Prostate carcinoma (Pca) – colloquially called prostate cancer – (synonyms: prostate adenocarcinoma; prostate carcinoma; prostate carcinoma; ICD-10 C61: malignant neoplasm of the prostate) is a malignant neoplasm of the prostate gland (prostate gland). Prostate carcinoma is the fifth most common malignant (malignant) disease worldwide. It is the most common cancer in men in Germany, accounting for 25.4% of all cancers diagnosed. The disease can start in different areas of the prostate and initially spreads within the prostate. As the disease progresses, tumor cells travel both lymphogenically (via the lymphatic channels to the lymph nodes) and hematogenically (via the bloodstream) to other parts of the body. There, metastases (daughter tumors) may form. The skeleton, liver and lungs are particularly affected. Prostate carcinoma is classified into:
- Incidental prostate carcinoma – normal palpation findings (palpation findings); tumor was discovered after surgery for benign prostatic hyperplasia (BPH).
- Manifest prostate carcinoma – tumor rectally palpable.
- Occult prostate carcinoma – initial manifestation of the tumor by detection of metastases without evidence of the primary tumor.
- Latent prostate carcinoma – clinically inconspicuous, detected only after death.
Frequency peak: the disease occurs from the age of 45, increases significantly with age and decreases again somewhat in older age. Up to 80% of people over 70 have latent (undetected) prostate cancer. The median age of onset is 69 years (2006). The incidence (frequency of new cases) is approx. 110 cases per 100,000 inhabitants per year in Germany.Taking age into account, the incidence per 100,000 men is as follows: approx. 15 in 45- to 49-year-olds, 61 in 50- to 54-year-olds, 212 in 55- to 59-year-olds, 417 in 60- to 64-year-olds, 608 in 65- to 69-year-olds, 716 in 70- to 74-year-olds, 719 in 75- to 70-year-olds, 611 in 80- to 84-year-olds, and 498 in 85-year-olds and older. Globally, Australia and the United States lead in incidence, while Asia and India have the lowest incidence of prostate cancer. Black Americans are more likely to develop prostate cancer than whites. Increasingly, prostate cancer is being detected earlier and earlier: most men (65.5%) are diagnosed at stage I cancer and 30% are diagnosed at stage II; only 2% of men had metastatic disease at the time of diagnosis. Course and prognosis: In the early stages, the disease is symptom-free. In the advanced stage, symptoms include micturition disorders (bladder emptying disorders) and bone pain. When the affected person complains of symptoms, metastasis to the local lymph nodes or to the skeleton has often already occurred.The chances of cure are greatest when there are no metastases yet and the tumor has not yet crossed the organ boundaries. Metastatic prostate cancer before age 50 is associated with a significantly worse prognosis. After matching certain tumor characteristics, mortality (number of deaths in a given period, relative to the number of the population in question) was increased by 28% – compared with mortality in men aged 50 to 59 years. The mortality rate is 20 per 100,000 men. This puts prostate cancer in third place among fatal tumor diseases in men (10.1%) in Germany after bronchial carcinoma (lung cancer) and colorectal carcinoma (colorectal cancer), and in seventh place when all causes of death are considered. Elevated serum triglyceride levels are associated with an increased risk of prostate cancer recurrence (recurrence of prostate cancer). The 5-year survival rate is 87% and applies to the average of all forms of prostate cancer. Comorbidity: Alopecia androgenetica increases the risk of men developing an aggressive form of prostate cancer (OR 1.60; 95% CI 1.37-1.86). In contrast, androgenetic alopecia (OR 1.05, 95% CI 0.90-1.06) was not associated with the non-aggressive forms of prostate cancer.
