Adenocarcinoma Of The Prostate
Adenocarcinomas develop in the gland cells that line the prostate gland and the tubes of the prostate gland. Gland cells make prostate fluid.
Adenocarcinomas are the most common type of prostate cancer. Nearly everyone with prostate cancer has this type.
There are 2 types of adenocarcinoma of the prostate:
Definition Of Intraductal Carcinoma Of The Prostate
Intraductal carcinoma of the prostate was defined according to McNeals criteria as described previously ., Briefly, intraductal carcinoma of the prostate is exemplified by well-circumscribed lesions bound by intact basal cells distended by overtly malignant-appearing epithelial populations. These lumen-spanning lesions are found almost exclusively in close proximity to invasive tumors.
Figure 1
Representative morphological features of intraductal carcinoma of the prostate. Hematoxylin and eosin staining. High molecular weight cytokeratin staining. Note the presence of intact basal cells and the similar appearance of intraductal carcinoma of the prostate and invasive cancer cells.
Finding Life When Facing Death
I know sooner or later that my life will end. I decided that I was NOT going to waste a moment that I spend with her being sorry for myself or sad. That does not mean I dont have occasional pity parties I just keep them to a minimum.
I truly feel more alive now than before cancer. The bad days are gifts because they make the good days that much more special. I have passed my expiration date and I am still doing relatively well. I can honestly say: I love my life!
FROM THE EDITOR:
Having access to medical innovations like Lupron and Zytiga, and the external radiation treatments allow patients with cancer to live better, longer lives. But those treatments arent always offered or available at first. That is why we all have to learn how to advocate for our own needs. Through education and research, support and teamwork, we can get fight to get access to the treatments we need to regain function and improve quality of life in the face of chronic, rare and terminal illnesses.
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Jatinder Kumar* Muhammad Umar Alam Karthik Tanneru Shiva Gautam Daniel Norez Charu Shastri Joseph Costa Mark Bandyk Hariharan Palayapalayam Ganapathi Shahriar Koochekpour Sanjeev Shukla And Kc Balaji
*Corresponding author:Received:Accepted:
Cite this as
Abstract
Purpose: To provide a comprehensive summary of published literature regarding influence of intraductal carcinoma of prostate on clinical outcomes in men with Prostate Cancer .
Methods: We compared the following clinical endpoints in men with PC with or without IDC-P Castration Resistant Free Survival and Overall Survival for metastatic PC , biochemical recurrence rate and/or cancer specific survival in men undergoing radical prostatectomy or radiotherapy . A meta-analysis was done by fixed effect model using 12 studies reporting Hazard Ratio and meeting the selection criteria.
Results: In Group 1 for men with IDC-P, the pooled HR for CFS and OS were 1.69 and 2.00 , respectively. In group 2a BR and CSS were higher in men with IDC-P with HR 2.63 and 2.87 respectively. Similarly, presence of IDC-P in group 2b demonstrated a HR of 2.04 for BR.
Men with IDC-P demonstrated poorer clinical outcomes including higher rate of BR following radical prostatectomy, radiation therapy either in primary and salvage settings, shorter time to CFS and poorer OS in men with metastatic disease. Our analysis and review of the literature suggest that IDC-P could be used as a novel prognostic and predictive morphological biomarker to influence clinical management in men with PC including pelvic lymph node dissection, pelvic radiotherapy or genetic testing.
Main article text
Survival By Tumor Grade
One way cancer is staged is by looking at the grade of cancer. Grade refers to how cancer cells look like under a microscope.
Traditionally for prostate cancer, this has been done using the Gleason Score, which was developed in the 1960s. Under this system, cancerous cells are categorized on a scale from 1 to 5. Grade 1 cells are considered normal prostate tissues, while cells in the grade 5 range have mutated to such an extent they no longer resemble normal cells.
In determining a Gleason score, a pathologist will examine a biopsy sample under a microscope and give a Gleason grade using the above scale to the most predominant pattern displayed, then a second grade to the pattern that is the second most predominant. Those two grades are then added to form the overall Gleason score .
In theory, Gleason scores could range from 2 to 10, but pathologists today rarely give a score between 2 and 5 and are more likely to be in the range of 6 to 10 with 6 being the lowest grade of prostate cancer.
Under the Gleason Score system, a 6 is considered low grade, 7 is intermediate and scores of 8, 9, or 10 are considered high-grade cancers.
The higher the Gleason score, the more likely it is the prostate cancer will grow and spread quickly.
However, there have been some issues with the Gleason system, and a new grading system, to act as an extension of the Gleason system, has been developed.
Under this system Gleason scores are now categorized into grade groups:
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Transitional Cell Carcinoma Of The Prostate
Transitional cell carcinoma of the prostate starts in the cells that line the tube carrying urine to the outside of the body . This type of cancer usually starts in the bladder and spreads into the prostate. But rarely it can start in the prostate and may spread into the bladder entrance and nearby tissues.
This is sometimes called urothelial carcinoma of the prostate. Between 2 and 4 out of 100 prostate cancers are this type.
Citation Doi & Article Data
Citation:DOI:Dr Joachim FegerRevisions:see full revision historySystems:
- Endometrial carcinoma of the prostate
- Endometrioid carcinoma of the prostate
- Prostatic ductal adenocarcinoma
Ductal adenocarcinomas of the prostate or prostatic ductal adenocarcinomas are malignant glandular neoplasms of the prostate and tend to be more aggressive than acinar adenocarcinomas.
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Advanced Prostatic Ductal Carcinoma In A Patient With A Long Survival Time Following A Total Pelvis Exenteration: A Case Report
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Abstract
Introduction
Ductal adenocarcinoma of the prostate wasinitially identified by Melicow and Patcher in 1967 . Initially, DAP was considered to arisefrom a Müllerian remnant of the prostatic utricle verumontanum. However, subsequent studies haveclearly confirmed the prostatic origin of DAP, which is supportedby a favorable response to orchiectomy, the expression ofprostatic-specific antigen and ultrastructural findings.
DAP is a rare subtype of prostate cancer thathas a poorly-understood etiology, and more commonly occurs inCaucasian males that are > 70 years of age . A previous study that reviewed thehistological slides of 2,600 prostatic carcinomas reported aprevalence of 0.40.8% for pure ductal adenocarcinoma and 5% formixed ductal adenocarcinoma .According to the latest Surveillance, Epidemiology and End Resultscancer registry database, 693/731,262 patients with acinarPCa have been identified as possessing ductal adenocarcinoma sincethe 1970s .
Case report
Discussion
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Related Articles
Is Adenocarcinoma Of The Prostate An Aggressive Cancer
1. What is adenocarcinoma of the prostate? Adenocarcinoma of the prostate is a type of cancer with a wide range of behavior from cases which are very slow growing with a low risk of causing men harm to cases which are more aggressive.
Is adenocarcinoma prostate cancer curable?
The short answer is yes, prostate cancer can be cured, when detected and treated early. The vast majority of prostate cancer cases are discovered in the early stages, making the tumors more likely to respond to treatment. Treatment doesnt always have to mean surgery or chemotherapy, either.
Is adenocarcinoma the most common prostate cancer?
Adenocarcinomas develop in the gland cells that line the prostate gland and the tubes of the prostate gland. Gland cells make prostate fluid. Adenocarcinomas are the most common type of prostate cancer.
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Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. This condition causes pain in the lower back and groin area, and may cause urinary retention. Symptoms include leaking and discomfort. In severe cases, a catheter may be required to relieve the symptoms. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. If these do not work, your symptoms could progress and become chronic.
An acute bacterial infection can cause a burning sensation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Patients may experience a fever or chills as a result of the infection.
Survival By Disease Recurrence
If a man develops an elevated PSA level after cancer surgery, then the disease is viewed as recurrent.
The number of lymph nodes at the time of prostatectomy can influence the risk of recurrence. One study suggests the removal of a large number of nodes is associated with an improvement in odds of recurrence, but this doesn’t appear to impact overall survival.
But disease recurrence doesn’t always influence survival times. If a recurrence does occur, the 15-year survival rate at the time of diagnosis may be as high as 94% in those with low-risk recurrence.
The main factors influencing survival rates are:
- The Gleason score
- The PSA doubling time
- Whether the recurrence occurred within three years or after three years
A recurrence that occurs within three years reduces survival rates by anywhere from 15 to 20%and even more, if the doubling time is short.
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Stage Iv Prostate Cancer Prognosis
Prostate cancers detected at the distant stage have an average five-year survival rate of 28 percent, which is much lower than local and regional cancers of the prostate. This average survival rate represents stage IV prostate cancers that have metastasized beyond nearby areas to lymph nodes, organs or bones in other parts of the body.
What Does Differentiation Mean
You may notice the word differentiation on your pathology report. This refers to the grade of the cancer. In other words, it relates to how abnormal your cancer cells look under a microscope. Well-differentiated adenocarcinoma is considered low grade. This type of cancer tends to grow and spread slower. Poorly differentiated adenocarcinoma is considered high grade because it usually spreads faster.
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How We Treat Prostate Cancer
The prognosis for metastatic prostate cancer can be discouraging, but some treatment centerslike the Johns Hopkins Precision Medicine Center of Excellence for Prostate Cancerspecialize in innovative, individualized therapy with the potential to improve outcomes.
How Is Ductal Prostate Cancer Diagnosed
The PSA test is one of the main diagnostic tools that is used to differentiate prostate cancer from benign disease, and very high PSA values are associated with metastatic disease51. However, serum PSA levels can vary in patients with DAC , despite strong expression of PSA on tumour immunohistochemistry8,52.
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What Is The Difference Between Carcinoma And Adenocarcinoma
Carcinoma is the most common form of cancer. It starts in the epithelial tissue of your skin or internal organs. Adenocarcinoma is a subtype of carcinoma. It grows in the glands that line the insides of your organs.
How long can you live with adenocarcinoma?
5-year relative survival rates for small intestine cancer
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Diagnosing Rare Prostate Cancers
Rarer prostate cancers can be harder to diagnose. For example, some dont cause your prostate specific antigen level to rise. This means theyre not always picked up by a PSA test. Because of this, some rare cancers may not be diagnosed until they have already spread outside the prostate. Read more about the PSA test and other tests used to diagnose prostate cancer.
Some rare prostate cancers may only be picked up after having a biopsy to check for prostate cancer, or surgery called transurethral resection of the prostate to treat an enlarged prostate. The tissue removed during the biopsy or TURP is looked under a microscope to see if you have common prostate cancer or a rare type of prostate cancer. Rare cancers arent always given a Gleason score after a biopsy. This is because they can behave differently to common prostate cancer and cant be measured in the same way.
Because rare cancer can be aggressive and spread outside the prostate, you will probably have more tests to see if they have spread. These include:
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Symptomatic treatment of an enlarged prostate usually involves a combination of medication and lifestyle changes. A diet rich in fruits and vegetables may be the best option if you suffer from chronic urination. It will help the body adjust to the increased size of the prostate. Also, taking regular urination intervals will help retrain the bladder to function properly. Inactivity also contributes to urine retention, and cold temperatures can increase the urge to urinate.
Invasive treatment of enlarged prostate includes medication that relieves the pressure on the urethra and bladder. However, if the condition is severe, it may require surgical intervention. If treatment is not successful, the enlarged prostate can become a potentially life-threatening disease. As the hormone levels in the body change, the enlarged prostate can lead to various complications, including urinary retention and even cancer. This is why it is critical to see a doctor for further evaluation.
Other Rarer Types Of Prostate Cancers
Other rarer cancers can develop in the prostate, these include:
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Cancer: Principles and Practice of Oncology VT DeVita, TS Lawrence, SA RosenbergWolters Kluwer, 2019
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The 2016 WHO Classification of tumours of the urinary system and male genital organs Part B: prostate and bladder tumoursP Humphrey and othersEuropean Urology, 2016. Vol 70, Issue 1
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Ductal adenocarcinoma of the prostate: increased mortality risk and decreased PSA secretionT Morgan and others
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Ductal Prostate Cancer: A Rare Form Of Prostate Cancer
Ductal prostate cancer is a rare type of prostate cancer. Men diagnosed with ductal prostate cancer are more likely to see their cancer spread and more likely to die from it. This weeks research blog investigates what is known about ductal prostate cancer and how its best treated.
Prostate cancer is the most commonly diagnosed cancer in Australian men. Like most common cancers, decades of research and clinical trials means that we know a lot about prostate cancer and there are many treatments available. As so many people are affected by prostate cancer worldwide, there are many foundations, support groups, booklets, online communities, webcasts and other sources of support and information available. Men with prostate cancer can also be treated by health professionals who have treated hundreds or thousands of similar cases before. Clinical trials give them a lot of information by which to recommend most the appropriate treatments.
Its a completely different story for people who have rare cancers.
Rare cancers in Australia
Rare prostate cancers
Some men diagnosed with prostate cancer are surprised to be told that they have a rare type of prostate cancer. This puts them in a similar situation as those with rare cancers. There is less information available to help them and their doctors only rarely see men with the same type of prostate cancer. But treatments for the common type of prostate cancer are usually used by those with a rare type.
General Information About Prostate Cancer
In This Section
The median age at diagnosis of carcinoma of the prostate is 67 years. Prostate cancer may be cured when localized, and it frequently responds to treatment when widespread. The rate of tumor growth varies from very slow to moderately rapid, and some patients may have prolonged survival even after the cancer has metastasized to distant sites, such as bone. The 5-year relative survival rate for men diagnosed in the United States from 2011 to 2017 with local or regional disease was greater than 99%, and the rate for distant disease was 31% a 98% survival rate was observed for all stages combined. The approach to treatment is influenced by age and coexisting medical problems. Side effects of various forms of treatment should be considered in selecting appropriate management.
Many patientsespecially those with localized tumorsmay die of other illnesses without ever having suffered disability from the cancer, even if managed conservatively without an attempt at curative therapy. In part, these favorable outcomes are likely the result of widespread screening with the prostate-specific antigen test, which can identify patients with asymptomatic tumors that have little or no lethal potential. There is a large number of these clinically indolent tumors, estimated from autopsy series of men dying of causes unrelated to prostate cancer to range from 30% to 70% of men older than 60 years.
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What Questions Should I Ask My Healthcare Provider
Talking with your healthcare provider can help you understand your situation and make informed decisions. Here are some questions you can ask to learn more about your diagnosis:
- What type of cancer do I have?
- Where is the cancer located?
- Has it spread to other parts of my body?
- What are my treatment options?
- How long will my treatment last?
- What are the possible risks and side effects?
- Can I work while I undergo treatment?
- Whats the goal of my treatment?
A note from Cleveland Clinic
If youve been diagnosed with adenocarcinoma, you may feel shocked, saddened or frustrated. Learning everything you can about your diagnosis can prepare you for possible treatment options and empower you to take control of your healthcare.
Last reviewed by a Cleveland Clinic medical professional on 07/30/2021.
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