Scientist have been able uncover five (5) types of prostate cancer with each having different type of genetic identification.
They compared 250 samples removed in surgery with the patients’ subsequent progress, Prostate Cancer: Scientist Identifies five types that are more likely to occur again.
Until now, there has been no reliable way to know which patients have the more aggressive cancers requiring the most urgent and intensive therapy.
But larger clinical trials are needed in order to arrive at the final conclusion of the above discovery.
Diagnosing the type of prostate cancer
Your doctor will find the type of prostate cancer you have by taking samples of cells from your prostate during a biopsy. A pathologist examines the cells in the laboratory under a microscope. The cells look different, depending on the type of cancer you likely have.
The most common type of prostate cancer
More than 9 out of 10 prostate cancers (90%) are a type called acinar adenocarcinoma (pronounced ass-in-ar ad-en-oh-car-sin-oh-ma). So nearly everyone diagnosed with prostate cancer has this type. It starts from gland cells in the prostate.
Many of these cancers grow extremely slowly and are not likely to spread. But some can grow more quickly.
There are other types of adenocarcinoma, which include atrophic, foamy, colloid and signet ring carcinoma. They are all treated in the same way as acinar adenocarcinoma.
This type of prostate cancer starts in the cells that line the ducts (tubes) of the prostate gland. It tends to grow and spread more quickly than acinar adenocarcinoma. So some men have an advanced prostate cancer when they are diagnosed.
You are most likely to have surgery to remove the prostate. This type of cancer is less sensitive to hormone therapy than acinar adencarcinoma. So you may have chemotherapy after surgery.
Transitional cell (urothelial cancer)
This type of prostate cancer starts in the cells that line the tube carrying urine – the urethra. The urethra passes through the prostate to carry urine from the bladder to the outside of the body. More commonly, this type of cancer may start in the bladder and spread into the prostate.
Transitional cell cancer of the prostate may spread into the bladder entrance and into nearby tissues. You are most likely to have surgery to remove your prostate and bladder. If you can’t have surgery for any reason, you are most likely to have chemotherapy.
Squamous cell cancer
Squamous cell prostate cancer starts from the flat cells covering the prostate gland. These are called squamous cells (pronounced sk-way-mus).
Squamous cell prostate cancer tends to grow and spread more quickly than adenocarcinoma of the prostate. So some men have an advanced prostate cancer when they are diagnosed. Doctors use the same treatments as for acinar adenocarcinoma but they may not work so well for this type of prostate cancer.
Carcinoid of the prostate
Carcinoid tumours start from cells of the neuroendocrine system, which is made up of specialised nerve and gland cells. These tumours are very rare and seem to be slowly growing. They may not cause any symptoms for many years and your doctor may recommend monitoring the cancer. But some of these tumours may grow more quickly and your doctor may then recommend surgery to remove the prostate.
Small cell cancer
This is a type of neuroendocrine tumour and is made up of small round cells. If you have this type of prostate cancer, you may not have a raised PSA (prostate specific antigen) test. So it is more difficult to pick up early and many men are diagnosed when it is already advanced.
Small cell prostate cancer tends to grow and spread more quickly than adenocarcinoma of the prostate. Hormone therapy does not work for this type of prostate cancer so you are more likely to have chemotherapy.
Sarcoma and sarcomatoid cancer
Sarcomas start from muscle cells. They often grow quite quickly. The most common type of prostate sarcoma in adults is leiomyosarcoma. It tends to occur in men between the ages of 35 and 60.
Sarcomatoid cancers have a mixture of sarcoma and adenocarcinoma cells.
With these types of prostate cancer, you are most likely to have surgery to completely remove your prostate gland. After surgery, you may have radiotherapy to the prostate or chemotherapy.
Next article on this series will deal on how to treat these cancers.
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