Prostate cancer is caused when some prostate cells mutate and begin to multiply uncontrollably. The prostate is a small, walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm. It is the second most common type of cancer in men and generally has a good prognosis due to the widespread use of early detection techniques.
The incidence of prostate cancer is estimated at approximately 25 cases per 100,000 population. The causes of prostate cancer are not clear, although some factors have been identified that increase the risk of developing the disease. In addition to genetic factors, such as the presence of BRCA1/2 mutations or hereditary syndromes such as Lynch syndrome, environmental factors have been identified that contribute to the increased risk of prostate cancer. Among them:
- It is more frequent after the age of 50.
- Ethnic origin, being more common in men of African-American origin. In addition, in them the probabilities of being more aggressive are increased.
- Exposure to certain chemical substances, such as agent orange.
- Chronic inflammation of the prostate
- Viral infections such as herpes, cytomegalovirus or papilloma, and sexually transmitted bacterial infections can increase the risk in patients with a genetic predisposition.
Prostate cancer is one of the most frequent cancers in men with a high hereditary component. Its heritability is estimated to be between 42-57%, which means that the genetic and environmental components contribute equally to the development of the pathology. In an association study that included more than 100,000 cases and 127,000 controls of different ethnicities, more than 200 susceptibility loci were identified. Among the genes, those associated with prostate biology, such as MSMB, stand out. These findings may greatly aid prostate cancer prevention, in combination with PSA screening, as men at high risk may benefit from earlier and more frequent screening.
It is common for prostate cancer not to present any symptoms in the initial stages of the disease. In general, they are tumors that evolve slowly and the symptoms appear in more advanced stages of the process. The most common symptoms are the following:
- Difficulty in starting to urinate.
- Weak or interrupted urine flow.
- Frequent urination, especially at night.
- Difficulty emptying the bladder.
- Pain or burning when urinating.
- Blood in the urine or semen.
- Persistent pain in the back, hips or pelvis.
- Pain on ejaculation.
These symptoms are common to other more frequent conditions so it is important to consult a medical specialist in case of occurrence.
The risk of developing prostate cancer is fundamentally related to age, race, family history and genetic predisposition of each individual. These factors are considered to be non-modifiable and there are currently no measures that can be taken to prevent it.
However, there are some measures that could reduce the risk of prostate cancer.
- Having a healthy weight.
- Healthy diet, with main consumption of fruit and vegetables, avoiding foods rich in fats.
- Decrease in the consumption of dairy products. Studies have associated excess consumption of dairy products with an increased risk of prostate carcinoma.
Prostate cancer screening programs are very effective in detecting prostate cancer. This, together with its slow evolution and the presence of characteristic symptoms, allows it to be a carcinoma with a good prognosis and a very low mortality rate.
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Conti DV, Darst BF, Moss LC, et al. Trans-ancestry genome-wide association meta-analysis of prostate cancer identifies new susceptibility loci and informs genetic risk prediction. Nature Genetics. 2021 Jan;53(1):65-75.
Brenes-Bermudez FJ and Alcántara-Montero Earlydetectionorscreeninginthepreventionofprostatecancer?. Spanish Society of Primary Health Care Physicians (SEMERGEN) 2017;43(2):100-108.