How Does Prostate Cancer Develop?

The prostate is a small gland of the size of a walnut, located below the bladder in men. It plays a crucial role in the production of seminal fluid. It relies on male hormones, particularly androgens like testosterone and dihydrotestosterone (DHT), to regulate male sex characteristics and reproductive functions.

Cancer, in general, is characterized by the transformation of a normal cell into an abnormal one that grows uncontrollably. In the normal process, the production and use of male hormones occurs smoothly, guiding and maintaining cell growth within the prostate. Occasionally, abnormalities (e.g. genetic changes) arise within prostate cells, triggering the development of cancer. The abnormal prostate cells lack the usual signals or "brakes" that regulate cell growth. Prostate cancer specifically occurs when a normal prostate cell starts growing out of control and forms a tumor.

Not all prostate cancers are the same. Some are slow-growing and confined to the prostate gland, posing minimal harm and requiring minimal or no treatment initially. In such cases, active surveillance or watchful waiting may be recommended to monitor cancer development over time without any need for aggressive treatment.

However, certain types of prostate cancers are more aggressive. They divide rapidly and have a higher likelihood of spreading or metastasizing to other parts of the body. This aggressive form often invades nearby tissues, such as the seminal vesicles and lymph nodes, necessitating prompt and intensive treatment.

Once prostate cancer forms, it becomes dependent on androgens as a source of fuel for its growth. This reliance on male hormones can be treated by drugs, collectively known as hormone therapy. The purpose of hormone therapy is to lower androgen levels and stop cancer growth.

Prostate cancer is a complex disease, and its development can be influenced by various factors. The common risk factors are:

• Old age — The risk of prostate cancer increases with age, and it is more common in older men
• Family history — Those with a family history of prostate cancer have a higher prostate cancer risk
• Genetics — Mutations in cancer susceptibility genes (e.g. BRCA2)
• Race — African American men have a higher risk of prostate cancer
• Obesity — A higher body mass index (BMI) is linked to a greater risk of fatal prostate cancer

Early detection is crucial for a better prognosis. Prostate cancer that has not spread beyond the prostate gland typically has a better outlook. In many cases, it may not significantly impact a person's natural lifespan. Regular screenings and awareness of risk factors play a vital role in the early detection and successful management of prostate cancer.