Incipient Prostate Cancer: Definition, Histology, and Clinical Consequences

Abstract

Initiation, latency, and promotion are the critical phases of malignant growth. Initiation of cancerous growth in the prostate of the aging man is the rule rather than the exception. Examining by step-section prostates taken from autopsies we find latent carcinomas in over 30% of patients over 45 years old (Table 1) (Dhom 1983). Evidence of tumors rises to more than 50% in males over 75 years. With age, tumor volume and the number of tumorous foci in the organ increase. About one-half of tumorous foci reach a diameter of more than 1 cm after the age of 70 years (Fig.1). Histologically, one can see predominantly well-differentiated carcinomas with increasing tumor volume. However, we also find less-differentiated tumors. Certainly, we deal with a very slow, but constant, cancer growth in the prostate. Unequivocally, this slow growth prevents the majority of tumorous foci from becoming manifest during the patients’ lifetime. On the other hand, the malignant process is overtaken by other age-related disorders, for example, by diseases of the cardiovascular system or by secondary tumors, which consequently determine morbidity and mortality.