Prostate cancer is one of the common diseases threatening men’s health. The prostate is a chestnut-shaped organ located just below the male bladder, tightly surrounding the urethra, and is an important component of the male urinary and reproductive systems. Pathologically, prostate cancer includes adenocarcinoma (acinar adenocarcinoma), ductal adenocarcinoma, urothelial carcinoma, squamous cell carcinoma, and adenosquamous carcinoma, with adenocarcinoma accounting for over 95%. Therefore, what we commonly refer to as prostate cancer specifically refers to prostate adenocarcinoma.
With the aging population and changes in diet and living environment, the incidence of prostate cancer is increasing year by year; on the other hand, as clinical detection technologies improve, its detection rate is also continuously rising; thus, how to effectively prevent and detect it early is related to the healthy lives of every man.
High-risk factors for prostate cancer
1. Age – The greatest risk factor
The 2022 “Guidelines for Prostate Cancer Screening and Early Diagnosis and Treatment in China” pointed out that the incidence and mortality rate of prostate cancer rank 6th and 7th among malignant tumors in Chinese men, respectively. Its incidence is at a relatively low level before the age of 55, gradually increasing after 55, peaking at ages 70 to 80; patients with familial hereditary prostate cancer tend to be diagnosed at a younger age, with 43% being 55 years old or younger.
2. Family hereditary – Linked to genetic factors
The more immediate relatives that have prostate cancer, the closer the relationship and the earlier the age of onset, the higher the relative risk for the individual to develop prostate cancer. If a first-degree relative (brother or father) has prostate cancer, the individual’s risk of developing prostate cancer increases by more than 1 time. If 2 or more first-degree relatives have prostate cancer, the relative risk can increase to 5 to 11 times. The risk of prostate cancer in the general male population significantly increases after 50 years, while in those with a family history of cancer, the risk clearly increases after 40 years. Compared to non-hereditary patients, hereditary prostate cancer patients are diagnosed at an earlier age.
3. Inflammation and infection – Inducing excessive cell proliferation
Chronic inflammation of the prostate can induce excessive cell proliferation and is involved in the development of infection-related cancers, such as colon cancer, esophageal cancer, and liver cancer. More and more evidence suggests that inflammation plays a key role in the malignant transformation process of the prostate.
4. Other factors – Unhealthy lifestyle habits
Excessive obesity, smoking, alcohol consumption, and high intake of meat and fat can increase the risk of developing prostate cancer. Individuals with sexually transmitted infections (STIs, especially syphilis), frequent sexual activity, and multiple sexual partners have an increased risk of developing prostate cancer. Additionally, the incidence of prostate cancer may be related to race and region.
What are the symptoms of prostate cancer?
Most early prostate cancer patients present symptoms such as urinary hesitance, difficulty urinating, and increased urinary frequency, but these symptoms can also occur in benign prostatic hyperplasia. Therefore, if you experience these symptoms, please consult a specialist in a timely manner. As the tumor grows, the following symptoms may appear:
Pressure symptoms: A progressively enlarging tumor can compress the urinary tract, leading to difficulties in urination, such as a weak urine stream and incomplete emptying. Additionally, symptoms like frequent urination, urgency, and increased nocturia may occur. Compression of the rectum can lead to constipation, compression of the ejaculatory duct may cause **pain, and compression of nerves can result in pelvic **pain.
Metastatic symptoms: Prostate cancer metastasis may directly invade the bladder, causing hematuria, invade the seminal vesicles causing hematospermia, and invade the colon leading to rectal bleeding and intestinal obstruction. Pelvic lymph node metastasis can cause swelling of both lower limbs. Distant metastasis of prostate cancer often leads to bone metastasis, resulting in bone pain, pathological fractures, or paralysis.
How is prostate cancer clinically diagnosed?
Prostate cancer primarily relies on digital rectal examination (DRE), tumor markers (
