull. 16, p. 315.
The effects of castration on advanced carcinoma of the prostate gland. Arch. Surg.
43, 209.
Schally, A. V., Kastin, A. J. & Arimura, A. (1971) Hypothalamic FSH and LH-regulating
hormone. Structure, physiology and clinical studies. Fertil. Steril. 22, 703721.
Girling, J. S., Whitaker, S. C., Mills, I. G., & Neal, D. E. (2007). Pathogenesis of prostate
cancer and hormone refractory prostate cancer. Indian Journal of Urology, 23(1),
35-42.
http://www.cancercenter.com/prostate-cancer/symptoms/
https://seer.cancer.gov/statfacts/html/prost.html
http://www.cancer.net/cancer-types/prostate-cancer/risk-factors-and-prevention
http://prostatecanceruk.org/prostate-information/are-you-at-risk/can-i-reduce-my-risk