FAQ : Prostate cancer
What is prostate cancer?
Prostate cancer is caused by an uncontrolled multiplication of prostate cells, forming a cluster of cells called a cancerous tumor. It is one of the most frequent cancers in France with more than 60,000 new cases per year. In most cases, it occurs after 50 years of age.
What are the histologies (subtypes) of prostate cancer?
There are several types of prostate cancer, the most common beingadenocarcinoma. It represents approximately 95% of cases and is formed in cells forming the lining tissue of the prostate. These cells are called epithelial cells.
What are the biomarkers or genetic mutations involved in prostate cancer?
Pancreatic cancer may be associated with multiple biomarkers and genetic mutations. The genes BRCA1, BRCA2 and HOXB13 are the most common in this type of cancer.
What is the PSA level?
The PSA level (Prostate Specific Antigen), determined by blood test, is also a factor to take into account. A PSA level of less than 4 ng/mL is considered normal. If there is a cancerous tumor in the prostate, this rate is likely to increase. However, the diagnosis is not based solely on this rate; further examinations (MRI, biopsies, rectal examination, etc.) must also be carried out.
What does the Gleason score correspond to?
The Gleason score is a measure of how aggressive prostate cancer is. This score is determined during the exam anatomopathological, during which aNumber ranging from 1 to 5is assigned to cancer cells (the more different the cell is from a normal cell, the greater the number assigned to it). The layout (also called growth model) cancer cells in the prostate are also taken into account.
Each growth model is assigned a number, which are then added together to determine the Gleason Coast. If two growth patterns are identified, the Gleason score is the sum of the two numbers. If three models are present, the largest number and the number assigned to the most common model are added together. In both cases, the maximum score is therefore 10. The higher this coast, the more aggressive the cancer is, that is, it will spread more quickly.
What are the stages of development of prostate cancers?
The TNM score is a classification system used to assess the stage of a cancer, plan treatment, and predict prognosis.
Three parameters must be taken into account:
- The T describes the size and extent of the primary tumor
- The N indicates whether the cancer faces a regional lymph node extension
- The M indicates whether the cancer has spread to other parts of the body, called metastases
Different stages of prostate cancer development exist, depending on how well the cancer cells are spreading. A Cancer in Stadium T1-T2/N0/M0 Corresponds to Cancer Located, that is, with a tumor that is only present in the prostate gland. The next stage (T3-4/N0-1/M0) is synonymous with CancerLocally Advanced. From the moment the cancer reaches the Stage M1, of MetastasisAre beginning to form, that is, the cancer has spread to other organs. Cancer is said Hormone-dependent because the growth of the tumor occurs thanks to the presence of testosterone, a hormone synthesized by the testicles. In the most severe cases, cancer is Hormone-resistantand will therefore not respond to standard hormonal treatments. However, new treatments may be available through clinical trials.
| Primary tumour | Description |
|---|---|
| T0 | There is no sign of a primary tumour. |
| T1 | The tumour cannot be felt during the digital rectal examination (DRE) nor seen on imaging. It might be found by chance during a biopsy or during surgery performed for another health problem related to the prostate or the bladder. |
| T1a | Cancer is found in 5 % or less of the tissue removed. |
| T1b | Cancer is found in more than 5 % of the tissue removed. |
| T1c | The tumour is detected by needle biopsy in one side or in both sides of the prostate. |
| T2 | The tumour can be felt by your doctor during a DRE and seen on imaging. The cancer is found only within the prostate. |
| T2a | The tumour occupies half or less of one side of the prostate. |
| T2b | The tumour occupies more than half of one side of the prostate. |
| T2c | The tumour is present in both sides of the prostate. |
| T3 | The tumour has grown through the outer layer of the prostate. |
| T3a | The tumour has grown through the prostate but has not invaded the seminal vesicles. |
| T3b | The tumour has grown through the prostate and has invaded the seminal vesicles. |
| T4 | The tumour has grown through the prostate and has invaded nearby structures such as the bladder, the rectum, the pelvic muscles and the pelvic wall. |
| Lymph nodes | Description |
|---|---|
| N0 | The cancer has not spread to any nearby lymph node |
| N1 | The cancer has spread to nearby lymph nodes |
| Distant metastases | Description |
|---|---|
| M0 | The cancer has not spread to other parts of the body |
| M1 | The cancer has spread to other parts of the body |
Treatments
How is prostate cancer treated?
There are several treatments for prostate cancer, which depend on the stage of the disease, the cancerous tumor, and the patient’s overall health condition.
What is surgery for prostate cancer?
Surgery is the only cure for prostate cancer. This operation is called the total prostatectomy(or radical prostatectomy) and consists in the surgical removal of the prostate. This procedure is prescribed primarily in the case of intermediate-risk tumors, but may also be offered for low-risk or high-risk tumors under certain conditions.
What is chemotherapy for prostate cancer?
Chemotherapy is a treatment that uses powerful drugs to destroy cancer cells by stopping them from multiplying or spreading in the body. Chemotherapy medications can be given intravenously (into a vein), orally (as tablets or capsules), or by subcutaneous injection (under the skin).
Chemotherapy may be used alone or in combination with other treatments such as surgery or radiation therapy, depending on the type and stage of the cancer, as well as the patient’s overall health. While chemotherapy can be very effective in destroying cancer cells, it can also damage healthy cells, leading to side effects such as hair loss, fatigue, nausea and vomiting, and suppression of the immune system.
In the case of prostate cancer, among the chemotherapies used, we find in particular:
- Estramustine (ESTRACYT)
- Mitoxantrone (NOVANTRONE)
- Docetaxel (TAXOTERE)
- Cabazitaxel (JEVTANA)
What is radiation therapy for prostate cancer?
Radiation therapy consists in using radiation (also called rays or radiation) to destroy cancer cells by blocking their ability to multiply. We are talking about a locoregional treatment of cancers.
In the case of prostate cancer, the patient may be treated with either external radiation therapy (using devices to target the tumor), or by Brachytherapy (implantation of radioactive sources near the tumor). It is indicated for localized cancers, in addition to other treatments for advanced forms, or as an exclusive treatment for low and medium risk cases.
What is hormonal therapy for prostate cancer?
Hormonal therapy is a drug treatment used in the treatment of cancers hormone dependent. This treatment involves the use of medications that block the effects of hormones in the body.
Hormonal therapy for prostate cancer aims to reduce the levels of male hormones (androgens) that stimulate the growth of cancer cells. This treatment is used in advanced cases or as an adjunct to radiation therapy for high-risk localized cancers. Options include anti-androgens, the LH-RH agonists and antagonists, or even the surgical castrationwhich consists in the removal of the inside of the testicles.