Prostate carcinoma is a malignant tumor that develops from the tissue of the prostate. It is the most common carcinoma in men and is the third most common cause of cancer in men, leading to death. The frequency of this disease increases continuously with age.
A characteristic feature of prostate cancer is its slow growth, which, if treated early, is associated with good chances of recovery. In the late stage of the disease, the tumor develops metastases in bones and lymph nodes. Up to 90% of all prostate carcinomas develop in the outer parts of the gland and can therefore be palpated in the routine examination, i.e. the digital rectal examination (DRU), mostly by the examiner.
A distinction is made between different forms of prostate carcinoma. If the tumor has been palpated in the routine examination or seen by means of an imaging procedure and confirmed by a biopsy, it is called a manifest or clinical prostate carcinoma. If a tumor is present, but is not detected during lifetime, it is called latent prostate cancer.
This is usually detected during autopsy examinations, i.e. after death. Studies have shown that the number of latent prostate carcinomas is much higher than the number of manifest ones. In the group of people over 80 years of age, for example, the incidence of prostate carcinoma is about 60%.
Furthermore, there is the incidence of prostate carcinoma, which is discovered by chance in the course of other examinations. An example of this would be the removal of tissue from the prostate gland due to benign prostate enlargement, in which the pathologist then detects a carcinoma. Occult prostate carcinoma is when metastases already occur in other parts of the body without the actual tumor being able to be found using standard examinations.
Causes
The exact origin of the prostate carcinoma has not been definitively clarified. However, there are indications that various factors can play a role in the development of the disease. On the one hand, there seem to be genetic factors that favour the occurrence of prostate carcinoma.
This is supported by the fact that the frequency distribution is different in different population groups. For example, colored Americans are significantly more likely to develop the disease than Asians. In addition, there are families in which prostate cancer occurs more frequently.
If a first-degree relative suffers from it, the individual risk increases by up to twice as much. There is also evidence that hormonal influences can also promote the development of prostate cancer. The male sex hormones, i.e. androgens, play a decisive role here.
It has been observed that men have a significantly lower risk for this disease after castration. In addition, the prostate gland and often the tumor shrinks when these hormones are deficient, which is often used in therapy. Last but not least, various environmental influences seem to have an effect on the development of prostate cancer. Whether or not diet also has an influence on this has been controversial so far.
