The 7 Types of Prostate Cancer

Normally when you hear about the different types of prostate cancer, you likely think of local and metastatic or advanced cancer; that is, cancer that is limited to the prostate and cancer that has spread beyond the organ. Yet the types of prostate cancer actually refer to the type of cell in which the cancer starts to develop.

Why is the type of prostate cancer important? Because knowing the cancer type, as well as the grade of cancer, can help your doctor decide which treatment approach to take.

Different types of prostate cancer
One type of prostate cancer makes up about 95 percent or more of the cases. That leaves about six other types that make up the remaining 5 percent. Here are the different types of prostate cancer.

Acinar adenocarcinoma
If you are diagnosed with prostate cancer, chances are it’s acinar adenocarcinoma, which is the most common type of prostate cancer. An adenocarcinoma is a type of malignant tumor that is formed from glandular structure in epithelial tissue, or the outer surface of an organ or gland.

This type of prostate cancer develops in the gland cells (aka, acini cells) that line the prostate and are responsible for producing the fluid that eventually becomes semen. Acinar adenocarcinomas form clusters and increase levels of prostate-specific antigen (PSA).

Ductal adenocarcinoma
This cancer begins in the cells that line the tubes or ducts of the prostate gland. Unlike acinar adenocarcinoma, this type of prostate cancer doesn’t always have an impact on PSA levels. This makes it potentially more difficult to detect. Men who have ductal adenocarcinoma usually experience a rapid growth and spread of the disease, as it is more aggressive than acinar adenocarcinoma.

Urothelial cancer
Also known as transitional cell cancer, this type usually begins in the cells surround the prostate, such as those that line the urethra, which is the tube that transports urine to the outside of the body. This type of cancer can act in two ways: it usually starts in the bladder and spreads to the prostate, but it also less often can originate in the prostate and travel to the entrance of the bladder and nearby tissues.

Urothelial prostate cancer is very rare. It often presents with bloody urine or difficulty urinating.

Squamous cell cancer
This type of prostate cancer develops from flat cells that cover the gland. Squamous cell cancer tends to grow and spread more rapidly than does adenocarcinoma. It makes up 0.5 to 1 percent of all prostate cancers and has a very poor prognosis.

Small cell prostate cancer
This type of prostate cancer consists of small round cells. It is a type of neuroendocrine cancer, which means it originates in cells that produce hormones. Small cell prostate cancer is very aggressive and does not cause changes in PSA levels. Once it is detected, it has already spread extensively and has a very poor prognosis.

Sarcomas develop in soft tissue, including nerves and muscles. They can develop in the blood vessels, lymphatic vessels, and smooth muscles of the prostate, and they typically spread to the lungs. The two most common prostate sarcomas are leiomyosarcomas and rhabdomyosarcomas, which affect men between ages 35 and 60. Like other rare prostate cancers, they are challenging to detect and don’t alter PSA levels.

Neuroendocrine tumors (NETS)
Also known as carcinoids, neuroendocrine tumors are found in nerve and gland cells that make and release hormones into the bloodstream. This type of prostate cancer is extremely rare and usually grow slowly. Not much is known about NETs, but they don’t have an impact on PSA levels and they appear to be hereditary. When these tumors begin to secrete hormones, they can cause symptoms such as diarrhea, rapid heartbeat, dizziness, facial flushing, and wheezing. This collection of symptoms associated with an NET is called carcinoid syndrome.

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Malik RD et al. Squamous cell carcinoma of the prostate. Reviews in Urology 2011; 13(1): 56-60

by Mens Health Editor

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