Prostate cancer begins when cells in the prostate gland start to grow out of control. The prostate is a gland found only in males. It makes some of the fluid that is part of semen.

The prostate is below the bladder (the hollow organ where urine is stored) and in front of the rectum (the last part of the intestines). Just behind the prostate are glands called seminal vesicles that make most of the fluid for semen. The urethra, which is the tube that carries urine and semen out of the body through the penis, goes through the center of the prostate. The size of the prostate can change as a man ages. In younger men, it is about the size of a walnut, but it can be much larger in older men.

Prostate cancer may cause no signs or symptoms in its early stages. Prostate cancer that's more advanced may cause signs and symptoms such as:
1) Trouble urinating
2) Decreased force in the stream of urine
3) Blood in the urine
4) Blood in the semen
5) Bone pain
6) Losing weight without trying
7) Erectile dysfunction

Researchers have found several factors that might affect a man’s risk of getting prostate cancer.
1) Age
Prostate cancer is rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50. About 6 in 10 cases of prostate cancer are found in men older than 65.
2) Race/ethnicity
Prostate cancer develops more often in African American men and in Caribbean men of African ancestry than in men of other races. And when it does develop in these men, they tend to be younger. Prostate cancer occurs less often in Asian American and Hispanic/Latino men than in non-Hispanic whites. The reasons for these racial and ethnic differences are not clear.
3) Geography
Prostate cancer is most common in North America, northwestern Europe, Australia, and on Caribbean islands. It is less common in Asia, Africa, Central America, and South America. The reasons for this are not clear. More intensive screening for prostate cancer in some developed countries probably accounts for at least part of this difference, but other factors such as lifestyle differences (diet, etc.) are likely to be important as well. For example, Asian Americans have a lower risk of prostate cancer than white Americans, but their risk is higher than that of men of similar ethnic backgrounds living in Asia.
4) Family history
Prostate cancer seems to run in some families, which suggests that in some cases there may be an inherited or genetic factor. Still, most prostate cancers occur in men without a family history of it. Having a father or brother with prostate cancer more than doubles a man’s risk of developing this disease. (The risk is higher for men who have a brother with the disease than for those who have a father with it.) The risk is much higher for men with several affected relatives, particularly if their relatives were young when the cancer was found.
5) Gene changes
Several inherited gene changes (mutations) seem to raise prostate cancer risk, but they probably account for only a small percentage of cases overall. For example:
a) Inherited mutations of the BRCA1 or BRCA2 genes, which are linked to an increased risk of breast and ovarian cancers in some families, can also increase prostate cancer risk in men (especially mutations in BRCA2).
b) Men with Lynch syndrome (also known as hereditary non-polyposis colorectal cancer, or HNPCC), a condition caused by inherited gene changes, have an increased risk for a number of cancers, including prostate cancer.
6) Diet
The exact role of diet in prostate cancer is not clear, but several factors have been studied. Men who eat a lot of dairy products appear to have a slightly higher chance of getting prostate cancer. Some studies have suggested that men who consume a lot of calcium (through food or supplements) may have a higher risk of developing prostate cancer. But most studies have not found such a link with the levels of calcium found in the average diet, and it’s important to note that calcium is known to have other important health benefits.
7) Obesity
Being obese (very overweight) does not seem to increase the overall risk of getting prostate cancer. Some studies have also found that obese men may be at greater risk for having more advanced prostate cancer and of dying from prostate cancer, but not all studies have found this.
8) Smoking
Most studies have not found a link between smoking and getting prostate cancer. Some research has linked smoking to a possible small increased risk of dying from prostate cancer, but this finding needs to be confirmed by other studies.
9) Chemical exposures
There is some evidence that firefighters can be exposed to chemicals that may increase their risk of prostate cancer. 10) Inflammation of the prostate
Some studies have suggested that prostatitis (inflammation of the prostate gland) may be linked to an increased risk of prostate cancer, but other studies have not found such a link. Inflammation is often seen in samples of prostate tissue that also contain cancer.
11) Sexually transmitted infections
Researchers have looked to see if sexually transmitted infections (like gonorrhea or chlamydia) might increase the risk of prostate cancer, because they can lead to inflammation of the prostate.
12) Vasectomy
Some studies have suggested that men who have had a vasectomy (minor surgery to make men infertile) have a slightly increased risk for prostate cancer, but other studies have not found this.

Causes Prostate Cancer:
On a basic level, prostate cancer is caused by changes in the DNA of a normal prostate cell. DNA is the chemical in our cells that makes up our genes, which control how our cells function. We usually look like our parents because they are the source of our DNA. But DNA affects more than just how we look. Some genes control when our cells grow, divide into new cells, and die:
a) Certain genes that help cells grow, divide, and stay alive are called oncogenes.
b) Genes that normally keep cell growth under control, repair mistakes in DNA, or cause cells to die at the right time are called tumor suppressor genes.
Cancer can be caused by DNA mutations (or other types of changes) that keep oncogenes turned on, or that turn off tumor suppressor genes. These types of gene changes can lead to cells growing out of control.
1) Inherited gene mutations:
Some gene mutations can be passed from generation to generation (inherited) and are found in all cells in the body. Inherited gene changes are thought to play a role in about 10% of prostate cancers. Cancer caused by inherited genes is called hereditary cancer. Several inherited mutated genes have been linked to hereditary prostate cancer, including BRCA1 and BRCA2, CHEK2, ATM, PALB2, and RAD51D, DNA mismatch repair genes (such as MSH2, MSH6, MLH1, and PMS2), RNASEL (formerly HPC1) and HOXB13.
2) Acquired gene mutations
Some genes mutate during a person’s lifetime, and the mutation is not passed on to children. These changes are found only in cells that come from the original mutated cell. These are called acquired mutations. Most gene mutations related to prostate cancer seem to develop during a man’s life rather than having been inherited.

Almost all prostate cancers are adenocarcinomas. These cancers develop from the gland cells (the cells that make the prostate fluid that is added to the semen). Other types of cancer that can start in the prostate include:
1) Small cell carcinomas
2) Neuroendocrine tumors (other than small cell carcinomas)
3) Transitional cell carcinomas
4) Sarcomas
These other types of prostate cancer are rare. If you are told you have prostate cancer, it is almost certain to be an adenocarcinoma. Some prostate cancers grow and spread quickly, but most grow slowly. In fact, autopsy studies show that many older men (and even some younger men) who died of other causes also had prostate cancer that never affected them during their lives. In many cases, neither they nor their doctors even knew they had it.

Prostate screening tests might include:
1) Digital rectal exam (DRE).
During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is adjacent to the rectum. If your doctor finds any abnormalities in the texture, shape or size of the gland, you may need further tests.
2) Prostate-specific antigen (PSA) test.
A blood sample is drawn from a vein in your arm and analyzed for PSA, a substance that's naturally produced by your prostate gland. It's normal for a small amount of PSA to be in your bloodstream. However, if a higher than usual level is found, it may indicate prostate infection, inflammation, enlargement or cancer.

If prostate cancer screening detects an abnormality, your doctor may recommend further tests to determine whether you have prostate cancer, such as:
1) Ultrasound.
During a transrectal ultrasound, a small probe, about the size and shape of a cigar, is inserted into your rectum. The probe uses sound waves to create a picture of your prostate gland.
2) Magnetic resonance imaging (MRI).
In some situations, your doctor may recommend an MRI scan of the prostate to create a more detailed picture. MRI images may help your doctor plan a procedure to remove prostate tissue samples.
3) Collecting a sample of prostate tissue.
To determine whether there are cancer cells in the prostate, your doctor may recommend a procedure to collect a sample of cells from your prostate (prostate biopsy). Prostate biopsy is often done using a thin needle that's inserted into the prostate to collect tissue. The tissue sample is analyzed in a lab to determine whether cancer cells are present.

When a biopsy confirms the presence of cancer, the next step is to determine the level of aggressiveness (grade) of the cancer cells. A doctor in a lab examines a sample of your cancer cells to determine how much cancer cells differ from the healthy cells. A higher grade indicates a more aggressive cancer that is more likely to spread quickly.
1) Gleason score.
The most common scale used to evaluate the grade of prostate cancer cells is called a Gleason score. Gleason scoring combines two numbers and can range from 2 (nonaggressive cancer) to 10 (very aggressive cancer) Most Gleason scores used to assess prostate biopsy samples range from 6 to 10. A score of 6 indicates a low-grade prostate cancer. A score of 7 indicates a medium-grade prostate cancer. Scores from 8 to 10 indicate high-grade cancers.
2) Genomic testing.
Genomic testing analyzes your prostate cancer cells to determine which gene mutations are present. This type of test can give you more information about your prognosis.

Doctors treating prostate cancer have a wide range of tools available:
1) Radiation Therapy
Radiation is the strategic use of ionizing radiation or photons to kill cancer cells. It works by damaging the cancer cells’ DNA (the genetic blueprint of the cancer cell).The targeted cells die without growing or replicating themselves. Radiation therapy, like surgery, is very effective at killing localized or locally advanced prostate cancer and has the same cure rate as surgery.
2) Radical Prostatectomy
Removing the entire prostate gland through surgery, known as a radical prostatectomy, is a common option for men whose cancer has not spread. For men with advanced or recurrent disease, other surgical procedures may be chosen, such as removal of lymph nodes, which are initial landing spots for the spread of prostate cancer.
a) Open radical prostatectomy is the classical way of surgically removing the prostate
b) laparoscopic (robotically assisted) radical prostatectomy has become very popular. This method requires small incisions to be made in the abdomen. A surgical robot’s arms are then inserted into the incisions. With a robotic interface, the surgeon controls the robot’s arms, which in turn control cameras and surgical instruments.
3) Hormone Therapy
Because testosterone serves as the main fuel for prostate cancer cell growth, it’s a common target for treatment. Hormone therapy (also called androgen deprivation therapy or ADT) is part of the standard of care for advanced and metastatic prostate cancer. ADT is designed to either stop testosterone from being produced or to directly block it from acting on prostate cancer cells.
4) Chemotherapy
Chemotherapy is given before pain starts. with the goal of preventing the cancer from spreading further to other sites, Many men who are suffering from their cancer will experience symptomatic improvement after starting chemotherapy.
a) Taxane Chemotherapy
Currently, taxane chemotherapy, given with prednisone, is the standard of care for men with metastatic prostate cancer that has spread and is progressing despite hormone therapy.
b) Platinum Chemotherapy
Platinum-based chemotherapy are used for the treatment of various cancer types. Platinum chemotherapy is not FDA approved for the treatment of prostate cancer; however, it is sometimes used in very advanced prostate cancer patients who have exhausted all other treatment options.
5) Active Surveillance
The concept of Active Surveillance has increasingly emerged as a viable option for men who decide not to undergo immediate radical treatment for prostate cancer (surgery or radiation therapy).
6) Immunotherapy
The immune system has the remarkable ability to kills cells that can cause harm, such as infected cells or cancer cells. However, in most patients with progressing cancer, anti-cancer immune responses either never developed or have been turned off by the cancer. One way to fight cancer is to hack the immune system, retraining immune cells to respond to the malfunctioning cancer cells.
a) Sipuleucel-T Immunotherapy
Sipuleucel-T is a cell-based prostate cancer vaccine for men with metastatic prostate cancer that is resistant to hormone therapy. This treatment is meant for men with minimal or no pain, and is most commonly given before chemotherapy.
b) Pembrolizumab
Pembrolizumab is a type of “immune checkpoint inhibitor,” which are a class of immunotherapies that block chemical signals that mask cancer cells and activate tumor-killing immune cells.
7) Precision Therapies
Precision medicine uses new diagnostic tests to treat the right patient with the right medicine at the right time based on the genetic make-up of that patient’s cancer. The promise of precision medicine is someday, there will be no trial and error for prostate cancer drugs. Precision diagnosis is the process of looking at the genetic and molecular characteristics of your unique tumor and using this information to identify the tumor’s weaknesses. Think of it like taking your cancer’s fingerprint. Because every cancer fingerprint is different, each cancer needs a custom-tailored treatment. Once that level of identification is possible, custom selected treatments have the potential to be effective with no more guess work. Since cancer is a “genomic” disease precision oncology is one of the most exciting fields in research today.

5-year relative survival rates for prostate cancer:
1) Localized: Nearly 100%, There is no sign that the cancer has spread outside the prostate.
2) Regional: Nearly 100%, The cancer has spread outside the prostate to nearby structures or lymph nodes.
3) Distant: 30%, The cancer has spread to parts of the body farther from the prostate, such as the lungs, liver, or bones.

Cancer is a life threatening disease that can affect anyone regardless of race, age, and gender. Traditional cancer treatments like radiotherapy and chemotherapy often result in undesirable and uncomfortable side effects such as vomiting, numbness, nausea, and diarrhea to name a few. Herbal medicine is a complementary therapy that some people with cancer use to ease cancer symptoms. Herbal remedies for cancer such as those commonly found in traditional medicine contains antimutagenic, anti-inflammatory, and apoptosis inducing compounds that help in slowing the development of cancer and relieve treatment side effects for patients.

Herbal medicine has a wide variety of applications but all of them rely on the sustainable use of various plant parts such as flowers, leaves, bark, and roots. Each part of a plant features different medicinal properties and uses. Although herbal medicine has countless use cases, cancer care is one of the most practical applications because of how harsh traditional oncology treatments can be on patients.

Herbal remedies are a part of a growing field of medicine called integrative oncology. Research conducted on the use of herbal medicine for cancer complementary therapy has proven herbs can:
• Slows the spread of cancer
• Reduces the side effects of cancer treatment
• Boosts immune system strength and functionality
• Minimizes the symptoms of cancer
• Attacks cancer cells

Several herbs may help control the side effects of conventional cancer treatment. However, doctors do not recommend that cancer patients take herbal medicine while undergoing normal traditional cancer treatment. Herbal medicines may be likely less to cause side effects than traditional drugs. But patients may can still experience complications. Some herbs may can cause negative interactions with chemotherapy drugs. Closely monitor how you feel before and after taking herbal remedies. Patients should always consult with their doctor before trying herbs as a complementary therapy or the supplements to avoid complications.