The prostate is the largest exocrine gland of the male urogenital apparatus. It is located under the bladder, in front of the rectum. It surrounds the urethral duct that carries urine from the bladder to the outside.
Two sections of the prostate can be distinguished:
A central part surrounding the urethra
A more peripheral part
This gland consists of a set of elements called lobules. These lobules consist of supporting tissue containing smooth muscle fibers, blood vessels and nerve endings, as well as glandular formations that secrete prostate and seminal fluid.
The prostate contains the ejaculatory ducts. The urethra, in this prostatic portion, is surrounded by two sphincters (muscle rings), one at the entrance and one at the exit.
Prostate cancer is a cancer of the elderly: it rarely occurs before 50. Year of life, and the incidence increases very quickly with age. In most cases, it is adenocarcinoma, which means that the cancer develops from the cells of the gland. Other forms are rare (about 3%).
epidemiology :
Prostate cancer is the second most common cancer in men worldwide, after lung cancer. Prostate cancer is most common in developed countries, but rates have also increased in developing countries. Due to the high number of prostate cancer cases detected by screening, prostate cancer is estimated to overtake lung cancer in just over ten years and will be the most common cancer in men worldwide.
The incidence is decreasing on average between 2010 and 2015 (-3.5% per year). This development is to be interpreted after a sharp increase in incidence up to 2005, followed by a rapid decline related to the changed practice of individual early detection by determining the PSA value (prostate-specific antigen).
Prostate cancer is a cancer with good prognosis, the net survival rate after five years is over 90%, and the steady decline in mortality between 1990 and 2018 (-2.8% per year) is a favorable factor, which is due, on the one hand, to improved treatment methods and, on the other, to the role of screening, which makes it possible to diagnose certain types of cancer in the early and therefore curable stages.
Proven risk factors :
Age, height, ethnicity, and a family history of prostate cancer are individual risk factors for prostate cancer. These are the only proven risk factors.
individual risk factors :
The age :
Age is the most important risk factor identified for prostate cancer.
Between 50 and 64 years the risk is 1% to 7%, between 65 and 74 years it rises from 14% to 26% and finally the risk between 75 and 79 years increases by 40% until it reaches 50% from 80 years.
The big size in adulthood :
High height in men is also thought to be associated with an increased risk of prostate tumor, but it is probably not the height itself that is at fault (WCRF, 2018).
Indeed, it is likely that it is the factors (growth velocity during childhood, genetics) leading to high growth that are actually responsible for an increased risk of prostate cancer.
Genetics and Family History :
Two genetic mutations, HOXB13 and BRCA2, are associated with prostate cancer. Germline mutations in BRCA2 are linked to a poor prognosis for prostate cancer (Nombela, 2019). The BRCA2 gene mutation is also implicated in increasing the risk of breast or ovarian cancer in women. Researchers are investigating other genetic mutations that may affect prostate cancer risk.
A family history of prostate cancer is also a known risk factor for prostate cancer – men who have first or second degree relatives with prostate cancer have an increased risk of developing the disease.
The greater the number of relatives and the younger age of diagnosis, the greater the risk of the development of the cancer of the anterosomihurova gland (Cussenot, 2004).
Ethnic origin :
Ethnic origin is also a recognized risk factor for prostate cancer: in sub-Saharan Africa and the Antilles, the incidence is above the global average (Crawford, 2003).
In the US, African-American men are 1.6 times more likely to develop prostate cancer than white men. These tumors are usually detected at a more advanced stage and a higher degree.
Behavioral risk factors :
Overweight, obesity :
The 2018 update conducted by the WCRF/AICR concluded the association of weight status (estimated by Body Mass Index or BMI) with increased risk of advanced prostate cancer (WRCF, 2018).
The data further show that abdominal adiposity (measured by waist circumference or waist-to-hip circumference ratio) is also predictive of prostate cancer risk
Suspected risk factors :
Epidemiological studies have investigated the role of numerous factors in the development of prostate cancer without identifying factors that are significantly associated with the risk of prostate cancer.
Further studies are needed to establish a link between these factors and the risk of prostate cancer.
Nutritional risk factors :
foods high in fat :
Although there is strong evidence of the effects of a high-fat diet on the development and progression of prostate cancer, the exact mechanisms by which a high-fat foods emphasizes the etiology of prostate cancer remain unclear.
Several hypotheses were established, including the consumption of fatty acids, which leads to inflammation, the induction of oxidative stress and a change in cell signaling.
Dairy products with high fat content :
Several epidemiological studies have reported that frequent consumption of dairy products with high fat content is associated with an increased risk of developing prostate cancer, but in other studies this association has not been observed.
The role of consuming dairy products with high fat content in prostate cancer risk is confirmed by in vitro studies in which milk modulated and promoted the proliferation of cancer cell lines LNCaP and PC-3.
Consumption of saturated fats, high calcium intake, a decrease in circulating levels of 1.25-dihydroxy vitamin D (the active form of vitamin D) and an increase in levels of insulin-like growth factor 1 (IGF-1) are several potential mechanisms, About which the consumption of milk and dairy products can affect the incidence and progression of prostate cancer (Bellamri, 2019).
calcium :
Calcium intake above the recommended daily intake (~1000 mg/day) is associated with an increased risk of developing prostate cancer (Wilson, 2015). The underlying mechanisms of high calcium absorption and the risk of high-grade prostate cancer require further investigation.
Vitamine D :
Several epidemiological studies have reported a link between low vitamin D levels and a higher risk of prostate cancer. 1,25-dihydroxyvitamin D (the active form of vitamin D) has antiproliferative effects that are controlled by the nuclear vitamin D receptor (VDR) pathway and lead to the expression of genes that lead to the termination of the cell cycle, apoptosis and cell differentiation are involved. Evidence indicating an increased risk of prostate cancer is limited at low plasma concentrations of vitamin D (Bellamri, 2019).
More detailed studies are needed to elucidate the crucial roles of vitamin D in the development of prostate cancer.
Alcool :
Researchers have found a dose-response relationship between the extent of alcohol consumption and the risk of prostate cancer, starting with the first glasses per day. In a meta-analysis, researchers found a dose-response relationship between the level of alcohol consumption and the risk of prostate cancer, starting with the first glasses per day. Alcohol consumption is not associated with low-grade prostate cancer. Instead, the authors suggest that high alcohol consumption at a young age should be investigated as a potential risk factor for high-grade prostate cancer. This might be explained by the prostate becoming weaker during puberty and adolescence.
red and processed meat :
Several epidemiological studies have investigated the role of red and processed meat in the risk of prostate cancer. Some meta-analyses report a high risk of prostate cancer with frequent meat consumption, while other studies found no overall effect on risk (Bylsma, 2015). The evidence remains limited.
fruit and vegetable :
Consuming fruits and vegetables may help prevent some cancers, but there is no proof that doing so can prevent prostate cancer. Only the antioxidant effect of lycopene contained in tomatoes seems to play a protective role (Fraser, 2005; Ellinger, 2006).
Physical activity :
Some studies suggest that physical activity may reduce the risk of prostate cancer, but only to a very small extent .
What Are the Symptoms of Prostate Cancer ? :
See your doctor as soon as possible if you experience any of the following symptoms:
- Difficulty starting urination.
- Weak or interrupted flow of urine.
- Urinating often, especially at night.
- Trouble emptying the bladder completely.
- Pain or burning during urination.
- Blood in the urine or semen.
- Pain in the back, hips, or pelvis that doesn’t go away.
- Painful ejaculation.
Keep in mind that illnesses other than prostate cancer may be to blame for these symptoms.
