Pathological classification of prostate cancer

Written by Zhou Zi Hua
Oncology
Updated on September 19, 2024
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The classification of precancerous lesions of prostate cancer is divided into two categories: intraductal carcinoma of the prostate and atypical adenomatous hyperplasia. Among these, the relationship between intraductal carcinoma of the prostate and prostate cancer is the closest. Intraductal carcinoma of the prostate is currently recognized as a precancerous lesion of prostate cancer, while atypical adenomatous hyperplasia has not been proven to be a precancerous lesion of prostate cancer according to current evidence. However, the biological behavior of this atypical adenomatous hyperplasia is not very clear yet, so it should be closely monitored. The histological classification of prostate cancer mainly includes the majority of acinar adenocarcinoma and a small amount of ductal adenocarcinoma, with acinar adenocarcinoma being a highly invasive malignant tumor.

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Written by Liu Liang
Oncology
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How long can one survive with prostate cancer?

The life expectancy of prostate cancer patients depends on the clinical stage at diagnosis, as well as the patient's sensitivity to various treatments such as endocrine therapy, chemotherapy, and radiotherapy. Patients diagnosed at earlier stages who are more responsive to treatment generally have better treatment outcomes and, consequently, a longer survival period compared to those who are diagnosed at later stages and have poor responses to treatment. Overall, prostate cancer patients tend to have a relatively long disease course, and the prognosis is generally good. Even patients with advanced prostate cancer exhibiting extensive bone metastasis can survive several years due to the effectiveness of endocrine treatments. The disease itself progresses slowly, so the prognosis for this type of cancer is comparatively favorable.

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Written by Liu Liang
Oncology
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Is prostate cancer prone to metastasis?

Prostate cancer most commonly metastasizes to bones, with multiple bone metastases frequently observed clinically. In fact, the majority of prostate cancer patients already have multiple bone metastases by the time they are diagnosed. Therefore, bone is the most common distant organ to which prostate cancer spreads. Other distant organ metastases, such as to the lungs and liver, are less common, unless in very advanced stages of the disease. Additionally, prostate cancer commonly invades locally, spreading to nearby pelvic structures and tissues, such as the bladder and rectum, which is a common form of local invasion and spread.

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Written by Zhou Zi Hua
Oncology
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What are the symptoms of prostate cancer?

Early-stage prostate cancer generally has no symptoms, but if the patient also has prostate enlargement, or in cases of mid to late-stage prostate cancer where the tumor invades the urethra or bladder, various degrees of urinary obstruction or irritative urinary symptoms may occur. This is characterized by frequent urination and urgency. If there are local infiltrative symptoms, perineal pain and sciatica might occur. If the vas deferens is compressed, it can cause back pain and pain in the testicles on the affected side. Invasion of the rectum can cause difficulty in defecation or obstruction of the colon, and if the membranous part of the urethra is involved, urinary incontinence may occur. The most common site of metastasis for prostate cancer is the bones. If it spreads to the bones, it can cause bone pain, pathological fractures, anemia, and spinal cord compression leading to paralysis of the lower limbs.

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Written by Liu Liang
Oncology
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How is prostate cancer treated?

The treatment principles of prostate cancer vary with different stages. For clinical stage T1-T2N0M0 prostate cancer, which is early-stage, patients can choose radical prostatectomy or radical radiotherapy. For patients with locally advanced prostate cancer, specifically staged T3 or T4 but without lymph node or distant metastasis, options include radiotherapy combined with hormonal therapy or solely hormonal therapy. For patients with distant metastasis, which indicates advanced-stage prostate cancer, treatment primarily involves hormonal therapy. If hormonal therapy fails, chemotherapy may be utilized. Additionally, for pain caused by bone metastasis, local radiotherapy or radionuclide therapy can be integrated into the comprehensive treatment approach.

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Written by Zhou Zi Hua
Oncology
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Prostate cancer radiotherapy is conducted in what way?

Indications for radiation therapy for prostate cancer include clinical stages T1 to T4, M0 to M1. M0-stage prostate cancer patients undergo radiation therapy techniques including external beam radiation and brachytherapy. External beam radiation techniques comprise conventional radiation therapy, three-dimensional conformal radiation therapy, and intensity-modulated radiation therapy. Permanent seed implantation is used only for the treatment of early-stage localized prostate cancer with a good prognosis. External radiation therapy is divided into three categories based on therapeutic objectives: curative, adjuvant, and palliative radiation therapy.