1 Analysis of prostate cancer in AtlantaStudent’s name Institution affiliation Professor Course Date of submission Cover page

2 Demographic InformationProstate cancer is a disease which is most common in men. It is called prostate cancer because of the part in men’s reproductive organ it attacks. It attacks prostate gland in men (Kanny et al.,2013). Majority of men in United states especially in Atlanta suffer from this disparity. There are about 162,000 cases of the prostate cancer in the America (Kanny et al.,2013). About 27,000 people have died of prostate cancer in America. The approximate number of people affected with prostate cancer in every seven people is one man. This disparity is most common to men ranging between 49 to 79 years The demographic information of prostate cancer in Atlanta. It focuses on age, gender, race, income and employment status.

3 Demographic information Cont.’Other than Atlanta, other countries in Jersey have high registry of their residents suffering from prostate cancer. According to the research done, whites are said to be more vulnerable to prostate cancer disparity (Hershman et al., 2005). The risks of the victims of prostate cancer tend to increase. This can be the case in case one of the parents in a family is suffering from the disparity for it becomes easy for the disparity to be transmitted to the children. Income can lead to the spread of the cancer in case there are no economic resources to be used to cater for the treatment of the cancer Kanny et al.,2013). Similarly, employment status of the individual in the family can contribute in the spread and cause of prostate cancer just the same way as the other disparities do. Continuation on the demographic information.

4 Definition of prostate cancerProstate cancer is a disease that is said to grow progressively in men.According to CDC, prostate cancer is very common among the American men (Frieden , 2011) It attacks the men’s prostate gland. It disease begins at the gland cells and thus the term adenocarcinoma. In other words, prostate cancer is also called adenocarcinoma (Collinsatal.,2005). The cancer mostly causes very many deaths especially to the old men. An approximate of 80% of men with 80 years are found suffering from this disparity though they die without them knowing they had the disease. Once the cancer attacks the gland, the corresponding alterations in both size and shape of the gland cells is noted. This is called Prostatic Intraepithelial Neoplasia(PIN). Most of the doctors have proven that the proportion of 50% of the men with fifty years have PIN. The named cells do not seem to have gone but remained in the gland while growing and multiplying (Collins at al., 2005). Basic definition and concept of prostate cancer is disease of men that progresses slowly

5 Classification of prostate cancerTumor Nodes Metastases(TNM) can be used by the doctors to know the stage of the cancer especially during the selection of the type of therapy to use (Heidenreich et al., 2011). At first, there is definition of the tumor size. The present nodes are also determined after the presence of the metastases are also determined. The restricted cancers and the spread cancer outside the gland are first differentiated when defining the TNM. As a result, the clinical found inside the prostate gland are T1 and T2 while T3 and T4 are found outside the gland. The techniques use to classify the type of prostate cancer:T1,T2,T3 and T4

6 Classification of prostate cancer cont.’The spread of prostate cancer can be determined in several ways. To determine whether the cancer has spread in the pelvis bones, a computer tomography is used to scan the bone. The evaluation of the prostate capsule and seminal vesicles can be done using endorectal coil magnetic resonance imaging.  More concept on classification of prostate cancer using computer tomography

7 Gleason score In this, a microscope is used to look at the samples of biopsy by the pathologist. A grading system of Gleason that ranges from 2-10 is used. The tumor is graded once the tissues of the cancer are detected by the pathologist ( Heidenreich et al., 2011). The extend of the abnormality of the tissues is caused by the increased number in the grading scale during the comparison with the normal tissues of the prostate. In the Gleason score, there are two numbers added. The two numbers are one to five and 1-5 for the second most common pattern. For example, a score of 3 is said to be have less aggressiveness to cancer cells as compared to score 4. There should be proper grading of the tumor so as to know the best treatment on it. Grading of the prostate tumors using the biopsy samples to detect by the pathologist

8 Causes of prostate cancerThere are very many factors that contribute to the spread of prostate cancer. According to CDC, there exists differences in the prevalence of prostate cancer related factors such as smooking and intake of alcohol (Frieden, 2011) The most primary factor is age and it is the risking factor. Under this, the old people with ages above 46years are more vulnerable to the disparity. Genetic make up of an individual can also lead to prostate cancer. This is said to be more common to the white people in America though it is more deadly to the Afro- Americans as compared to the white Americans (Carey, 2006). In case a man’s twins are born suffering for prostate cancer, the man is said to be under the risk of being affected too. Similarly, there are genes such as BRCA2 gene that can contribute to the spread. Maun factors that cause prostate cancer are age, gender, diet and genetics

9 Causes of prostate cancer cont.’The diet of the food taken can cause prostate cancer. Most of the foods like those found in the Mediterranean region are said to reduce the probability of people suffering from prostate cancer. However, the consumption of Excess alcohol led to about 75,000 deaths in the United States from 2006 up to 2010 (Frieden , 2011). There are some medications that lead to the spread of prostate cancer. For instance, there is a close link between the prostate cancer and the ant-inflammation medicines (Heidenreich et al., 2011). Statins used to reduce the level of cholesterol in the body is said to reduce the risk of a person developing prostate cancer. Obesity rises chances in which prostate cancer spreads. It increases risks in metastasis thus leading to death of people who are obese. Other causes of prostate cancer are medications, obesity and STIs

10 Signs and symptoms of prostate cancerDuring the first stage of prostate cancer, symptoms do not appear hence not easy to be noted. The only way to determine whether the individual has the disparity is the blood check up.CMS provides guidelines on individuals suffering from prostate cancer (Carey, 2006) The later symptoms tend to come up as the disease progresses. The patient of prostate cancer usually urinates often. As a result of this, the patient keeps on waking up at night to go to urinate since his bladder fills fast. During urination, the patient finds it difficult to pass out urine through the urethra. In the similar manner, urination becomes hard once the patient commences the urination. This happens since he fails pain (Frieden , 2011). The patient may find it hard and very painful during ejaculation though he does it rarely. The patient finds it hard to maintain his erection in some cases. It is not easy to identify the symptoms of cancer at the early stages.Pain contributes to the highest symptom.

11 Symptoms in the advanced stageAt the late stage of the progression of the disease, the patient may start experiencing pain in his bones especially around the vertebra (Heidenreich et al., 2011). His proximal end of the femur may also pain and this makes the patient under pressure. The patient’s legs become very feeble thus making him unable to walk comfortably. This implies that the cancer has already spread to the pelvis (Carey, 2006). If the cancer spreads to the spine and the compressed spinal cord, the patient experiences incontinence in the urinary system. The patient can also develop facial incontinence especially if the cancer has developed up to the spine. Advanced symptoms are very critical and it is associated with the pain in the vertebra

12 Treatment of prostate cancerDuring the early stages, one has to wait and no immediate measures taken. From CMS centers, Carey,(2006) stated that the prostate can be removed during radical prostatectomy and radioactive seeds implanted into the prostate. A conformal radiotherapy can be carried out to shape the radiation beams. The beams of higher intensity can be used during modulated radiotherapy. In the advanced development of the cancer, a combination of both hormone therapy and radiotherapy can be applied to treat (Carey, 2006). Radical surgery can also be applied so as to remove the prostate. Hormone therapy is very effective during the advanced stage as it slows down the growth of cancer cells (Collins at al., 2005). Radiotherapy and hormone therapy are very crucial in treatment of prostate cancer

13 References Carey, B. P., Coleman, R. E., Grigsby, P. W., & Siegel, B. A. (2006). Medicare coverage of PET for cervical cancer. Journal of the American College of Radiology, 3(1), Collins, A. T., Berry, P. A., Hyde, C., Stower, M. J., & Maitland, N. J. (2005). Prospective identification of tumorigenic prostate cancer stem cells. Cancer research, 65(23), Frieden TR 2011; Centers for Disease Control and Prevention. Forward: CDC Health Disparities and Inequalities Report — United States, MMWR Suppl;60(1):1–2. PubMed Heidenreich, A., Bellmunt, J., Bolla, M., Joniau, S., Mason, M., Matveev, V., ... & Zattoni, F. (2011). EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. European urology, 59(1), Hoffman, R. M., Gilliland, F. D., Eley, J. W., Harlan, L. C., Stephenson, R. A., Stanford, J. L., ... & Potosky, A. L. (2001). Racial and ethnic differences in advanced-stage prostate cancer: the Prostate Cancer Outcomes Study. Journal of the National Cancer Institute, 93(5), Kanny D, Liu Y, Brewer RD, Lu H. 2013; Centers for Disease Control and Prevention . Binge drinking — United States, MMWR Supply;62(3):77–80. These are the main materials used to gather the information about prostate cancer