Adenocarcinoma is the most well-known type of prostate cancer, accounting for 95% of cases. The remaining 5% are rare, and some do not present symptoms. In this article, you will learn about the types of prostate cancer, their symptoms, and the most common treatments. Follow along with the content we’ve prepared!
Among the types of prostate cancer, the most well-known is adenocarcinoma, which causes an abnormal increase in the number of prostate cells. There are other types that are rare and may not present symptoms, sometimes being diagnosed at more advanced stages.
In today’s blog, you will discover the types of prostate cancer, learn about symptoms, diagnosis, and available treatments.
Common Types of Prostate Cancer
Adenocarcinoma is the most common type of prostate cancer, accounting for 95% of cases. It forms in the glandular cells of the prostate that produce prostate fluid, one of the main components of semen. In adenocarcinoma, these cells proliferate abnormally, forming malignant tumors.
Adenocarcinoma
Adenocarcinoma results from genetic mutations affecting the glandular cells of the epithelium, a tissue found not only in the prostate but also in the lungs, intestines, and breasts.
These mutations cause the cells to multiply uncontrollably, forming malignant tumors that can spread to other parts of the body. There are two types of adenocarcinoma:
- Acinar adenocarcinoma: 95% of adenocarcinomas are of this type, and it is diagnosed via prostate biopsy, a test requested after changes in the rectal exam and PSA test;
- Ductal adenocarcinoma: This is one of the less common types of prostate cancer, accounting for about 3% of prostate carcinomas. It is more aggressive and is often diagnosed alongside acinar adenocarcinoma.
Rare Types of Prostate Cancer
Learn about the rarest types of prostate cancer:
Small Cell Carcinoma
Small cell carcinoma is one of the rarest and most aggressive types of prostate cancer, representing less than 1% of cases, with an average survival rate of 10 months after diagnosis, according to an article published in the Revista de Saúde. The same publication also highlights that it is more common in African American men.
It develops in the neuroendocrine cells of the prostate, responsible for the production and release of hormones that act on prostate tissue growth.
One peculiarity is that small cell carcinoma may not present symptoms and also does not cause changes in PSA levels, which occurs in conventional prostate adenocarcinoma.
When symptoms such as blood in the urine or semen appear, the disease is in an advanced stage, with the possibility of spreading to the bones, causing pain and fractures.
Ductal Carcinoma
Ductal carcinoma is a type of prostate cancer that originates in the prostate ducts, where prostate fluid is produced.
It is a highly aggressive prostate malignancy because it can invade nearby tissues in a short time. Furthermore, ductal carcinoma does not present symptoms in most cases and also does not show elevated PSA levels, making early diagnosis difficult.
When the patient experiences difficulty urinating, which occurs due to the tumor’s pressure, the cancer is already advanced.
Mucinous Carcinoma
Mucinous carcinoma is a rare malignant prostate tumor characterized by excessive mucus production by cancerous cells.
This mucus interferes with prostate function, making it difficult for urine to pass, and also causes pelvic pain, complicating diagnosis.
Squamous Carcinoma
One of the rarest types of prostate cancer, squamous carcinoma accounts for 0.5% to 1% of prostate malignancies. According to this case report published in the Scientific Journal of Urology of the Brazilian Society of Urology, prostate squamous carcinoma has a life expectancy of 14 months from diagnosis and can spread to the bones, liver, and lungs.
Transitional Carcinoma
Transitional carcinoma originates in the transitional cells lining the urethra and bladder, which protect tissues from toxic substances in the urine and allow the bladder to expand. These cells are called “transitional” because their shape changes from flat to rounded depending on the volume of urine.
Since it originates in the cells of the urethra and bladder region, transitional carcinoma can behave like bladder cancer and have symptoms such as difficulty urinating and blood in the urine.
Prostate Sarcoma
The article in the Brazilian Journal of Cancerology on prostate sarcoma explains that this tumor is rare, representing less than 0.1% of prostate cancers in adults. Diagnosis is usually at an advanced stage.
Regarding symptoms, the study presented in the publication reports that the patient had complaints of frequent nighttime urination, reduced urine stream, and the rectal exam showed an enlarged prostate.
What is the Most Severe Grade of Prostate Cancer?
The severity of prostate cancer is measured by the Gleason Score, which rates the affected areas seen in the biopsy. The two most affected areas each receive a score. For example, in a medical report stating Adenocarcinoma Gleason 8 (4+4), this means that the two most affected areas each received a score of 4.
In the Gleason Score, the minimum score is 6 and the maximum is 10. The higher the score, the greater the tumor’s aggressiveness.
When is Prostate Cancer Considered Advanced?
Some types of prostate cancer, such as small cell carcinoma and ductal carcinoma, do not present symptoms, so when they do, it is because the cancer is advanced. Know the symptoms:
- Difficulty urinating, weak or interrupted urine flow, the sensation of not being able to completely empty the bladder, and increased urinary frequency, especially at night;
- Hematuria, which is blood in the urine;
- Prostate cancers can spread to the bones, in which case symptoms include pain in the spine, knees, hips, thighs, and shoulders;
- Loss of appetite and weight loss;
- Kidney failure.
How to Diagnose Prostate Cancer Early?
The incidence of prostate cancer is higher in men aged 50 and older.
Since tumors usually do not present symptoms, it is essential to have annual follow-ups with a urologist and undergo a rectal exam and PSA test.
If both tests show abnormalities, the doctor will request a biopsy, transrectal ultrasound, and MRI to confirm the suspicion of a malignant tumor. If cancer is confirmed, a prostate CT scan may be recommended to assess the extent of the disease.
Symptoms of Prostate Cancer
Frequent urination, especially at night, and a weak urine stream are some symptoms of prostate cancer. Learn the others:
- Blood in the urine or semen;
- Reduced semen volume;
- Pain when urinating or ejaculating;
- Erectile dysfunction;
- Pain in the lower back, pelvis, and hips;
- Weakness or numbness in the legs.
Recommended Treatments for Each Type of Cancer
Learn about the treatments for the types of prostate cancer we presented here:
Adenocarcinoma
- Prostatectomy, which is the removal of the prostate, can be:
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- Open: removal of the prostate through an incision that separates the abdominal muscles;
- Laparoscopic: removal of the prostate through small incisions in the abdomen, where the cannula and camera are inserted to aid in the procedure’s precision;
- Robotic: a cannula and camera are also used, with the difference being the use of a robotic arm.
- Radiotherapy: The affected cells are eliminated by radiation.
- Ablative therapies: treatments that destroy diseased tissue and aim to inhibit testosterone production through medication or removal of the testicles.
If the cancer has spread to other areas, treatments include chemotherapy and radiotherapy, which is indicated for cases of bone metastasis.
Small Cell Carcinoma
Chemotherapy-based treatment. Surgery is recommended in the early stages near the prostate. Radiotherapy offers local control of the disease.
Ductal Carcinoma
More intensive treatment, including surgery, radiotherapy, and hormone therapy to inhibit testosterone production.
Mucinous Carcinoma
Prostate removal, radiotherapy, therapy to reduce hormones that promote tumor growth, such as abiraterone, apalutamide, or enzalutamide, and chemotherapy.
Squamous Carcinoma
Prostate removal, radiotherapy, chemotherapy, and hormone therapy.
Transitional Carcinoma
Prostate removal (open surgery), chemotherapy, therapy to reduce hormones that promote tumor growth, external radiotherapy, and high-intensity focused ultrasound (HIFU), a treatment that uses high-intensity ultrasonic waves for non-invasive treatment.
Prostate Sarcoma
Multidisciplinary treatment that includes prostate removal, radiotherapy, chemotherapy, and therapy to reduce hormones that promote tumor growth.
Prevention for a Healthy Life
Maintaining a healthy lifestyle can help reduce the risk of prostate cancer. Learn how:
- Healthy eating with the addition of foods good for the prostate;
- Regular physical exercise;
- Maintaining a weight appropriate for your height;
- Avoiding cigarettes, alcohol, and illicit drugs.
Early Diagnosis is Essential
Routine consultations with a urologist and preventive exams are essential because they increase the chances of detecting prostate cancer at early stages.
You can also take care of your health by following urologist and andrologist Dr. Paulo Egydio on TikTok and also on Kwai to get the latest tips from someone who has dedicated over 25 years to male health. Take care!
