NCCN Guidelines for Patients
Prostate Cancer, Version 1.2016
Prostate cancer basics
A disease of cells │Cancer's threat
A disease of cells
Cancer is a disease of cells. Inside of cells are coded
instructions for building new cells and controlling
how cells behave. These instructions are called
genes. Genes are a part of DNA (
cid), which is grouped together into bundles called
See Figure 2
. Prostate cancer
occurs when normal cells begin to grow faster or die
slower. Either pattern causes a tumor to form. Some
prostate cancers occur from abnormal changes,
called mutations, in genes.
Aging, being of African-American descent, and having
family members with prostate cancer have been
linked to a higher chance of getting prostate cancer.
Other related factors include contact with Agent
Orange, obesity, smoking, and poor diet. Not all men
with these conditions get prostate cancer and some
men without these conditions do. Prostate cancer is
common among older men. However, prostate cancer
in older men often doesn’t become a problem.
Almost all prostate cancers are adenocarcinomas.
Adenocarcinomas are cancers that start in cells that
line glands and, in the case of prostate cancer, make
semen. Adenocarcinomas of the prostate are the
focus of this book.
Cancer cells don’t behave like normal cells in three
key ways. First, prostate cancer cells grow more
quickly and live longer than normal cells. Normal cells
grow and then divide to form new cells when needed.
They also die when old or damaged as shown in
. In contrast, cancer cells make new cells
that aren’t needed and don’t die quickly when old or
damaged. Over time, cancer cells form a mass called
the primary tumor.
The second way cancer cells differ from normal cells
is that they can grow into (invade) other tissues. If not
treated, the primary tumor can grow large and take
over most of the prostate. It can also grow beyond
the prostatic capsule and invade nearby tissues. This
growth is called extracapsular extension.
Third, unlike normal cells, cancer cells can leave the
prostate. This process is called metastasis. In this
process, cancer cells break away from the tumor and
merge with blood or lymph. Lymph is a clear fluid that
gives cells water and food and contains germ-fighting
blood cells. Then, the cancer cells travel in blood or
lymph through vessels to other sites. In other sites,
the cancer cells may form secondary tumors, replace
many normal cells, and cause major health problems.
Most men with prostate cancer will not die of this
disease. However, prostate cancer is the second most
common cause of death from cancer in men. Most
prostate cancers grow slowly but some grow and
spread quickly. Doctors describe these latter cancers
as “aggressive.” Why some prostate cancers grow
fast is unknown and is being studied by researchers.