• The disease
• Diagnosis
• Treatment options

Definition

In prostate cancer, abnormal cells proliferate in the prostate, a male genital gland involved in the production of seminal fluid which combines with semen to form sperm. Male hormones, particularly testosterone, stimulate the development of this cancer by helping the cancer cells to proliferate.

Symptoms and impact on health

Prostate cancer develops very slowly. The disease can go undetected for years, because the early stages are generally asymptomatic, apart from trouble urinating – which can also be attributed to the enlargement of the prostate with age.
However, there are a number of urinary symptoms that could point to prostate cancer:

• frequent need to urinate,
• urinary urge,
• decreased force in the stream of urine,
• inability to urinate.

Other symptoms, such as bone pain, may also appear at more advanced stages.

Risk factors

Although the causes of prostate cancer remain unknown, several risk factors seem to be involved:

• Age: prostate cancer is exceptionally rare before age 40, with diagnosis usually occurring after age 70.
• Family history: 20% of cases are prostate cancers that run in families, where there at least two cases involving first-degree relatives (father or brother), or second-degree relatives (grandfather or uncle). The hereditary form (i.e. at least three cases of prostate cancer in first- or second-degree relatives) accounts for 5% of prostate cancer cases.
• Ethnic origin and geography: the incidence of prostate cancer in Africa, Northern Europe and the United States is far higher, compared with a very low incidence in Southeast Asia.

Incidence

Estimates put the number of prostate cancer diagnoses in Europe and the United States at one in six men. Prostate cancer is responsible for more than 80,000 deaths every year in Europe. Although the mortality rate is declining (the survival rate is currently 83.4%), the incidence of the disease has risen sharply, in line with the greying of the population.