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image PROSTATE CANCER (PCa), image, African American men 40 years old, 1st…

- - - - Mayo Clinic, 2019
        
        Decreased force in urine stream
        
        Erectile dysfunction
        
        Trouble urination
        
        Incontinence
        
        Blood in Semen
        
        Bone Pain
        
        Discomfort in the pelvic area
    - - Mayo Clinic, 2019
        
        Metastasizes (Cancer that spreads)
    - - Very Heterogeneous Disease
        
        Molecular alterations
        
        Somatic or Germline mutations
        
        Focal deletions
        
        Amplifications
        
        Gene Fusions that entail the intra-patient and inter-patient heterogeneity
        
        Major molecular subclasses include a variety of gene fusions involving ETS family transcription factors
        
        ERG
        
        ETV1/4
        
        FLI1
        
        NDRG1
        
        RAF Kinase
        
        Androgen signaling plays a key role in health prostate function - aberrant activation of this signaling has been linked to the initiation and metastatic progression of PCa
        
        Disease progression to advanced stage / Castrate-resistant prostate cancer (CRPC)
        
        PCa cells bypass their dependency on the androgen signaling by somatic mutations or amplifications of
        
        AR gene
        
        constitutively active splice variants (AR-V7 and ARv567es
        
        Mutations in the ligand binding domain of AR (F877L and T878A)
        
        Activation of androgen-regulated genes via glucocorticoid receptor
        
        manifested by several molecular and phenotypic changes resulting in transition of androgen-independent CRPC to therapy-induced NEPC
      - Cellular Plasticity (dynamic transition of a cell between one state to another)
        
        Bidirectional process which involves changes both at the molecular and phenotypic levels of cells
        
        Mounting evidence suggests that genes involved in the embryonic development are subverted or reactivated during malignant transformation of cells
        
        These acquired molecular attributes enable the tumor cells to elude the constraints of normal growth and escape immune surveillance of the body
        
        This plasticity also aids PCa cells to develop resistance against the targeted therapies in several different ways
        
        Phenotypic conversions
        
        Cellular reprogramming
        
        Transition from one cell lineage to another
    - - tissue damage from
        
        infection
        
        Autoimmune disease
        
        Circulating carcinogens or toxins
        
        From diet
        
        Urine that has refluxed into the prostate
- - - - Prostate Cancer Foundation, n.d.
        
        Black Men are 76% more likely to develop PCa
        
        Black men are 2.2 times more likely to die from PCa
    - - Prostate Cancer Foundation, n.d.
        
        Genes for PCa can run in families
        
        Men with a relative with PCa are twice as likely to develop the disease
        
        Men with 2 or more relatives with PCa are 4 x more likely to get the disease
  - - - Risk of developing PCa in rural china 2%
      - Risk of developing PCa in the United States 17%
      - Men who live north of 40 Latitude have the highest risk of dying from prostate cancer in the US
    - - Area of controversy
        
        Prostatitis
- - - - Controversial in men with no symptoms
        
        Men in their 50's
      - Recommended for men with symptoms or risk factors
      - Prostate Cancer Foundation, n.d.
        
        45 years old + discuss the risks and benefits with MD
        
        Men with a family history of prostate cancer
    - - High levels could indicate infection, inflammation, enlargement and/or cancer
    - - when biopsy confirms cancer
        
        Additional test may be needed to determine the stage of the cancer
        
        Bone Scan
        
        Computerized tomography (CT) scan
        
        Magnetic Resonance Imaging (MRI)
        
        7 Tesla (7T) magnet imaging technology
        
        Position Emission Tomography (PET) scab
        
        Prostate-Wpecific Membrane Antigen (PSMA)
- - - - Most scores used range from 6-10
        
        Score 6= Low-grade prostate cancer
        
        Score 7= Medium-grade prostate cancer
        
        Score 8-10 indicate high-grade cancers
- - - - Diet
        
        Avoid high fat diets
        
        Fruits
        
        Vegetables
        
        Whole Grains
        
        Prostate Cancer Foundation, n.d.
        
        Eat more Fish (High in Omega 3 fatty acids)
        
        Prostate Cancer Foundation, n.d.
        
        High Calcium intake
    - - 5-alpha reductase inhibitors
        
        Finasteride (Propecia, Proscar)
        
        Dutasteride (Avdart)