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The term cancer encompasses a large number of diseases that are characterised by the development of abnormal cells that divide and grow uncontrollably in some part of the body. Prostate cancer originates in the prostate gland.
The prostate gland is part of the urinary tract and the male reproductive system. It is located below the bladder and in front of the rectum, surrounding the urethra. It is similar in size to a walnut or a chestnut and tends to grow with age. The main function of the prostate is to produce seminal fluid, which makes up part of the semen. It also plays a role in urinary continence.
How many people does Prostate Cancer affect?
The prevalence varies depending on the age of the man, the area he lives, and his origin.
This cancer is very rare in men under 30, but in men over 80 it is found in up to 60% of the autopsies performed for other causes of death.
It is frequent in Oceania, North America and Western Europe. The population most prone to developing this disease are men of African origin, followed by those of Caucasian origin. The least likely to develop it are those of Asian origin.
The incidence ranges from 110 cases per 100,000 inhabitants in areas where the disease is most frequent, to 3 cases per 100,000 inhabitants in the least-affected areas.
In Western Europe there are 85-95 cases per 100,000 inhabitants.
Type of Prostate Cancer
As in most tumours, the stage of the disease is given by the depth of the tumour, the presence of affected lymph nodes (adenopathies) and distant metastases.
In the case of prostate cancer, a classification is used based on a biopsy or surgical analysis (anatomopathological classification). This classification is known as the Gleason grading system and is widely used. Recently, it has been replaced by a more updated scheme, ISUP grading, which categorises tumours on a scale of 1 to 5. The higher the number, the more aggressive the disease.
Prostate cancer can therefore be divided into:
Low risk. Low PSA (less than 10), not very aggressive in the biopsy (ISUP 1, Gleason 6) and small, confined to the prostate (T1-T2a).
Intermediate risk. Intermediate PSA (10-20), moderately aggressive in the biopsy (ISUP 2-3, Gleason 7), confined to the prostate (T2b).
High risk. Elevated PSA (greater than 20), aggressive in the biopsy (ISUP 4-5, Gleason greater than or equal to 8), confined to the prostate (T2c)
Locally advanced. Tumour that has spread beyond the prostate to nearby organs and/or lymph nodes within the pelvis.
Metastatic. Ganglions outside the pelvis or distant metastases (usually bone, liver, lung, etc.).